Intrusive thoughts are unwanted thoughts, impulses or mental images that often cause significant anxiety, stress and impairment within an individual’s ability to function. These thoughts may surround the fear of committing an act one consider to be harmful, violent, immoral, sexually inappropriate, or sacrilegious. There is no intent to act on these thoughts (although your OCD may attempt to persuade you that there is that chance) and these thoughts bring no pleasure, causing extreme distress.

Sexual Intrusive Thoughts consist of unwanted sexual thoughts. This may include sexual orientation fears, such as the fear of being or becoming LGBTQ. It may also contain intrusive, unwanted mental imagery of sexual behaviors or actions that the individual does not desire, the fear of committing a harmful sexual act or being sexually aggressive. Individuals with OCD may also be plagued by unwanted intrusive thoughts/images that they may commit a sexual act to a child. This is not the same as having a sexual fantasy or being homophobic.

Examples of sexual intrusive thoughts:

            • Recurrent fear of molesting a child
            • Recurrent fears that one might be homosexual, when in fact he/she is not
            • Repetitive thoughts of possibly touching someone inappropriately on impulse
            • Unwanted sexual thoughts or images involving animals, religion, etc.

Harming Intrusive Thoughts consist of unwanted thoughts or images that one might harm themselves or someone else on impulse. Individuals within this OCD subtype have no intent to hurt themselves or others and the intrusive thought or image often causes a significant amount of anxiety and disturbance for these individuals. Rituals for harm OCD may include reassurance seeking, confessing and avoidance behaviors in order to prevent the possibility of acting on impulse (such as: removing knives from the home, refusing to be around sharp objects, etc.).

Examples of intrusive thoughts:

▪️Intrusive thoughts or mental images of harming/killing one’s spouse, parent, child, or self

▪️Repeatedly worrying that one has or will physically assault another person

▪️Repetitive thoughts that one has said or written something inappropriate

▪️Mental images or thoughts that one considers sacrilegious or blasphemous


DISCLAIMER: The content found here is intended to serve as educational content and is not intended to replace therapy. For treatment-related questions, please be sure to work with your local provider or contact a local clinician.

Videos: Intrusive Thoughts

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Chad Wetterneck, PhD, discusses sexual intrusive thoughts and how they occur in a variety of ways. Common ways include doubting whether or not your sexual orientation is what it really is and imaging yourself acting on what you consider an unwanted impulse.

Chad Wetterneck, PhD, discusses the fears associated with sexual intrusive thoughts. One of the fears is wondering whether or not you would act on an unwanted impulse. Another fear is wondering what type of person does this make you if you are thinking this way.

Chad Wetterneck, PhD, provides an example of a sexual intrusive thought. It is important to practice exposing yourself in order the alleviate symptoms.

Chad Wetterneck, PhD, discusses the stigma around sexual intrusive thoughts. This condition often becomes under-diagnosed, and there is a double layer of stigma associated with sexual intrusive thoughts. The first layer is mental health, and the second layer is a topic that is not frequently discussed in culture, such as sex.

Chad Wetterneck, PhD, discusses the difference between sexual intrusive thoughts and fantasy. sexual intrusive thoughts are unwanted thoughts. Fantasy thoughts bring pleasure.

Chad Wetterneck, PhD, discusses a treatment known as exposure and response prevention (ERP). Slowly exposing yourself to more triggers can reduce the amount of sexual intrusive thoughts.

Harm OCD is associated with intrusive thoughts. Intrusive thoughts are unwanted thoughts, impulses or "mental images". These thoughts may surround the fear of committing an act you consider to be harmful or violent to yourself or others. There is no intent to act on these thoughts, although your OCD may attempt to persuade you that you will. These thoughts bring no pleasure and cause extreme distress. Elizabeth McIngvale, PhD, explains how exposure and response prevention (ERP) is used to treat those who suffer from Harm OCD.