Intrusive Thoughts Worksheet PDF Printable and Guide

Written by Dr Lucy Russell DClinPsyc CPsychol AFBPsS
Dr Lucy Russell Clinical Psychologist Founder of They Are The Future
Author: Dr Lucy Russell, Clinical Psychologist

I’m Lucy Russell, a clinical psychologist specializing in cognitive behavioural therapy. In this article I delve into managing intrusive and unwanted thoughts using practical strategies and a CBT worksheet. 

The article and intrusive thoughts worksheet pdf are designed to empower you directly with tools for better mental wellbeing.

a teen girl resting head on hand anxious and thoughtful

About Intrusive Thoughts

Intrusive thoughts are unwelcome, often distressing, thoughts or images that suddenly appear in our mind.

They are a common experience in the human mind, affecting both adults and children.

Such thoughts can range from mildly annoying to intensely troubling, encompassing various types of thoughts that can disrupt our daily life.

Understanding these thoughts is the first step towards managing them.

Negative thoughts, in particular, can lead to negative thinking patterns that impact our well-being. However, it’s important to remember that experiencing these thoughts does not define us or our ability to be good parents or individuals.

To combat intrusive thoughts, cognitive restructuring, a technique rooted in positive psychology, can be incredibly effective. It involves identifying and challenging negative thoughts, and replacing them with positive thoughts.

This process helps in reshaping our thinking patterns towards a more positive outlook, enhancing our overall well-being.

More on that later!

Managing intrusive thoughts worksheet pdf page 1

Types of Intrusive Thoughts

Intrusive thoughts can vary widely, reflecting the complexity of the human mind. Here are some examples:

  1. Safety Concerns: Thoughts of harm coming to oneself or loved ones, despite no real threat.
  2. Violent Images: Sudden, unwanted images of causing harm to others, even when such actions are completely out of character.
  3. Inappropriate or Forbidden Thoughts: These might involve socially or morally unacceptable ideas, causing significant distress, or unwanted sexual thoughts.
  4. Health Anxieties: Persistent worries about having a serious illness, despite medical reassurance.
  5. Perfectionism: Thoughts about needing things to be perfect or done in a specific way, leading to distress when this is not achieved. Sometimes it may be accompanied by the thought that something bad will happen if things aren’t perfect.
  6. Doubts about Relationships: Unfounded worries about the stability and fidelity of personal relationships.

Although I talk about intrusive thoughts, they can also appear as images rather than thoughts.

This is really common so it’s important to hold it in mind.

Download Your Intrusive Thoughts Worksheet HERE

You can download you free intrusive thoughts worksheet pdf directly below.

How to Use Your Intrusive Thoughts Worksheet PDF

Our Intrusive Thoughts Worksheet PDF is a great tool designed to help you manage negative automatic thoughts and foster personal growth. Here’s how to make the most of it:

  1. Start with the Checklist: On page 1, you’ll find a checklist of strategies to manage intrusive thoughts. Try these strategies one at a time, dedicating about two weeks to each. This allows you to fully experience their effect and determine which ones resonate with you.
  2. Experiment and Evaluate: Remember, different strategies may work better for different types of thoughts. It’s a process of experimentation and discovery, so be patient and open-minded as you explore each technique.
  3. Mark Your Favorites: As you work through the strategies, check the box next to the ones that you find most effective. These are your go-to techniques that you can rely on when intrusive thoughts arise.
  4. Track Your Thoughts and Strategies: Use page 2 to note down specific intrusive thoughts you experience and the strategies that help you manage them. This record can be incredibly insightful, helping you identify patterns and the most effective techniques for your unique experiences.

By engaging with this worksheet, you’re taking proactive steps towards managing intrusive thoughts and enhancing your mental well-being.

Managing intrusive thoughts worksheet pdf page 2

Coping With Intrusive Thoughts

Here are eight powerful strategies for you to try.

1. Thoughts Are Just Thoughts: Remember, thoughts are not truths. They are just mental events that have popped into your mind. It’s okay to have them without fearing or acting upon them.

2. Acknowledge, Don’t Engage: Recognize an intrusive thought as just that. Acknowledge its presence without getting entangled in its content.

3. Let Thoughts Pass: Visualize your thoughts like leaves floating down a river. They come, and they go. This visualization can help you understand the temporary nature of thoughts.

