Postpartum Anxiety & OCD – What are intrusive thoughts?

Most mothers that come to us talk about having intrusive thoughts or worrying constantly. ⁠Of course, if you are a new parent, it makes sense that you feel anxious at times, since you are now in charge of this new little life with no owner’s manual to guide you! ⁠Your primal protection mechanisms are in high gear, and it’s you are acutely aware that it’s your job to keep this little one alive.⁠ Below we describe some common thinking patterns in perinatal anxiety & OCD and elaborate on intrusive thoughts.


Common Thinking Patterns in Anxiety & OCD


Overestimation of threat/catastrophizing

As the name suggests, people experiencing OCD find that their minds often lead them to assume the worst-case scenarios. Their anxiety about the future will ask, “what if? What if the worst happens?” They may also have distinct, graphic images about terrible things happening, as we will discuss more below.

Inflated responsibility

This is also referred to as “magical thinking” and is the belief that you are responsible for preventing bad things from happening to others, usually people close to you. People with OCD with then can obsess about every little thing that they do, and hold perfectionistic standards for themselves. They will also engage in rituals which, on some level, they believe will prevent misfortune, accidents, injuries, or illness.

Thought-action fusion

Individuals with OCD typically hold a strong mental association between their thoughts and their actions. However, the reality is that a thought has no bearing on whether it will happen. For example, if you thought that you’d like to win the lottery, would that happen? This question can serve as a good reminder to help defuse this belief.

Intolerance of uncertainty (IU)

This is a common mental habit, at the core of any kind of anxiety disorder, including OCD. IU is where an individual is chasing 100% certainty and control, and they feel very uncomfortable sitting in ambiguity. Of course, this is not a realistic pursuit given that there is so much outside of our control in life, especially during the perinatal period. The gap between what is being pursued and what is realistic, can lead a woman to feel overwhelmed, out of control, and self-blaming.


Intrusive thoughts are common in motherhood

One of the ways postpartum anxiety can manifest is in intrusive thoughts. Some examples in a new mother would be:

“what if I fall down the stairs and drop my baby?”

“what if grab the kitchen knife and stab my baby?”

“what if the baby stops breathing while I’m asleep?”

“what if I drive off the road with the baby in the car?”

Intrusive thoughts are ideas and images that come to mind suddenly and are typically unwanted by the person experiencing them. This could be a thought which makes you feel a little bit uncomfortable, or cause you to feel disturbed, disgusted, ashamed, and a range of other emotions. Often women experiencing these suffer in silence, as they do not want to even tell their partner the nature of the thoughts – for fear of judgment or what is could mean about them as a mother. This is capture so well by the book Good Moms Have Scary Thoughts, by Karen Kleiman. This is an excellent resource for women experiencing intrusive thoughts postpartum. 


Intrusive thoughts are not the same as action

Thought-Action Fusion is a term used to describe the assumption is that if you’re having a thought, especially a serious one, then there must be some truth to it. This is one of the many reasons why intrusive thoughts can feel overwhelming and also why many people feel reluctant to open up about having intrusive thoughts. They may withhold their experience from their partner, friends and family, or even medical professionals. It’s important to know that THOUGHTS DO NOT EQUAL ACTION. Thoughts are just mental occurrences and it doesn’t mean you’ll act on them.


Intrusive thoughts do not define you

We find that in our counseling office, most of the women become quite emotional and upset when sharing their intrusive thoughts. This is understandable, as the thoughts can be quite disturbing, especially to say out loud for the first time. Know that YOU ARE NOT YOUR THOUGHTS!

A major shift occurs when our clients start trusting that this is the case – as they can detach their identity and meaning from their thoughts, they typically feel less worried about what could happen, and they can begin to ease up on themselves.

New mothers who describe unwanted intrusive thoughts are NOT any more likely than those without these thoughts of acting on these thoughts. It’s also important to familiarize yourself with when these intrusive thoughts may be turning into perinatal OCD. You can read more about perinatal OCD here.  ⁠

The Postpartum Depression & Anxiety Workbook

Take control of your postpartum mental health with our popular Postpartum Depression & Anxiety Workbook. This is an easy-to-read guide, with therapist-designed exercises and techniques to help you manage intrusive thoughts, work through anxiety, and build self-care strategies. This is the roadmap to feeling more like yourself!


Ready to Get Started with Counselling?

You don’t need to go through this alone. We have a team of counsellors that can help you work through anxiety, OCD, or postpartum adjustment. Our in-house therapist Sara specializes in perinatal anxiety and OCD. If you’d like to work with her, you can learn more on her bio page here


Crisis Resources for Perinatal Mental Health in Canada

Canadian Crisis Hotline (phone or text): 9-8-8

Pacific Postpartum Support Society: 1.855.255.7999

Postpartum Support International (helpline): 1.800.944.4773

Postpartum Support International (website):

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