Intrusive Thoughts · Kitchener, Waterloo & Cambridge
An intrusive thought is an unwanted thought, image or urge that arrives uninvited and upsets you because it runs against what you want. Almost everyone has them: in interviews with 777 university students in 13 countries, 93.6% reported at least one in the previous three months. Having them does not mean you have OCD. If they keep returning, distress you or change what you do, a counsellor is your first visit at CARESPACE, either a Registered Psychotherapist or a Registered Social Worker. If you intend to act on a thought, have a plan, or are thinking about suicide, go straight to the urgent section below.
What intrusive thoughts are
Their content is often violent or sexual, or a fear of doing something embarrassing or inappropriate. Three signs mark one: it is unusual for you, it bothers you, and it feels hard to control.
They are not wishes. Researchers who study them in new parents describe them as thoughts that do not reflect a person’s actual wishes or intentions, and that are felt as unacceptable and out of keeping with who the person is. Many people who have them have no mental health disorder at all.
Sometimes they are one part of something larger:
- OCD. The thoughts return as obsessions and are answered with compulsions, repeated actions or mental rituals. The treatment detail is on our OCD page.
- Post-traumatic stress. They are common in post-traumatic stress disorder, which can follow a life-threatening or extremely stressful event. See trauma and PTSD.
- Stress and anxiety. Both often set them off. See stress and anxiety.
- Depression. In new parents, these thoughts are likely to matter more when they come as part of depression, an anxiety disorder or OCD.
What causes them
The sources give no single cause. A big enough life stress raises the risk, and hormone shifts can bring a short-term increase, for example after the birth of a child.
Thoughts of harm coming to your baby
A research team in British Columbia, summarizing earlier studies, reports that between 70 and 100% of new mothers have unwanted, intrusive thoughts of harm coming to their baby, and that as many as half have unwanted thoughts of harming their baby on purpose. The thoughts usually peak in the first few weeks after the birth. Fathers have them frequently too.
A 2017 UK article for family doctors says such thoughts are not in themselves indicative of risk, and that a parent who has them is no more likely to harm their infant intentionally than any other parent. The B.C. team later tested this. Among 388 new mothers from a province-wide sample, 44.4% reported unwanted thoughts of harming their baby on purpose; aggression toward the infant was reported by 2.6% of them and by 3.1% of the mothers without such thoughts, and the authors found no evidence that the thoughts raised the risk. The same researchers had earlier called the evidence preliminary, resting on few, small studies.
What changes the picture is intent or history: if a parent says they intend to act on the thoughts, or has harmed the baby before, the risk needs to be taken seriously. The article’s advice is that these thoughts be assessed by a clinician, so tell a physician or nurse practitioner about them.
Parents tend to keep these thoughts secret, out of shame and out of fear that the baby will be taken away, so here is how confidentiality works. Registered Psychotherapists and Registered Social Workers are required by their colleges to explain the limits of confidentiality to clients (the social workers’ college says early in the relationship), and you can ask about those limits before you say anything else. One limit is the duty to report: everyone in Ontario, including professionals who work closely with children, who has reasonable grounds to suspect that a child is, or may be, in need of protection must report it to a children’s aid society, and a professional must do so even when the information is otherwise confidential. The UK article says these thoughts are not in themselves a sign of risk; what it says must be taken seriously is an intention to act on them or a history of harming the baby. It calls for careful assessment so that unwanted thoughts can be told apart from the situations that should lead to child protection steps.
When to get urgent help
Call 911 or go to an emergency department now if any of these apply:
- You intend to act on a thought of harming yourself or someone else, or you have a plan.
- You have already harmed your baby or someone else on purpose.
- After a birth, you or the new mother are seeing or hearing things that are not there, hold beliefs that are plainly untrue, are very confused, or have a mood that is racing or changing fast. The NHS in the UK treats postpartum psychosis as a medical emergency. It usually starts suddenly, within two weeks of the birth, and a mother may not realize she is ill, so a partner, relative or friend may be the one who has to act.
- At any time, you are hearing voices that no one else hears, or have trouble telling what is real, alongside thoughts of harming yourself or someone else.
Do not wait for a counselling appointment for any of these: nobody at CARESPACE can assess that kind of risk by phone or online.
