HOW CAN I STOP MY INTRUSIVE THOUGHTS?

Again, intrusive thoughts are normal, so you can’t stop them. But if intrusive thoughts are troubling you, then wellestablished treatments are available. For OCD (and body dysmorphic disorder), this is usually cognitive behavioural therapy (CBT) and exposure and response therapy, although there are separate, tailored CBT approaches for other disorders like PTSD. CBT focuses on helping you to change the way you think, including how you react to intrusive thoughts. Exposure and response therapy challenges you to confront the object of your fear, so if you have cleaning compulsions, it might involve touching the taps in a public toilet without carrying out ritual cleaning.

Although these treatments don’t benefit everyone to the same degree, what benefit they do offer is backed up by strong evidence. There are also other new approaches, like mindfulness and compassion-focused therapy (which encourages patients to develop a more self-supportive inner voice), but they don’t yet have the data behind them. “There’s evidence that [they] work better than nothing, but there are very few direct comparisons,” Freeston says, referring to how they compare with the standard approaches.

Developing new treatments also involves learning more about what causes intrusive thoughts. Coles is currently working on the relationship between sleep disturbances and intrusive thoughts in OCD. “People with OCD tend to stay up really late,” she says, “It’s just initial data, but this seems to potentially be related to not being able to get the thoughts out of your head.”

Radomsky’s group is working on helping people to change certain beliefs that might be related to their intrusive thoughts. For instance, the belief that their memory might not be very good; correcting that can help people get on top of repetitive checking behaviours. Another focus is beliefs about losing control. “People believe sometimes that if they lose control of their thoughts, they might lose control of their behaviour,” he says. “Those beliefs in OCD are inevitably false.”

For anyone who feels that intrusive thoughts may be becoming a problem, he recommends The Anxious Thoughts Workbook by David A Clark.