Updated: Jan 20
The following blog post contains examples of scary and intrusive thoughts that one may find triggering. They have been italicized. Please skip this portion if reading examples of scary or intrusive thoughts is difficult for you. If you feel that you and your baby are not safe or in danger, please dial 911 or go to the emergency room immediately. If you need extra support to manage symptoms, please contact your healthcare provider immediately, or if you would like to address your concerns with a perinatal or maternal mental health provider, please visit www.postpartum.net to find a local provider with specialized training in this area.
“I can’t stop thinking about my baby drowning in the bath tub.” “This horrid scene of throwing my baby against the wall keeps popping into my mind.” “I keep imagining car accidents every time I drive in the car with my baby.” “I can’t stop thinking about dropping my baby down a flight of stairs.”
Mama, do thoughts like these sound familiar? If so, I would like to start off by saying that you are not alone. Approximately 91% of new mothers and 88% of new fathers report obsessive or intrusive thoughts about their baby (1). I understand this statistic may not alleviate much discomfort because if we are being totally honest, experiencing intrusive thoughts flat out sucks. They tend to be accompanied by a lot of feelings like anxiety, overwhelm, shame, guilt, disgust, and sadness. I know this because I, too, experienced intrusive thoughts after the birth of my first daughter.
What are intrusive thoughts?
Scary thoughts, psychologically termed intrusive thoughts, are thoughts, images, or ideas that enter the mind at unpredictable times, are unwanted, and often feel uncontrollable, vivid, and real (1 and 2). They are often one of the least talked about experiences in parenthood for fear of judgment. Intrusive thoughts during pregnancy and postpartum generally involve harm occurring to the baby in some way. For example, thoughts of losing the baby, thoughts of suffocation, unwanted ideas of intentional harm, unacceptable sexual thoughts, fears of contamination, and thoughts of illnesses or accidents (2).
Why do intrusive thoughts happen?
While it may seem counter intuitive to the thoughts themselves, they tend to stem from increased levels of anxiety rooted in a strong desire to protect the infant. Unfortunately though, we do not have control over what comes to our minds and when. We do; however, have control over the way in which we respond to the intrusive thoughts. When addressing intrusive thoughts from a professional standpoint, it is not the specific thought or idea itself that is problematic, but rather, the degree of distress that is caused as a result of the thought.
How do I make intrusive thoughts go away?
One question that often comes up is, “How do I get rid of them?” This is a fair question, and regrettably, when it comes to intrusive thoughts, there is no making them (easily) disappear. Instead, we want to focus on developing and implementing strategies to cope with them when they occur as opposed to ways of getting rid of them. Forcing yourself to stop thinking about the thought, suppressing the thought, or attempts to push it out of your mind amplifies it and tends to make matters worse. Resistance around the intrusive thought(s) is like adding fuel to a fire; overtime, the thought(s) tend to become more prominent.
As the focus shifts to implementing coping strategies, the thoughts, over time, become more manageable and tolerable. I’ve outlined some strategies for coping with intrusive thoughts below; however, if you’re interested in learning more about intrusive thoughts during pregnancy and postpartum, I offer an entire workshop on this topic called When Your Mind Feels Hijacked.
Grant yourself permission to allow the thought to pass through your mind instead of trying to avoid it or engaging in behaviors to alleviate the accompanying anxiety and discomfort. In other words, try your best to sit with the thought and let it run its course. Avoiding the thought may provide temporary relief in the moment, but it does not make you any more equipped to handle the thought when it comes up again (because it will). The analogy of a bus stop comes to mind when I think of this. You may be waiting at a bus stop and when the bus arrives, you can choose to get on the bus, or you can choose to watch it drive off. When you get on the bus, you engage in the familiar, you do what you normally would (in this case, trying to avoid the thought, distracting, or doing something else). When you watch the bus slowly drive away (letting the thought run its course) and perhaps consider an alternative method of transportation, you’re actively choosing to do something different. The latter is much harder and it requires more effort, but eventually, you begin to realize that walking is more pleasant than taking the bus. In the process of sitting with your thoughts, you are teaching your mind and body that the anxiety will lessen and that you can handle the discomfort instead of fleeing from it; over time, the intrusive thoughts will calm down on their own (this is a process called habituation).
Kindly remind yourself that you are not your thoughts and that your thoughts do not equal action or outcomes. The fear of acting out the thought can be debilitating, but this simple reminder can go a long way. The fact that a mother is aware of her scary thoughts is a good thing.
Name it to tame it. When you’re experiencing a scary thought, call it out and acknowledge it for what it is; a scary thought.
Try not to place judgment on yourself when you experience a scary thought. There is, unfortunately, so much shame that gets wrapped up in this experience, but scary thoughts do not define you or your ability to be a good mom.
Talk about the thought(s) with someone you trust. This can be in the context of individual therapy with a provider trained and qualified to address them, with your spouse, or a close friend. Keeping the experience bottled up inside can perpetuate feelings of guilt, potentially exacerbate the problem, and increase feelings of loneliness.
Connect with other mothers or parents with whom you feel comfortable. Meaningful connection with others may offer much needed validation, unity, and comfort. Such connections can help propel parents forward in their parenthood journey.
Intrusive thoughts are most commonly observed in Postpartum Obsessive Compulsive Disorder (PP-OCD), where a mother may engage in compulsive behaviors, excessive behavioral avoidance, or covert strategies (e.g., mental rituals) in order to reduce anxiety and distress associated with the thoughts. They may also be a symptom of Postpartum Depression (PPD), Postpartum Anxiety (PPA), or Postpartum Posttraumatic Stress Disorder (PP-PTSD).
If you’re experiencing intrusive thoughts that are persistent, distressing, or pervasive, and they interfere with your ability to care for yourself or your baby properly, it is important to seek support and help from a licensed professional. Dr. Kaffer and I are available to support you every step of the way.
Please remember that you are not alone.
All the best, Dr. Pickering
*This blog post was originally written by Dr. Alice Pickering on dralicepsyd.com and has been cross posted.
References: 1. Kleiman, K., & Raskin, V. (2013). This isn’t what I expected: Overcoming postpartum depression. Da Capo Lifelong Books. 2. Abramowitz, J. S., Schwartz, S. A., & Moore, K. M. (2003). Obsessional thoughts in postpartum females and their partners: content, severity, and relationship with depression. Journal of Clinical Psychology in Medical Settings, 10(3), 157-164.
Resources for Support:
“This Isn’t What I Expected: Overcoming Postpartum Depression” by Karen Kleiman, MSW, LCSW and Valerie Raskin, MD
“Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood” by Karen Kleiman, MSW, LCSW, and Amy Wenzel, Ph.D.
Postpartum Support International (PSI) at www.postpartum.net
PSI Helpline: 1-800-944-4773
Postpartum Depression Helpline: 1-800-PPD-MOMS/1-800-773-6667
Psychology Today at www.psychologytoday.com
The National Institute of Mental Health at www.nimh.nih.gov/index.shtml
National Suicide Prevention Lifeline: 1-800-273-TALK/1-800-273-8255
National Suicide Hotline: 1-800-SUICIDE/1-800-784-2433