4. Question the Thought: Consider if a thought is helpful or not. This can prevent you from dwelling on unproductive or distressing ideas.

5. Mindfulness and Meditation: Engage in mindfulness exercises. These practices can create a space between your thoughts and reactions, offering peace. For example, spend 2 minutes on mindful listening. Set a timer. Focus on all the near and far sounds you can hear, in the present, without judgement. If your thoughts wander, gently bring them back to the sounds.

Mindful Listening: Another Exercise For You to Try

Find a comfortable and quiet space.

Play a piece of music or natural sounds (like rain or birds chirping). Close your eyes and focus solely on the sounds you hear.

Notice the different instruments, pitches, and rhythms in the music, or the varying intensities and patterns in the natural sounds.

If your mind wanders to intrusive thoughts, gently guide it back to the sounds.

This practice helps anchor your mind in the present moment, creating a break from intrusive thoughts.

6. Write It Down: Jot down intrusive thoughts. You can even make bubble writing and colour it in! This takes courage but it can make intrusive thoughts seem less daunting and more manageable.

7. Embrace the Illogical: Remember that not all thoughts make sense. They don’t always carry deep meanings or truths.

8. Find Your Flow: Engage in activities you love. Activities that absorb your attention can provide a break from intrusive thoughts. For example, singing, playing a sport you love, or digital art.

a woman in a park doing deep breathing

Intrusive Thoughts in Daily Life

Intrusive thoughts can significantly affect our daily lives, leading to a negative view of ourselves and the world

These distressing thoughts often result in cognitive distortions, where our reality is viewed through a skewed, negative lens. This can make everyday situations seem more daunting or threatening than they truly are.

For example, someone experiencing intrusive thoughts about being seen as incompetent at work might develop the cognitive distortion known as “mind reading.”

They may wrongly assume that others view them negatively, leading to heightened self-doubt and withdrawal from great opportunities, despite a lack of evidence to support these beliefs.

The presence of these thoughts can disrupt focus, reduce productivity, and strain our relationships. 

Without effective coping strategies, we may find ourselves caught in a cycle of anxiety and avoidance. This limits our ability to enjoy life and engage in meaningful activities. 

That’s where this article and your intrusive thoughts worksheet pdf comes in!


Intrusive Thoughts and Mental Health Issues

Intrusive thoughts can play a significant role in various mental health conditions, often exacerbating or contributing to their development.

Understanding this connection is crucial for effective management and treatment.

Obsessive-Compulsive Disorder (OCD)

In OCD, intrusive thoughts often manifest as persistent, unwanted ideas or impulses that cause significant distress. These thoughts can lead to compulsive behaviors as attempts to alleviate the anxiety they produce.

The cycle of obsessive thoughts and compulsive actions is a hallmark of this disorder.

Post-Traumatic Stress Disorder (PTSD)

Individuals with PTSD may experience intrusive thoughts related to past traumatic events.

These thoughts can trigger intense emotional responses, including fear, anger, or sadness, and are often accompanied by vivid flashbacks or nightmares, making it challenging for individuals to move past the trauma.

It requires specialist support from a mental health professional.

Anxiety Disorders

Intrusive thoughts are also common in various forms of anxiety disorders. They can provoke excessive worry and fear about future events or situations, contributing to a heightened state of anxiety.

In some cases, this can escalate to panic attacks, where the individual experiences an intense and overwhelming fear or discomfort, often with physical symptoms.

The emotional response to intrusive thoughts can vary widely but typically involves significant distress.

For people with these conditions, intrusive thoughts are not easily dismissed and can become consuming, impacting daily functioning and overall quality of life.

Addressing intrusive thoughts within the context of these mental health conditions often involves targeted therapies, such as cognitive-behavioral therapy (CBT).

This therapy helps people adjust their reaction to intrusive thoughts and reduce their impact.

Intrusive Thoughts Worksheet Example: Sonali Age 17 

Sonali, a 17-year-old, was troubled by intrusive thoughts about potential harm to her mother and younger sister.

These thoughts were distressing and at odds with her true feelings, causing significant anxiety and fear.

In search of support, Sonali’s family sought the expertise of a clinical psychologist, who introduced them to cognitive-behavioral therapy (CBT). The aim of the therapy was not to replace negative beliefs with positive ones but to assess their accuracy and find more accurate and helpful perspectives.

