What to Say—and Not Say—to Someone Having Intrusive Thoughts

Have you ever had a disturbing thought pop into your head out of nowhere—something you'd never consider actually doing?Intrusive thoughts are unwanted thoughts, images, or urges that can feel upsetting, confusing, or wildly out of character. They're more common in people with obsessive-compulsive disorder (OCD) but can happen to anyone, and they can involve everything from violence and sex to religion, relationships, and the fear of having done something wrong.Many people are able to brush off the occasional intrusive thought and move on quickly. People with OCD, on the other hand, can get stuck trying to figure out what the thought means—and whether they might act on it. “We stop and we treat that thought as super important and meaningful,” says Alissa Jerud, a clinical psychologist and clinical assistant professor of psychiatry at the University of Pennsylvania.Intrusive thoughts can feel especially disturbing because they often involve someone or something the person cherishes. “We tend to have intrusive thoughts about the things we care most about,” Jerud says.Some of Jerud’s patients have kept their intrusive thoughts to themselves for 20 years before telling her. They might b...