See a physician or nurse practitioner as soon as you can if a thought of harming someone no longer upsets you, if you find yourself bringing it on deliberately, or if fear of a thought is stopping you from caring for your baby, for example from feeding.
If what you have is a fear that you might act on a thought you do not want, with no intention of acting, start with a counsellor, a physician or a nurse practitioner. The NHS in the UK lists the fear of deliberately harming yourself or others among the common obsessions.
If you cannot tell which kind of thought you are having, use the crisis numbers below.
If you are thinking about suicide, or you do not feel safe, do not wait for an appointment: use the numbers below.
If you are in crisis or thinking about suicide, help is available right now.
- Call or text 9-8-8, the Suicide Crisis Helpline, at any hour.
- Call Here 24/7 at 1-844-437-3247 for addictions, mental health and crisis services in Waterloo Region, at any hour. here247.ca
- Call 911 or go to the nearest emergency department if you or someone else is in immediate danger.
The emergency departments in Waterloo Region are:
- WRHN @ Midtown (formerly Grand River Hospital), 835 King St. W., Kitchener
- WRHN @ Queen’s Blvd. (formerly St. Mary’s General Hospital), 911 Queen’s Blvd., Kitchener
- Cambridge Memorial Hospital, 700 Coronation Blvd., Cambridge
If you cannot get there safely, call 911.
What the evidence says about intrusive thoughts
- No guideline covers intrusive thoughts on their own. These points come from research on new parents in Canada and the UK, an article reviewed by Harvard Health’s medical editor, and, where OCD is involved, Ontario Health’s 2020 quality standard.
- Pushing them away backfires, and so does avoiding what sets them off. Repeated attempts to suppress an intrusive thought can make it stronger, and the UK article tells parents that avoiding the situations that bring the thoughts on tends to make them more frequent.
- Asking about them has not been shown to make things worse. The same article says there is no evidence that asking a parent about these thoughts makes acting on them more likely.
- CBT is what the sources point to when they persist. Cognitive behavioural therapy is described as one strategy that is often successful, and the UK article says persistent intrusive thoughts in parents can be treated with standard cognitive behavioural techniques.
- Medication. None of the sources recommends one for intrusive thoughts unless they are part of a diagnosed condition.
How CARESPACE helps with intrusive thoughts
Counselling & Psychotherapy
The sources name CBT without setting out a program for intrusive thoughts, so ask a counsellor how they would approach yours. If your thoughts come with rituals, ask when you book whether a counsellor trained in exposure and response prevention is available; if none is, ask a physician or nurse practitioner for a referral, because Ontario’s standard says this therapy should come from someone with expertise in treating OCD. Registered Psychotherapists and Registered Social Workers provide counselling and do not diagnose or prescribe.
More about cognitive behavioural therapy (CBT) →
Nurse Practitioner
A Nurse Practitioner can do the medical side: ask about the thoughts, look for depression, anxiety or OCD, and prescribe if a diagnosis calls for medication. This is a booked appointment, not a route to emergency care.
See our nurse practitioner team →
Where most people start
If the thoughts are unwanted and upsetting and none of the urgent signs apply, start with a counsellor.
How your team works together
Counselling does most of the work. A diagnosis where one is needed, care after a birth and any medication belong to a physician or nurse practitioner.
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Evening availability
Ummehani Rehmani, BSc, MSc, RP (Qualifying)
Psychotherapist
You may be functioning on the outside while feeling anxious, emotionally exhausted, disconnected, or uncertain underneath.
Browse by service: counselling and nurse practitioner.
What to expect at your first visit
A counsellor is the first appointment. You can begin by asking about confidentiality and its limits. After that, it can help to have thought about:
- What the thoughts are about, in whatever words you can manage. Writing them down beforehand is fine.
- What you do afterwards. Avoid something, check, ask for reassurance, repeat a phrase in your head.
- When they started, and what was happening then: a birth, a frightening event, a stretch of stress.
How much you say, and when, is up to you. You leave the first visit with a plan.
What you can do at home
Harvard Health’s advice has three parts:
- Identify it. Recognize the thought as intrusive, not as something you believe or intend.
- Accept it. Let it be there instead of trying to make it go away.
