From TIME · Angela Haupt · · 3m
How to help someone with intrusive thoughts
When a loved one shares disturbing thoughts they can't control, what you say next matters. Experts explain how to respond with compassion and avoid making things worse.
In brief
When a loved one shares disturbing thoughts they can't control, what you say next matters. Experts explain how to respond with compassion and avoid making things worse. Intrusive thoughts are unwanted disturbing thoughts that happen to many people but especially those with OCD. Experts say responding with compassion…
What are intrusive thoughts
Intrusive thoughts are unwanted thoughts, images, or urges that feel upsetting or out of character.They can involve violence, sex, religion, relationships, or fear of wrongdoing.
Why they feel especially disturbing
Intrusive thoughts often involve someone or something the person cherishes most. People with OCD get stuck trying to figure out what the thought means and whether they might act on it, unlike others who brush…
“We tend to have intrusive thoughts about the things we care most about.”
The shame people carry
Some of Alissa Jerud's patients kept their intrusive thoughts secret for twenty years before telling her. They worry the thoughts reveal something terrible about who they are, wondering if they might be a monster.
“Why am I having these thoughts? What does it say about me? Maybe I'm a monster.”
Start with gratitude and reassurance
Thank your friend for trusting you. Avoid responses like "How could you think that?" which reinforce shame. Make clear the disclosure won't affect your relationship: "This doesn't change how I think about you."
“I'm so glad you shared this with me.”
Acknowledge how scary it feels
Recognize the distress: "That sounds really scary to have stuck in your head." Pay attention to your tone and expression. If you look startled, acknowledge it rather than hoping they didn't notice.
“I guess I wasn't expecting that, but I want to hear more.”
Avoid the reassurance trap
Repeated reassurance can become part of the OCD cycle. When someone keeps asking the same question, answering again and again leaves them needing another answer when doubt returns. A single response isn't necessarily a problem.
Support without feeding the cycle
Instead of debating what the thought means, acknowledge their discomfort and express confidence in their ability to get through it.Say: "I know this feels really uncomfortable right now.
“I know this feels really uncomfortable right now. I'm not going to help you go down the rabbit hole, but I'm happy to sit with you while it's hard.”
Ask what kind of support they need
Find out whether they want you to listen or help them figure out next steps.They might simply want you to know what they've been going through.
“Do you want me to just listen, or do you want help figuring out what to do next?”
Know when professional help is needed
If unwanted thoughts cause significant distress or interfere with daily life, offer to help find a therapist.For OCD, look for someone trained in exposure and response prevention, or ERP.The International OCD Foundation maintains a directory.
Distinguish thought from intention
There's an important difference between an unwanted thought about harm and wanting or intending to act.If unsure what someone means, ask calmly: "Is this a thought that scares you, or something you want to do?"
Keep being their friend
After someone opens up, keep treating them as you always have.Send memes, ask if they're coming to dinner, include them in usual activities.People fear disclosure will change how others see them.
“No one's perfect. The goal isn't to be perfect, it's just to be supportive.”
The short version
Intrusive thoughts are unwanted disturbing thoughts that happen to many people but especially those with OCD. Experts say responding with compassion, avoiding reassurance cycles, and asking what support they need helps most.
