Notice: For general interest only; may contain inaccuracies. Not a diagnosis, treatment, prognosis, or professional, clinical, or legal advice. Reading this creates no counsellor-client relationship. By reading this page, you agree to these terms. Full disclaimer. In an emergency, call 911.
You are standing on a subway platform and a thought appears: What if I pushed someone? You are holding a kitchen knife and an image flashes — unbidden, horrifying, nothing like who you are. You are in the middle of prayer and something blasphemous surfaces uninvited. You do not want these thoughts. You have never acted on them. Yet they keep coming, and the shame of having them can feel worse than the thoughts themselves.
If this is you, two things are true at once: the experience is more common than almost anyone admits, and it is one of the most treatable problems in clinical psychology.
Most people have intrusive thoughts — the research is clear
In a landmark 1978 study, Rachman and de Silva asked a non-clinical population whether they experienced unwanted, intrusive thoughts with content identical to the obsessions reported by people diagnosed with OCD. The answer was striking: roughly 80 to 90 percent did (Rachman & de Silva, 1978). Violent images, sexual taboos, fears of contamination, impulses to shout something inappropriate — the content was indistinguishable from clinical obsessions. The difference was not in what the thoughts said, but in what the person did with them.
This finding has been replicated across cultures and decades. Intrusive thoughts are a normal product of a brain that runs simulations — predicting, warning, rehearsing — all day long. The system is noisy by design. Most people notice a disturbing thought, shrug, and move on. A smaller number get stuck.
Why some thoughts stick: the role of meaning
The thought itself is not the problem. The problem begins when you interpret it as meaningful: I must be a terrible person to think this. What if it means I secretly want to do it? What if I lose control?
This interpretation — what clinicians call thought–action fusion — turns a passing neural event into a personal emergency. The thought now feels like evidence of danger, so you try harder to suppress it. And that is where things go wrong.
The suppression paradox
Wegner and colleagues (1987) demonstrated what they called the ironic process theory of mental control. When you instruct yourself not to think about something — a white bear, in their famous experiment — the monitoring process required to check whether you are thinking about it keeps the target active. Suppression does not silence the thought; it amplifies it.
For intrusive thoughts, the effect is devastating. You push the image away. It returns louder. You conclude you are failing to control your own mind. You push harder. The cycle tightens. What started as a three-second flash becomes an hours-long loop of dread and self-monitoring.
When intrusive thoughts become OCD
Obsessive-compulsive disorder affects roughly one to two percent of the Canadian population, making it one of the most common anxiety-related conditions. The hallmark is the obsession–compulsion loop: an intrusive thought (obsession) produces distress, which the person tries to neutralise with a mental or physical ritual (compulsion) — checking, washing, seeking reassurance, mentally reviewing, praying in a specific pattern. The compulsion provides brief relief, reinforcing both the belief that the thought was dangerous and the habit of ritualising.
Not everyone with distressing intrusive thoughts meets criteria for OCD. Some live with what clinicians informally call “Pure O” — obsessions without visible rituals, though mental compulsions (replaying, analysing, seeking internal certainty) are almost always present. Others experience intrusive thoughts as part of generalised anxiety, post-traumatic stress, or postpartum mood disorders. The mechanism — meaning-making plus suppression — is the same.
How counselling helps: ERP and cognitive approaches
Exposure and response prevention (ERP) is the gold-standard psychological treatment for OCD and intrusive-thought disorders. A meta-analysis by Olatunji and colleagues (2013) found large effect sizes for CBT including ERP across multiple controlled trials, with gains maintained at follow-up.
The logic is counterintuitive but well supported: instead of avoiding or suppressing the thought, you allow yourself to experience it — deliberately, repeatedly, without performing the compulsion that usually follows. Over time, the brain recalibrates. The thought fires but the alarm does not, because you have learned, at a felt level, that the thought is noise, not signal.
Cognitive therapy works alongside ERP by targeting the beliefs that gave the thought its power in the first place: Thinking it means I want it. If I don’t control this thought, something terrible will happen. A good person would never think this. These beliefs are examined, tested, and replaced with more accurate ones — not through reassurance (which is itself a compulsion) but through structured reasoning and behavioural experiments.
What this looks like in Samuel’s practice
In individual counselling, the work typically begins with psychoeducation — understanding the mechanism well enough that the thought loses some of its mystique. Then graded ERP: starting with exposures that produce moderate discomfort and progressing at your pace, never flooding. Cognitive restructuring runs in parallel, especially for thought–action fusion and inflated responsibility.
For clients whose intrusive thoughts sit on top of trauma — a car accident, an assault, a childhood experience — EMDR may be integrated to process the underlying memory before or alongside the ERP work. For those whose nervous system is chronically over-alert, neurofeedback training can help lower the baseline arousal that keeps the brain scanning for threat.
Sessions are available in English or Farsi. For Iranian-Canadian clients, the cultural dimension matters: intrusive thoughts with religious or moral content can carry extra weight in a context where وسواس (obsessive doubt) is understood through a spiritual rather than clinical lens, and where admitting to blasphemous thoughts feels like a moral failing rather than a symptom. Samuel names that cultural layer without judgment and works within it. See: Farsi Therapist Vancouver.
ICBC and CVAP coverage
If intrusive thoughts, flashbacks, or obsessive replaying began or worsened after a motor-vehicle accident, ICBC covers counselling on your active claim with no doctor referral required. If the trigger was a crime — an assault, a threat, witnessing violence — the Crime Victim Assistance Program (CVAP) provides similar coverage. Samuel direct-bills both programs, so you do not have to submit the claim yourself.
Fees and expenses are also covered by FNHA, IFHP, RCMP, VAC, and most extended-health plans, with direct billing available.
You do not have to keep white-knuckling this
Intrusive thoughts thrive on secrecy and shame. The moment you say them out loud to someone who is not shocked — who has heard the same content a hundred times and knows exactly what to do with it — the grip loosens. That is what the first conversation is for.
The first 20-minute phone call is free and confidential: 604-721-0604.
See also: Individual Therapy in Vancouver · EMDR Therapy Vancouver · ICBC Counselling Vancouver · CVAP Counselling Vancouver · Farsi Therapist Vancouver
Disclaimer: This article is for educational and informational purposes only and does not constitute professional advice, diagnosis, or treatment. Consult a qualified professional for any mental-health decisions.
Written with expert editorial assistance.
References
- Olatunji, B. O., Davis, M. L., Powers, M. B., & Smits, J. A. J. (2013). Cognitive-behavioral therapy for obsessive-compulsive disorder: A meta-analysis of treatment outcome and moderators. Journal of Psychiatric Research, 47(1), 33–41. https://doi.org/10.1016/j.jpsychires.2012.08.020
- Rachman, S., & de Silva, P. (1978). Abnormal and normal obsessions. Behaviour Research and Therapy, 16(4), 233–248. https://doi.org/10.1016/0005-7967(78)90022-0
- Wegner, D. M., Schneider, D. J., Carter, S. R., & White, T. L. (1987). Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53(1), 5–13. https://doi.org/10.1037/0022-3514.53.1.5