- Do not judge yourself. Having a strange or disturbing thought does not indicate that something is wrong with you.
Outlook
This can be short-lived: Harvard Health says you might not need help forever, and that it may be a very short-term thing. OCD is different, because it is unlikely to get better on its own; see our OCD page.
Help with intrusive thoughts in Kitchener, Waterloo and Cambridge
Kitchener. Counselling in Kitchener. Locations: Victoria North, Fischer-Hallman, Westmount East and Deer Ridge.
Waterloo. Counselling in Waterloo. Locations: Weber North, Uptown Waterloo and Waterloo GoodLife.
Cambridge. Counselling in Cambridge. Location: Hespeler Road.
The city pages linked above show the locations and practitioners for each service, with their next availability.
Common questions
Do intrusive thoughts mean I have OCD?
Not on their own. In OCD they keep coming back as obsessions and are answered with compulsions. Our OCD page explains what to look for.
Does having a violent or sexual thought mean I will act on it?
The NHS in the UK, writing about the obsessive thoughts of OCD, puts it this way: they are just thoughts, and having them does not mean you will act on them. The urgent section above covers the exceptions: a thought you intend to act on, and a thought that has stopped upsetting you.
I keep having thoughts of hurting my baby. Is something wrong with me?
These thoughts are common in new parents, and the research so far has not found that they make a parent more likely to harm a child. Tell a physician or nurse practitioner about them, and act on the urgent signs above if any apply.
Is an intrusive thought about harming myself the same as being suicidal?
If you are thinking about suicide, use the crisis numbers above now. If you cannot tell which kind of thought you are having, use the crisis numbers above. The two are not necessarily the same: a fear of deliberately harming yourself is on the UK NHS’s list of common obsessions. But people with OCD also have a higher risk of suicidal thoughts, so this is not something to settle alone or from a web page.
Who can I talk to about intrusive thoughts in Kitchener, Waterloo or Cambridge?
A CARESPACE counsellor in any of the three cities. For anything urgent, the crisis lines in the urgent section above answer at any hour.
Do I need a referral?
No. Book online or call 519-208-2273. You pay at each visit and receive a receipt for your extended health plan. More on fees and insurance →
Sources
- Radomsky AS, Alcolado GM, Abramowitz JS, et al. Part 1: You can run but you can’t hide: Intrusive thoughts on six continents. Journal of Obsessive-Compulsive and Related Disorders, 2014 (summary only).
- Collardeau F, Corbyn B, Abramowitz J, Janssen PA, Woody S, Fairbrother N. Maternal unwanted and intrusive thoughts of infant-related harm, obsessive-compulsive disorder and depression in the perinatal period: study protocol. BMC Psychiatry, 2019.
- Fairbrother N, Collardeau F, Woody SR, Wolfe DA, Fawcett JM. Postpartum Thoughts of Infant-Related Harm and Obsessive-Compulsive Disorder: Relation to Maternal Physical Aggression Toward the Infant. Journal of Clinical Psychiatry, 2022 (summary only).
- Lawrence PJ, Craske MG, Kempton C, Stewart A, Stein A. Intrusive thoughts and images of intentional harm to infants in the context of maternal postnatal depression, anxiety, and OCD. British Journal of General Practice, 2017.
- Ontario Health. Obsessive-Compulsive Disorder: Care in All Settings (quality standard), 2020.
- Bilodeau K. Managing intrusive thoughts. Harvard Health Publishing, reviewed March 2024.
- NHS (UK). Symptoms: obsessive compulsive disorder (OCD), reviewed April 2023 (its next review was due April 2026), and Postpartum psychosis, reviewed October 2023 (its next review was due October 2026).
- Centre for Addiction and Mental Health (CAMH). Psychosis.
- College of Registered Psychotherapists of Ontario. Professional Practice Standards, Standard 3.1: Confidentiality.
- Ontario College of Social Workers and Social Service Workers. Code of Ethics and Standards of Practice, Principle V: Confidentiality, 2023.
- Government of Ontario. Report child abuse and neglect, updated April 2026.
- 9-8-8: Suicide Crisis Helpline. 988.ca.
- Here 24/7 (addictions, mental health and crisis services, Waterloo Wellington). here247.ca.
Related conditions
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