Don’t think about a white bear

A few weeks ago, I was at a wedding afterparty. It was held on the rooftop of a Brooklyn hotel, and getting there involved an exhilarating, if slightly treacherous, climb up a fire escape one hundred feet above the city.

When we arrived, we were greeted by flashing lights, a DJ blasting music, and bottle sparklers crackling in the air.

Amidst this scene, I was chatting with some friends.

I can’t do heights, a friend said, as we peered hesitantly toward the railing of the rooftop, I have this weird thought of, like, what if I jump off?! The conversation soon evolved. A friend shared that one of their law school classmates was plagued with a different, but related, type of thought. The classmate worried that, if they were cold-called in class, they would forgo answering the question and instead begin shouting obscenities.

We soon recognized these examples for what they were: intrusive thoughts.

And for all you non-psychologists out there, the answer is yes. These are the types of things I talk about at parties.

My psychology training (finally) pays off

When it comes to the topic of intrusive thoughts, my training as a psychologist has come in handy for more than just questionably-appropriate party conversations.

During the period after my son was born, I’d occasionally have intrusive thoughts about accidents befalling the baby that were, to say the least, upsetting.

For example, I’d be going through my typical, postpartum day, putting him in a onesie adorned with tiny, smiling cartoon breakfast foods,

and carrying him down the stairs, when I’d be suddenly stricken with a fear of tripping and dropping him over the side of the railing. Or I’d be in the kitchen, slicing avocado, the baby happily plopped in his colorful activity center, when I’d imagine the knife somehow flying out of my hands and piercing his little, fuzzy head. It was disturbing.

I’d feel a sudden surge of anxiety, and find myself walking extra slowly down the stairs, or gripping the kitchen knives just a little tighter.

Had it not been for my psychology training, a likely spiral of worry would have ensued: What is wrong with me?! Am I crazy? Am I a danger to the baby? Should I turn myself into the authorities and call off this whole parenting thing?

But thanks to my training, I knew that, despite my anxiety, these types of thoughts were, in fact, just thoughts, and that my baby was safe. I also knew that I wasn’t alone in having them.

So what, exactly, are intrusive thoughts?

The term intrusive thoughts broadly refers to unwanted thoughts, images, or impulses that, true to their name, intrude on our consciousness. Often, these thoughts are disturbing, socially unacceptable, and/or ego-dystonic (i.e., they conflict with our views of ourselves and the types of things we would do or say). They tend to occur more frequently during times of stress or hormone shifts, but they can pop up anytime, often seemingly at random.

Research suggests that these types of intrusive thoughts are extremely common postpartum. Between 70 and 100% of new moms report intrusive thoughts of harming their babies, with half of those having thoughts of harming their babies on purpose.

Data on fathers is more scarce, but suggests the numbers may be similar.

Outside of the parenting realm, intrusive thoughts are surprisingly common, too. Even in nonclinical adult populations (i.e., adults without diagnoses like OCD or PTSD), research suggests 74% to 94% of people experience them.

To get a flavor, here are some common categories and types of intrusive thoughts, taken from measures used in the research (i.e., the Obsessive Intrusions Inventory, International Intrusive Thoughts Interview Schedule, and Postpartum Intrusions Interview):

General:

• Contamination: Getting sick from touching a door; giving a disease to a stranger
• Harm to self: Running a car off the road; jumping off a high place
• Harm to others: Insulting family, friends, or strangers; hitting others with car
• Sexual: Sex with an unacceptable person; catching an STD; strangers naked
• Doubt: Accidentally leaving the stove on; accidentally leaving home unlocked
• Religious/immoral: Committing a sin; “blasphemous” thoughts

Postpartum:

• Intentional harm to baby: screaming at baby; shaking baby; hitting baby; touching baby’s genitals in inappropriate way
• Accidental harm to baby: baby falling from high surface; suffocation; drowning

I thought I was the only one!

Though intrusive thoughts like these are extremely common in the general population, they are also a hallmark feature of Obsessive Compulsive Disorder (OCD). In OCD, the thoughts (obsessions) tend to occur at greater frequency, duration, and intensity. They typically become so distressing that a person engages in behavioral rituals (compulsions) to try to get rid of them, like washing hands, checking door locks, or trying to mentally replace every “bad” thought with a “good” thought or phrase. Exposure and Response Prevention (ERP) therapy is highly effective for treating this, so if you’re struggling with these symptoms, know that help is available.

Importantly, having intrusive thoughts is not associated with any increase in acting on them. In fact, it is in large part because these thoughts are so outside the realm of things we would actually do that they can be so distressing.

They are not some kind of secret indication of our deep-seated desires, nor do they say anything about who we are as people.

They are just mental noise—one of the tens of thousands of thoughts that pop into our heads, outside of our control, everyday.

So, what can we do about them?

Have you ever been in a pool or some other body of water, and you have a beach ball, and you decide it might be fun to try to stuff it under the water? No? Okay, clearly we were very different people as children, but stick with me here.

What happens when you try to keep a beach ball underwater? You fight it, you push it down, you wrestle with it a bit. You keep trying to stuff it down, but no matter how much effort you put into it, the ball keeps popping back up. In fact, it seems like the harder you push it down, the more buoyantly it shoots back up.

Intrusive thoughts—or really any thoughts, for that matter—are like the beach ball. The more we try to suppress them, the stronger they bounce back. This is known as Ironic Process Theory, or more commonly, the white bear problem,

 so-named for a 1987 study in which subjects assigned not to think about a white bear paradoxically reported thinking about it more than those explicitly told to think about it.

This phenomenon can be intensified with intrusive thoughts. Because their content is often upsetting, alarming, or disturbing, we start reading into them. What is wrong with me?! we think, I need to stop thinking like this. And then we go through all sorts of mental gymnastics trying to get rid of the thoughts, all the while worrying what they mean about us, and, paradoxically, making it more likely that they’ll continue to occur with increasing frequency and intensity.

The key, then, when intrusive thoughts occur, is to do the hardest thing of all: nothing. Notice the thought, recognize it for what it is (oh, that’s an intrusive thought. Nothing to see there!), and move on with your day. The less we care about them, the less power they have.

The first step, of course, is recognizing that they’re normal, and that when we have them, we’re not alone. Talking about them can help with this. Makes for a great party conversation, actually.