Experiencing intrusive thoughts with PTSD

Trauma is common — research shows that most people will go through at least one traumatic event in their lifetimes. Life after trauma can be scary and difficult. You might experience symptoms ranging from difficulty sleeping and nightmares to physical symptoms like stomach pain.

Although they’re not recognized as an official symptom of post-traumatic stress disorder (PTSD), many people who’ve gone through a traumatic event have intrusive thoughts. You might suddenly experience stressful, scary, or disturbing thoughts related to the trauma you experienced.

If so, you’re not alone. Most people experience intrusive thoughts from time to time. Trauma-related intrusive thoughts are often upsetting, but they’re a common part of rebuilding your life after trauma. And by taking certain steps — including getting professional mental health support — you can free yourself from their power.

Can trauma cause intrusive thoughts?

Many people who’ve gone through a traumatic event experience intrusive thoughts. When related to trauma, intrusive thoughts are often a part of “re-experiencing” — a core symptom of PTSD.

Whether or not you live with PTSD, you could re-experience the traumatic event and experience intrusive thoughts, images, or sensations. Some research suggests that people who use avoidance-based thought-regulation strategies — trying to cope with thoughts and feelings by pushing them away — are more likely to face intrusive thoughts after trauma.

You may be more likely to experience intrusive thoughts if you also live with another mental health condition, like obsessive-compulsive disorder (OCD). It’s estimated that 10% to 40% of people with PTSD are also diagnosed with OCD. One of the key symptoms of OCD is obsessions, or severely upsetting intrusive thoughts that cause intense feelings of fear, shame, or disgust. 

But keep in mind that you don’t need to have OCD to experience trauma-related intrusive thoughts. Intrusive thoughts are very common in people with PTSD.

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How do intrusive thoughts affect people with PTSD?

If you live with PTSD, you might experience intrusive thoughts on a daily or almost constant basis. Others with PTSD may only experience intrusive thoughts when they face a trauma trigger.

Regardless of how often you experience trauma-related intrusive thoughts, they’re usually uncomfortable, frightening, or distressing. Having these thoughts appear seemingly out of nowhere can cause disruptions in your life. For example, you might get distracted at work because you’re having intrusive thoughts.

You might have thoughts like:

• “What if the traumatic event happens again?”
• “It’s all my fault that it happened.”
• “I’ll never feel safe no matter where I go.”
• “I shouldn’t have trusted anyone. I should’ve seen it coming.”
• “I’m weak for not being able to move on.”
• “What if I can’t protect myself next time?”
• “I’m broken because of what I’ve been through.”
• “People are probably judging me for what happened.”
• “What if I never feel normal again?”
• “I should’ve done something to prevent it.”
• “Everything is a threat, and I have to stay alert.”
• “This feeling will never go away.”

Intrusive thoughts can also appear as imagery or sensations. For example, you may have a sudden flashback in which you feel in your body as if you’re re-experiencing the traumatic event. You might suddenly be disturbed by images of what happened.

If you also live with OCD, you might have more intense or unrealistic intrusive thoughts. For example, if you live with co-occurring harm OCD and PTSD, you might have intrusive thoughts like, “What if I hurt my child just like I was hurt?”

These types of intrusive thoughts can cause intense feelings of guilt and shame. It’s important to remember that intrusive thoughts aren’t an indication that you want to act on these thoughts. Having uncomfortable thoughts doesn’t make you a bad or evil person. Thoughts are just thoughts.

How you can deal with trauma-related intrusive thoughts

Intrusive thoughts about past trauma can be disruptive and even become debilitating when they get severe. But there’s hope — there are ways to deal with intrusive thoughts and continue to live your life in spite of them.

Identify them

The first helpful step you can take is to identify intrusive thoughts as exactly what they are: intrusive thoughts. This can help because, sometimes, you might unconsciously internalize your intrusive thoughts and feel guilt and shame about them. Or you might be so frightened by your thoughts that you feel as if the traumatic event is happening again.

Try to name the intrusive thoughts as intrusive thoughts. When you see them as only thoughts and nothing more, they may lose their power over you.

Don’t fight them

Like we’ve already mentioned, research suggests that people who try to avoid or push away uncomfortable thoughts are more likely to deal with intrusive thoughts. So when you’ve identified a thought as intrusive, try not to push it away. This can be hard to do, as these thoughts can be painful and scary. It’s natural to want to avoid them.

But, as much as you can, try to sit with the thoughts. Allow yourself to acknowledge them without judgment. You might say to yourself, “This thought is here, and it’s difficult, but it doesn’t define me or control me.” Practicing mindfulness or grounding techniques can help you sit with your thoughts while remaining connected to the present moment.

Write about them

Journaling may be able to help you process intrusive thoughts. When you write about your thoughts, you give them a space to exist outside of your mind. This can make them feel less overwhelming and more manageable.

Set aside some time to journal about the thoughts you’re having, how they’re affecting you, and any emotions that come up. You don’t need to worry about structure or grammar — just let the words flow. If it feels safe to do so, you might even explore how these thoughts connect to your trauma. Just keep in mind that processing traumatic memories is best done with the support of a licensed therapist. 

Journaling regularly can also help you notice patterns in your thoughts and triggers, which can be valuable for understanding and addressing them.

Learn about trauma and PTSD

Learning more about how trauma affects your brain and body can also help. After you experience a traumatic event, your body and mind may react in ways that make you feel frightened and out of control. Intrusive thoughts can be part of that. 

By equipping yourself with knowledge about trauma, you can begin to reframe your intrusive thoughts as a normal response to the experiences you’ve been through. Understanding how your brain reacts to trauma — like how certain areas handle fear and store memories — can help you make sense of intrusive thoughts and feel more in control. 

Treatment options for intrusive thoughts with PTSD

One of the best ways to deal with trauma-related intrusive thoughts is to seek mental health treatment. The symptoms of PTSD — including intrusive thoughts and any other re-experiencing symptoms you might have (like nightmares or flashbacks) — can be treated with the right support.

Some of the most effective types of therapy for PTSD include:

• Eye movement desensitization and reprocessing (EMDR)
• Cognitive behavioral therapy (CBT), including more specific treatment methods like trauma-focused CBT
• Dialectical behavior therapy (DBT)
• Prolonged exposure
• Narrative therapy

If you live with co-occurring OCD that’s making intrusive thoughts worse, that condition will also need to be addressed. OCD is usually treated with a combination of medication and a specific type of cognitive behavioral therapy called exposure and response prevention (ERP).

Treatment may not make intrusive thoughts go away entirely. Almost everyone experiences intrusive thoughts at times. But a therapist can help you become less frightened or disturbed by these thoughts and focus on the other, more fulfilling and joyous parts of your life.

Find care with Rula

If you’re experiencing intrusive thoughts related to trauma or PTSD, you’re not alone. These thoughts can be scary, but you can overcome them with the support of a therapist and other important people in your life.

At Rula, we’ve connected clients and therapists for millions of therapy sessions. Our network of 10,000+ therapists have expertise in over 80 clinical specialties, including PTSD. You can get an appointment with a therapist as soon as tomorrow.

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