Life Kit: How to Deal with Intrusive Thoughts

Podcast: Life Kit by NPR
Host: Marielle Segarra
Guest Experts: L.A. Johnson (reporting and lived experience), Unique Clark (perinatal mental health therapist), Dr. Brooke Smith (clinical psychologist)
Air Date: August 25, 2025

Episode Overview

This episode tackles the complicated, distressing topic of intrusive thoughts—those unwelcome, sometimes disturbing images or ideas that pop into our minds seemingly out of nowhere. Host Marielle Segarra and NPR senior visuals producer L.A. Johnson share personal experiences and speak with mental health professionals to unpack the nature of intrusive thoughts, why we get them, and most importantly, practical ways to cope.

Key Discussion Points and Insights

1. Intrusive Thoughts: Definition and Normalcy

• What Are Intrusive Thoughts?
  • Distressing, repetitive, and unwanted thoughts that can involve disturbing images, fears, or urges.
  • Common triggers include anxiety, depression, OCD, PTSD, and major life changes (ex: postpartum period).
• Prevalence
  • “In an international study… 94% had experienced distressing, unwanted, intrusive thoughts in the prior three months.” – Marielle Segarra (02:35)
• Lived Experience
  • L.A. Johnson describes a postpartum episode where she had a frightening thought about harming herself, sparking fear and prompting her to seek help. (01:37)
• Psychologist Viewpoint
  • “The majority of people do have intrusive thoughts… somewhere like 80, 90% of the population gets intrusive thoughts.” – Dr. Brooke Smith (06:33)

2. Why Intrusive Thoughts Happen

• They Often Reflect What Matters Most
  • “If we have intrusive thoughts about something, it's probably pretty likely that it's an area that we care a lot about… our mind will like, latch onto that because we place importance on this area.” – Dr. Brooke Smith (08:17)
• Brain as Flypaper
  • “Our brains are kind of like flypaper… our mind tends to regurgitate information back to us.” – Dr. Brooke Smith (09:05)
• Reassurance & Fact-Checking
  • “I've walked down the stairs with my baby a thousand times and haven't fallen once.” – L.A. Johnson (12:17)

3. The Emotional and Behavioral Impact

• Disruption of Daily Life
  • Intrusive thoughts can cause parents to avoid ordinary activities (e.g., carrying the baby downstairs, taking baths).
• Role in Mental Health
  • "Mental health disorders like PTSD, OCD, anxiety, or depression can play them up more.” – Unique Clark (06:41)

4. Coping Tools and Techniques

Key Takeaways:

Takeaway 1: You Are Not Alone

• Intrusive thoughts are universal—even people without a mental health diagnosis get them.
• Open communication and community normalize the experience.

Takeaway 2: Ground Yourself Using Mindfulness (09:15 – 12:01)

• Five Senses Exercise: Name things you can see, feel, hear, taste, and smell.
• TIP Skills:
  • Temperature change (hold something cold/hot)
  • Intense exercise (jumping jacks, running)
  • Paced breathing (box breathing: inhale 4, hold 4, exhale 4, hold 4)
  • Paired muscle relaxation (squeeze and release muscles)
• Quote: “The ideal again is like to bring you back to what is happening right now.” – Unique Clark (10:02)

Takeaway 3: Acceptance is Key (12:17 – 15:53)

• Acceptance vs. Avoidance

  • Trying to suppress or eliminate intrusive thoughts makes them stronger.
  • “It's like trying to problem-solve and fix the weather, right?… we have control over how much we suffer about our intrusive thoughts, but we don't have control over the thoughts themselves.” – Dr. Brooke Smith (13:14, 13:31)

• Experimental Proof

  • Study with three groups: control, suppression, acceptance. Acceptance group showed lowest physiological distress.
  • “The more the group allowed themselves to feel the distress, the less distressed they became.” – L.A. Johnson (15:43)
  • “Acceptance showed lower skin conductance levels than both of the other conditions.” – Dr. Brooke Smith (15:53)

• Cognitive Defusion

  • See thoughts as passing phenomena, not facts or identity.
  • “Rather than seeing your thoughts as who you are and as real, we can actually… look at our thoughts as opposed to from our thoughts.” – Dr. Brooke Smith (16:17)

Takeaway 4: Talk About It and Seek Support (17:37 – 19:06)

• Reduce Isolation

  • “If people are isolated, that's when those thoughts happen too. Because there's no one to bounce off these ideas…” – Unique Clark (17:59)

• Personification for Humor

  • “One woman in Unique's group therapy gave her intrusive thoughts a name: Gertrude the Intruder... It gave us a way to connect over it. It lightened the mood.” – L.A. Johnson (18:34)

• Mantras & Sharing

  • Share your mantra with friends/supports: “The thought came and now I can watch it float away like leaves on a stream or a cloud in the sky. Or that this thought isn't me and I'm doing a good job.” – Unique Clark (19:42)

Takeaway 5: Notice Patterns and Triggers (19:06 – 20:31)

• Intrusive thoughts may worsen with lack of sleep, excessive social media use, stress, or hunger.
• Self-care: prioritize rest, nourishment, and seeking help when needed.

Notable Quotes & Memorable Moments

• L.A. Johnson’s Bath Story:
  • “I was just beginning to relax when all of a sudden I had a disturbing thought pop into my head. What if I just slipped under the water for a while, put my head under and just stayed there? …That's not me. Where was that thought even coming from anyway? I was really, really scared.” – L.A. Johnson (01:37)
• On Acceptance:
  • “See, that's kind of the hitch, right? Is like if you still want them to be gone, then you're not really accepting, right? And so that's actually the thing that's going to keep them in place.” – Dr. Brooke Smith (13:55)
• Normalizing the Experience:
  • “It's a truly common experience. So part of just even talking about it can help normalize the experience that like other people in my life, other people that I know share this experience too.” – Unique Clark (18:24)
• Dr. Smith's Own Experience:
  • “I still have them probably once every couple weeks. I'll just get some like really weird thought… I'm like, okay, that's a weird thought. I'm just gonna keep going.” – Dr. Brooke Smith (20:20)
• Why Fear Can Be a Good Sign:
  • “When the thoughts are scary, that's okay… It's when they're not so scary anymore, is when we start to worry.” – Unique Clark (20:31)

Important Segment Timestamps

• Intro & Postpartum Story: 00:18 – 02:35
• Intrusive Thoughts Prevalence & Definition: 02:35 – 06:33
• Why They Happen & Psychological Purpose: 08:17 – 09:15
• Mindfulness & Grounding Techniques: 09:15 – 12:01
• Acceptance & ACT Therapy Insights: 12:17 – 15:53
• Therapist’s Study on Acceptance: 15:10 – 16:46
• Talking About Your Thoughts & Support: 17:37 – 19:55
• Recap of Key Steps: 21:13 – 22:28

Recap of Coping Steps

1. Learn what intrusive thoughts are; everyone has them.
2. Use mindfulness to ground yourself during moments of distress.
3. Accept intrusive thoughts rather than fighting them.
4. Talk about your experiences and seek support; notice your triggers.

Final Notes

The episode reassures listeners that intrusive thoughts are part of the human condition, do not reflect one’s character or intentions, and are best managed through acceptance, mindfulness, and reaching out for support—not through avoidance or self-judgment.

For those struggling with intrusive thoughts and especially if thoughts of self-harm arise, the show stresses the importance of contacting immediate help (988 Suicide & Crisis Lifeline).