The psychologist worked with Sonali to uncover the root causes of her intrusive thoughts.

Together, they explored the underlying beliefs contributing to her distress.

Sonali learned to question the validity of her intrusive thoughts, examining evidence for and against them, and to consider alternative, more balanced viewpoints.

An effective treatment strategy involved Sonali practicing the acknowledgment of her intrusive thoughts as mere thoughts, not realities.

She learned to let these thoughts pass without attaching undue significance to them, a skill that required her to tolerate discomfort without immediate resolution.

Through dedicated application of CBT techniques, Sonali began to be able to spot and assess her thoughts more clearly and to understand that they did not dictate her reality.

This new understanding allowed her to manage her anxiety more effectively and to live with a greater sense of peace and security.

a teen girl worried and anxious sitting in a chair

Intrusive Thoughts: Getting Help for Your Child or Yourself

When intrusive thoughts become overwhelming for you or your child, seeking help is a crucial step towards recovery.

Cognitive Behavioral Therapy (CBT) is among the most effective approaches for managing intrusive thoughts.

It focuses on changing the way we respond to these thoughts, rather than trying to eliminate the thoughts.

Diverse Therapeutic Interventions

Mental health professionals use different forms of therapy to address intrusive thoughts.

These can range from Exposure Therapy, which gradually exposes us to the source of our fear, to Mindfulness-Based Cognitive Therapy, which emphasizes being present and non-judgmentally aware of our thoughts and feelings.

Exposure and Response Prevention

ERP, used in conjunction with CBT, involves learning to resist the urge to perform compulsive behaviors in response to intrusive thoughts.

It’s particularly effective for conditions like Obsessive-Compulsive Disorder.

a therapist and client in cosy therapy room

Qualified Professionals

It’s essential to consult with qualified mental health professionals, such as licensed psychologists or psychiatrists, who have experience in treating intrusive thoughts.

A qualified therapist will guide you or your child through the complexities of your experiences.

Tailored Treatment Plans

In general treatment plans should be individually tailored, taking into account the person’s history, what has contributed to the development of the intrusive thoughts, and their specific needs and goals.

This personalized approach ensures that the strategies and interventions are most relevant and beneficial for the person’s unique situation.

With the right support and a tailored treatment plan, both adults and children can learn to manage their intrusive thoughts more effectively, leading to improved wellbeing and quality of life.

Intrusive Thoughts Worksheet PDF: Summary

Understanding how to manage intrusive thoughts is essential to maintaining your mental wellbeing. The most important thing to remember is that we can be in charge of our thoughts and not the other way around.

In this article I have aimed for a comprehensive guide that you can use straight away for either yourself or your child.

I wanted to fill the guide with practical use strategies and insights into how intrusive thoughts can impact daily life. 

Using the strategies outlined in my Intrusive Thoughts Worksheet PDF and above, you will not only have a comprehensive understanding of your intrusive thoughts but you can immediately use effective ways to navigate them. 

Remember, personal growth comes from acknowledging your intrusive thoughts and learning how to manage them.

Related Articles

CBT Worksheets For Anxiety: Free ABC Anxiety Worksheet

Window of Tolerance Worksheet: Children’s Emotion Regulation

Fight or Flight Worksheet: Free PDF and Guide

Your Boundaries Worksheet (Healthy Boundaries for You & Your Child)

Dr Lucy Russell is a UK clinical psychologist who works with children and families. Her work involves both therapeutic support and autism assessments. She is the Clinical Director of Everlief Child Psychology, and also worked in the National Health Service for many years. In 2019 Lucy launched They Are The Future, a support website for parents of school-aged children.

Through TATF Lucy is passionate about giving practical, manageable strategies to parents and children who may otherwise struggle to find the support they need.

Lucy is a mum to two teenage children. She lives in Buckinghamshire with her husband, children, rescue dog and three rescue cats. She enjoys caravanning and outdoor living, singing and musical theatre.

UK parents, looking for expert parenting advice?

Dr. Lucy Russell’s Everlief Parent Club offers a clear path towards a calmer, happier family life. This monthly membership includes exclusive workshops, direct support from child psychologists, and access to our private Facebook community.

Together, we can move towards a calm, happy family life and boost your child’s wellbeing. Become a member today!