Intrusive Thoughts

We have a special guest blog today from my London colleague Dr Caroline Boyd, who has done some fascinating research on maternal mental health, in particular intrusive thoughts. Her research has helped reduce shame & stigma surrounding common issues that most mothers experience but don’t often talk about. I’m very pleased to be able to share her work with you.

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Hi, I’m Caroline. I am a perinatal clinical psychologist and I work with parents around all aspects of the transition – from pregnancy to childbirth and beyond. I have over 10 years’ experience working in the NHS and mental health settings, and specialise in supporting new parents in my independent psychology practice, Parent Therapy Hub.

My published research explores mothers’ experiences of intrusive thoughts about their babies. Knowledge is power: I speak at conferences, and share psychology ideas on Instagram, my blog, and podcasts such as Motherkind to help parents feel more connected – to themselves and their children – and less alone. You can follow me on Instagram @_drboyd.

Trigger warning – discussion of unwanted intrusive thoughts of harm coming to the baby. Please take care when reading.

What are intrusive thoughts?

“What if I drop my baby? What if my baby stops breathing? What if I throw my baby off the balcony?”

Unwanted, intrusive worries of harm coming to our baby are really common – especially in early motherhood when our threat system is on high alert.

These attention-grabbing, anxiety-driven thoughts include word thoughts (such as “What if my baby stops breathing?”), vivid images (e.g. a mental picture of the baby rolling off the changing mat), and impulses or urges (a sudden impulse to throw the baby). Broadly, there are two categories of unwanted, infant-related harm thoughts.

One is accidentally harming a child, reported by nearly every single woman in my study and larger studies. Examples include an image of the baby suffocating, or falling or being dropped.

The second type are thoughts of intentional harm – reported by 1 in 2 women. Examples of intentional harm thoughts include screaming at the baby, or impulses to shake or throw the baby. These harm thoughts can pop into a mother’s mind unexpectedly and evoke horror – even though she would never deliberately hurt her baby.

Women often feel intense shame, guilt or horror when they have these thoughts – which means they don’t talk about them. Shame keeps us from sharing our thoughts which can be experienced as frightening and paralysing. The very fact mums feel ashamed or horrified about having these thoughts is a strong sign that they’re not going to hurt the baby. These thoughts tend not to sit comfortably with the woman – meaning that they’re not indicative of risk in themselves. Brand new research (Fairbrother et al, 2022) shows that experiencing these unwanted thoughts makes you no more likely to deliberately hurt your baby than any other parent.

Why else don’t mums talk about their thoughts?

Many women believe their unwanted thoughts are a sign that they’re a ‘bad’ mum. It’s the meaning that mothers draw from their thoughts and visions that gives them power. None of the women I interviewed in my published study shared their harm thoughts with a health professional, due to fears of being judged an unfit mother or having their baby taken away. This is what I call the policing effect of aspiring to be “Supermum”. It relates to Western-centric myths of motherhood – the Supermum myth – promoting the idealised mother as ‘natural’, blissed-out and forever fulfilled. This toxic myth gets internalised, leading to mums believing that they must prove to themselves and others that they’re always calm, coping and in control.  Of course, when we experience the messy reality of having a baby, we discover how living up to this ideal is impossible, and it sets women up to fail.

What helps?

3 tips for managing your unwanted intrusive thoughts:

1) Understand why they occur in early motherhood

Mums can experience these kinds of thoughts as part of the adjustment to having a baby – a way of adapting to the huge responsibility. Unwanted, intrusive thoughts about our babies made the women I interviewed more conscious of their power in contrast to their baby’s acute vulnerability. This means these thoughts can be understood as an adaptive response – helping mums figure out what’s morally acceptable, and what’s not. A bit like an ‘effective warning system’.

2) Talking really helps

These kinds of thoughts can become problematic when mums interpret them to mean they’re somehow failing or a bad mother. For more vulnerable women, their intrusive thoughts may lead to the development of Obsessive Compulsive Disorder (OCD). This is why talking about your thoughts is so important – bringing validation and huge relief – and helping you make sense of them.

Try taking a small risk and talk to a trusted mum friend or partner. When women can talk about their intrusive thoughts, and feel validated (a mum friend may well have similar experiences given how common these thoughts are), they realise they’re not a bad mum, and feel less alone.

3) Practising mindfulness skills to help you notice your thoughts – and let them go

What’s most important for helping you manage these unpleasant thoughts is about how you respond in the moment. Unfortunately, the more we fight or struggle against our thoughts, the more they grow in power and intensity. So try practising mindfulness skills to help you separate from your thoughts – helping to disempower them. Next time you experience an unwanted thought of harm about your baby, try telling yourself gently: “Hello there harm thought. You’re simply a thought. This experience doesn’t mean anything bad about me. I’m a good enough mum and I am safe.” This practice of noticing your thoughts, acknowledging them with kindness and then letting them go allows you to step back from your thoughts – giving you more space to respond rather than react.

**Note on help-seeking**

If you’re struggling with your intrusive thoughts, please talk to a trusted health professional, such as your GP. You can also access private talking therapy in the United Kingdom (eg www.bacp.co.uk/search/Therapists). For emergency support in the United Kingdom, please call 999 or visit A&E. For emergency support in the United States, please call your doctor, 911, or visit your nearest hospital Emergency Room.

For more info, please see Caroline’s Instagram page @_drboyd

Refs: Fairbrother et al (2022), Boyd & Gannon (2019), Stadlen (2004).

Caroline’s new book, Mindful New Mum: A Mind-Body Approach to the Highs and Lows of Motherhood, is available to purchase here:

When I was asked to write Mindful New Mum, I knew I wanted to make it as helpful as possible for a new mum. I’ve read lots of the parenting books & research so you don’t have to – my aim is to share ideas accessibly in a way I hope reassures & anchors you as a new mum.

Mindful New Mum is an antidote to all the parenting manuals prescribing a “right” way to mother. I offer holistic care with a focus on mindful compassion, evidence-based psychology ideas, meditations, visualisations plus nutritional advice, natural remedies, baby massage & yoga.

Birthing this baby was a real labour of love – bringing together all my ideas & experience from my clinical practice, published research and my own experience as a parent. I really hope my book helps mums understand:

• Significant brain, body, and identity shifts during this transformation known as “matrescence”.
• The intense, emotional rollercoaster of this first year, explaining why experiencing feelings such as anger & anxiety doesn’t make you a “bad” mother.
• Why it’s important to learn to self-soothe, with practical psychological strategies to help you nurture yourself, as well as soothe your baby.
• Why couple dynamics shift with the arrival of a baby, and ways to stay connected.
• How to use your values to guide your decision-making, making choices that fit for YOUR family.
• I also include info on intrusive thoughts – & real-life experiences from mums.