• Images or impulses of hurting others
• Thoughts of harming a partner, child, or stranger
• Fear of “snapping” or doing something out of control

• Unwanted sexual thoughts involving inappropriate or taboo subjects
• Fear of being attracted to someone you should not be attracted to
• Sexual images or impulses that feel disturbing

• Blasphemous thoughts
• Fear of sinning, offending God, or violating moral rules
• Fear of being a “bad person”

Learn more about Scrupulosity OCD

• Thoughts that your partner is wrong for you
• Thoughts that you don’t really love them
• Doubts that feel intrusive or ego-dystonic

Learn more about Relationship OCD

• Thoughts questioning your sexual orientation
• Thoughts questioning your gender identity
• Fear of becoming someone morally or socially unacceptable

Learn more about SO-OCD

• Mental reviewing: “Why did I think that? What does it mean?”
• Checking emotional responses (“Did I feel arousal? Did I feel anger?”)
• Avoiding people, objects, or situations connected to the thought
• Repeating mental phrases or prayers
• Seeking reassurance from therapists, partners, or online communities
• Testing yourself (“If I imagine it on purpose, how does it feel?”)

• Avoiding children, family members, or certain locations
• Avoiding knives, driving, religious spaces, or physical closeness
• Avoiding media, photos, or conversations that trigger unwanted thoughts

Intrusive Thought OCD affects people of all ages, backgrounds, and identities. It is one of the most misunderstood forms of OCD due to the taboo nature of the themes, which can increase secrecy, shame, and compulsive avoidance.

This subtype frequently overlaps with:

• Harm OCD
• Contamination OCD
• Sexual Orientation OCD
• Relationship OCD
• Symmetry/Just-Right OCD
• Scrupulosity
• Postpartum OCD
• Moral responsibility themes

You may be experiencing this subtype if:

• Thoughts feel alien, unwanted, or out of character
• You engage in mental checking or analysis
• You avoid situations that trigger specific thoughts
• You fear what the thought “means” about you
• You try to push the thought away or replace it with a neutral one
• You look for evidence that you’re not dangerous, immoral, or deviant
• You perform rituals to make the thought go away or feel less threatening

Exposure and Response Prevention (ERP) is the most effective treatment for intrusive thoughts of any theme. ERP does not target the thought content—it targets the response to it.

ERP helps by:

• Allowing intrusive thoughts to show up without reacting
• Reducing avoidance and mental checking
• Teaching the brain that thoughts do not require action
• Decreasing the “meaning” placed on the thought
• Increasing tolerance for uncertainty
   

Examples of ERP for Intrusive Thought OCD may include:

• Intentionally bringing up feared thought themes
• Writing or reading scripts containing intrusive content
• Engaging in previously avoided situations
• Reducing reassurance and mental reviewing
• Practicing non-engagement with thoughts
   

ERP is structured, collaborative, and paced so exposure feels challenging but manageable.