Have you ever looked out the window of a building and thought “I could just jump?” Or imagined saying something insanely inappropriate in a crowded room? Or, has anyone ever told you, “don’t even think about it” and you immediately started thinking of exactly what they told you not to think about? That last question demonstrates the pink elephant paradox, or the tendency for intrusive or unwanted thoughts to become more bothersome the more you try to suppress them. Most people experience intrusive thoughts, although extremely frequent or disturbing thoughts may indicate a psychological disorder such as anxiety or OCD.

Common intrusive thoughts include fleeting urges to put oneself in danger (without suicidal ideation or actual desire of harm), urges to do something inappropriate in public, or pervasive thoughts about ones’ health or identity. Intrusive thoughts themselves are not harmful and usually disappear relatively quickly without causing significant anxiety. Studies have shown people are not likely to act on disturbing thoughts, and that intrusive thoughts don’t generally indicate mental illness or subconscious desires to follow through on the thought.

The exact cause for intrusive thoughts is unknown, although a common trigger in a healthy brain is stress. Some researchers believe intrusive thoughts are misinterpreted warning signals, or serve to protect from potential dangers. For instance, the urge to jump off a bridge usually causes someone to step back, protecting them from falling. However, excessive intrusive thoughts may indicate anxiety or OCD, a condition which produces compulsions often resulting from a desire to eliminate an intrusive thought or seek reassurance that the thought is not true. 

However, many find trying to “get rid of” intrusive thoughts impossible – oftentimes, trying to get rid of a thought just makes it worse. This can be explained by the Pink Elephant (or white bear) paradox, which states that the more you try to suppress a thought, the more it will bother you. A 1987 study titled “The Paradoxical Effects of Thought Suppression” described a “white bear” phenomenon, in which participants asked not to think of a white bear became more obsessed with a white bear than those asked to think of one. This also explains why advice such as “just don’t think of that” or “try thinking of something else” is useless and often more harmful than helpful. 

Intrusive thoughts can contribute to rumination, negative thought patterns, distractibility, and depression. While relatively common even in healthy people, intrusive thoughts are often debilitating in patients with OCD and anxiety. Intrusive thoughts alone rarely require therapy, although therapy in OCD or anxiety patients may be beneficial in reducing unwanted thoughts. A popular treatment option for OCD and anxiety is exposure-response prevention therapy (ERP), or exposure to the fear brought by an intrusive thought without providing the typical response (usually some form of compulsion). For instance, patients with a fear that they will drive recklessly are instructed to drive without performing compulsive actions to demonstrate they will not actually swerve off the road. 

Effective management strategies for intrusive thoughts, both in healthy people and those struggling with OCD or anxiety, include understanding and acceptance of these thoughts. People should aim to understand that the unwanted thought they are experiencing is an intrusive thought and accept its presence rather than attempting to “get it out” of their head or over-analyze the implications of the thought. It is especially important not to judge yourself for having the thought, whether it just popped into your head or if you’re struggling with OCD or anxiety. 

Information gathered from UniversityHospitals, Ness Labs, Psychology Today