How to Manage Intrusive Thoughts with Acceptance and Commitment Therapy (ACT)

Dr Sara Carr, Clinical Psychologist & Director of Find My Psychologist

Posted 07.09.2023

Have you ever found yourself tangled in a web of intrusive thoughts, those uninvited mental guests that disrupt your peace of mind? Intrusive thoughts, ranging from everyday worries to distressing and disturbing notions, are a common part of the human experience. But what makes them distressing, and how can we manage them effectively? In this evidence-based exploration, we’ll dive into the world of intrusive thoughts, understand what they are not, and discover Acceptance and Commitment Therapy (ACT) strategies to better manage these thoughts.

What Are Intrusive Thoughts?

Intrusive thoughts are unwelcome and often distressing thoughts, images, or ideas that involuntarily enter our minds. They can be about a wide range of subjects, including personal fears, doubts, regrets, or even violent or disturbing scenarios. It’s crucial to understand that intrusive thoughts are a natural part of human cognition and are not indicative of mental illness or intent. In fact, research shows that almost everyone experiences them to some extent, with up to 94% of people experiencing unwanted, intrusive thoughts, images and/or impulses (Moulding et al., 2014).

Why Do Intrusive Thoughts Become More Distressing?

Intrusive thoughts become distressing when we react to them in unhelpful ways. This reaction typically involves trying to suppress or avoid these thoughts, which ironically increases their frequency and intensity. As an example, over the next ten seconds as you are reading this sentence, try NOT to think about a pink elephant. Whatever you do, do not think about that elephant… of course, as soon as we try to ignore something in our mind, it tends to return with even more power.

The anxiety and discomfort caused by these thoughts can trigger a vicious cycle, making them even more distressing. Understanding this cycle is the key to managing intrusive thoughts effectively.

What Intrusive Thoughts Are Not

It’s essential to clarify what intrusive thoughts are not to reduce unnecessary worry and stigma. Intrusive thoughts do not necessarily reflect your true desires or intentions. For example, having a disturbing thought about harming someone does not mean you actually want to harm anyone. Intrusive thoughts are a product of our complex minds and do not define who we are as individuals.

Acceptance and Commitment Therapy (ACT) for Managing Intrusive Thoughts

Acceptance and Commitment Therapy (ACT) is a well-established therapeutic model that can be highly effective in managing intrusive thoughts. ACT, developed by Steven Hayes, encourages individuals to accept their thoughts without judgment, make room for them, and take meaningful actions aligned with their values. Unlike some therapies that aim to eradicate symptoms entirely, ACT acknowledges that suffering is an inherent part of life. Let’s explore some evidence-based strategies from ACT that can help you manage intrusive thoughts.

Cognitive Defusion

Cognitive defusion is a technique in ACT that helps individuals detach from their thoughts. Instead of seeing your thoughts as facts or commands, you learn to view them as just mental events. Some of these events may be facts, others will not. One way to practice cognitive defusion with intrusive thoughts is to simply prefix them with “I am noticing I am having the thought that…” For example, instead of saying “I am a terrible person for having this thought,” you can say, “I am having the thought that I am a terrible person.”

This subtle shift in language can distance you from your thoughts and reduce their impact on your emotions.

Mindfulness and Present-Moment Awareness

Mindfulness is a core component of ACT. It involves being fully present in the moment, observing your thoughts and feelings without judgment. When intrusive thoughts arise, mindfulness can help you step back and observe them without getting entangled in their emotional grip.

One evidence-based mindfulness technique is the Five Senses Exercise, also known as 54321. Notice 5 things you can see, 4 things you can hear, 3 things you can touch, 2 things you can smell, 1 thing you can taste. This exercise encourages you to focus on each of your five senses one at a time, grounding you in the present moment. When intrusive thoughts surface, you can use this exercise to redirect your attention to your immediate sensory experience, instead of getting taken away by the thought to a place that ends in distress.

Values Clarification and Commitment

Identifying your core values is a fundamental part of ACT. When you are clear about what truly matters to you, you can make decisions and take actions that align with those values. This, in turn, reduces the impact of intrusive thoughts on your behavior.

For example, if one of your values is “compassion,” and you have intrusive thoughts related to harming others, you can consciously choose to respond with compassionate actions, such as practicing kindness towards yourself and others. This commitment to your values can help you manage and defuse the power of intrusive thoughts.


Acceptance, as the name suggests, is a central concept in ACT. It involves acknowledging and making room for your thoughts and feelings, even the uncomfortable ones. Rather than struggling against intrusive thoughts, you accept their presence as part of your mental landscape.

Three simple steps to manage intrusive thoughts:

  1. Identify the thought as intrusive. Label the thought: ‘that’s just an intrusive thought; it’s not how I think, it’s not what I believe, and it’s not what I want to do,’”
  2. Don’t fight with it. When you have an intrusive thought, try to accept that it is here. Don’t try to push it away. Just acknowledge it then turn your attention to something you want to spend time and energy on. Your mind might keep reminding you about this thought, so repeat this step – acknowledge and refocus. You may need to keep shifting your attention several times before your mind settles, and that’s ok.
  3. Don’t judge yourself. Know that having a strange or disturbing thought does not indicate that something is wrong with you: “It’s ok to have this thought; Other people have intrusive thoughts”.


Intrusive thoughts can be distressing, but they don’t define your character or intentions, and they don’t have to control your life. By understanding what intrusive thoughts are, why they become distressing, and what they are not, you can begin to change your relationship with them. Acceptance and Commitment Therapy (ACT) offers evidence-based strategies to help you manage intrusive thoughts effectively. Through cognitive defusion, mindfulness, values clarification, and acceptance, you can learn to coexist with your thoughts, whilst making room for the things that truly matter to you. Remember, you are not your thoughts, and with practice, you can master your mind and find peace.

If unwanted and intrusive thoughts are starting to disrupt your daily life, particularly if they’re impairing your ability to work or to do things you enjoy, it may be helpful to seek help from a mental health professional.

An assessment with a psychologist is a good place to start to better understand the history and maintenance of your intrusive thoughts. Whilst you may be experiencing shame associated with these thoughts, the psychologists registered on Find My Psychologist are trained to doctoral level and can provide a non-judgemental space to explore your concerns.


About the Author

Dr Sara Carr is a clinical psychologist working in both the NHS and private practice in the South of England.

Passionate about people gaining access to safe and evidenced-based psychological services when they need it, Sara launched Find My Psychologist.

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