The scary, intrusive thoughts you can only confess to a search engine

Editor's note: This story discusses violent and graphic mental imagery.

Most people have experienced an intrusive thought even if they can't put a name to it.

These unwelcome flashes of imagination force us to consider horrible scenarios. A new mother might envision dropping her child several stories; a pedestrian might picture hurling himself in front of an oncoming car; a devout person might see herself blaspheming god.

Intrusive thoughts, say experts, have no bearing on a person's intentions or moral character. Rather, they are the product of the brain's constant motion — sometimes what it produces is inexplicably terrifying.

Most of the time, people quickly abandon these thoughts. But for those with a type of obsessive compulsive disorder, such ideas and images come at a relentless pace and can lead to severe anxiety without effective treatment.

The taboo nature of these thoughts is often so great that people who experience them may go years, or a lifetime, without telling a spouse, therapist or trusted religious adviser.

The rise of the internet, however, has given people a new confessor: the search engine.

That blank box, with its blinking cursor, holds considerable promise for people with this type of OCD. While an internet search cannot offer a cure, it does provide a safe harbor of anonymity that makes it possible for people to learn that they have a common and treatable mental illness and to find others living with the same condition.

When anxiety supersedes logic

That's what happened to Aaron Harvey, executive creative director of the New York ad agency Ready Set Rocket. Harvey, 35, spent two decades living with severe anxiety that stemmed from OCD.

At different times he feared being a pedophile, imagined killing himself and thought he might see the devil upon looking in the mirror. These were not just passing thoughts; they consumed his waking life.

This Tweet is currently unavailable. It might be loading or has been removed.

"Anxiety is something that supersedes logic," Harvey, 35, says.

Finally, in a moment of despair in 2014, he searched for "violent thoughts" and discovered a website explaining OCD-related intrusive thoughts, which tend to incorporate themes of violence, sex and religion. Sometimes it can be a mix of all three.

The condition is often referred to as "pure obsessional" or "pure O." These terms are meant to convey that, in contrast to physical compulsions like frequent hand washing, checking or organizing, the illness often plays out exclusively in one's mind. People who experience intrusive thoughts may attempt to drive them away by practicing mental compulsions such as counting, praying and self-reassurance.

Though it can be shocking when the brain produces these random taboo thoughts, they are a normal and common experience for those with or without OCD, says Jeff Szymanski, executive director of the International OCD Foundation.

In many cases, they emerge infrequently, cause little to no anxiety and may be easily dismissed. People with OCD, however, find their brain regularly generates troubling thoughts. Mistakenly, they believe a thought represents a desire to act. Panicked efforts to avoid and suppress their thought process only make things worse.

Scientists don't yet understand what causes OCD, but suspect it has multiple origins, including genetics and differences in brain functioning. An estimated 1 percent of the U.S. population has OCD, and half of those cases are severely debilitating, according to the National Institute of Mental Health.

The revelations from Harvey's internet searching helped him seek and find treatment, but the preponderance of impersonal and jargon-filled sites also convinced him that the internet could better help people identify their condition and finally get relief.

In March, he launched IntrusiveThoughts.org, a sleek website that describes symptoms of OCD subtypes, explanatory videos, first-person essays and treatment information.

Harvey hopes to reach people with life-saving resources that took him 20 years to find.

"What is the online journey someone in this position is going to take?" he asks. "The first thing they’re going to do is confide in Google."

'I'm not alone in the universe'

Jon Hershfield, a psychotherapist who has OCD and specializes in treating the disorder, has seen this play out firsthand.

Hershfield, director of The OCD and Anxiety Center of Greater Baltimore, runs a Yahoo Group called Pure O, which is dedicated to helping people with primarily mental compulsions.

The group has more than 2,800 subscribers and membership is available only to those with the disorder. While some OCD listservs permit family members and researchers to join, Hershfield wants to ensure that people feel comfortable disclosing thoughts they've probably never shared with anyone else.

The conversations often focus on unwanted sexual thoughts related to pedophilia, blasphemy and violence as well obsessions concerning sexual orientation and relationships.

New moms, in particular, may obsess over dangerous or deadly accidents occurring to a newborn, or imagine personally causing harm to their child.  

This Tweet is currently unavailable. It might be loading or has been removed.

"The main problem is struggling with whether these thoughts represent your identity," says Hershfield.

The group is designed to help members make that vital distinction — and keep reinforcing it in times of doubt. The goal, Hershfield adds, is not for members to definitively prove fears about their identity wrong, but to encourage them to accept uncertainty and develop self-compassion.

Hershfield, 39, understood that he had OCD as a teenager and received treatment early on, though he says he didn't take it "seriously" until his late 20s. The internet became essential in his recovery not because it could provide long-sought answers, but because it offered a sense of community.

Hershfield is also careful to stress that excessive online searching can be "toxic" for those with OCD if it becomes a compulsion of reassurance rather than a source of information or support.

"When I reached out to the internet, it was to feel not so isolated," he says. "I wasn't going to make the strides I had to make on my own, and discovered no, I'm not alone in the universe. I’m not the only person in the world who has this problem."

Wendy Mueller sees the same empowering effect in her Yahoo Group called OCD-Support, which has more than 5,400 members and includes discussion of OCD's many subtypes. When new members who have intrusive thoughts join, she says they often respond with some variation of, "I can't believe this — I thought I was the only person in the world who had these kinds of thoughts. I thought if I told anyone, I'd be locked up in a mental asylum and my kids would be taken away from me."

In return, strangers often offer encouragement, resources and reassurance. The exchanges are moderated by Mueller and two other volunteers; experts in the field frequently weigh in with medical guidance.

Mueller believes the oversight is critical. Without some level of monitoring and professionalism, bad information can spread and commenters may bully those who share intrusive thoughts.

Still, many members of OCD-Support commonly use fake names, afraid of the stigma associated with the condition or that it might be used against them.

Through the listserv, Mueller hopes to draw people from isolation and offer them hope: "What a tremendous relief to have people one by one saying, I think that just like that too."

Changing the experience

As Harvey knows, it can be an arduous path from identifying and understanding the disorder to getting effective treatment.

He began working with a psychiatrist in 2014. For the past year, his treatment has focused on a technique known as Exposure Response Prevention (ERP), which has been shown to be effective in helping patients systematically confront their fears and experience less distress as a result.

Harvey has since tried, for example, driving without putting his car in park when he comes to a stop, a tactic he'd previously used compulsively when he feared hitting pedestrians. He uses anxiety-management skills like yoga and meditation to create calm in what he describes as a very busy mind.

This Tweet is currently unavailable. It might be loading or has been removed.

In addition to ERP, psychiatrists may also use antidepressants at higher than usual dosages to treat this subtype of OCD, but Harvey found that the side effects outweighed the benefits in his case. He still experiences intrusive thoughts, but finds it easier to let them pass.

Harvey wants to make it easier for people to learn about diagnosis and treatment while avoiding the detached clinician's voice common to medical websites, including those about OCD.

Harvey's target audience is teens and young adults between the ages of 13 and 24. IntrusiveThoughts.org, a nonprofit site, aims for a softer tone of voice and focuses on storytelling. Its modern design, with a black, white and yellow color palette, might appeal to users otherwise tempted to spend their free time on Snapchat or Instagram.

The traditional long blocks of bulleted text are replaced by first-person essays and brief explanatory paragraphs. Harvey also enlisted Dr. Steven Phillipson, a psychologist specializing in OCD and clinical director of the Center for Cognitive Behavioral Psychotherapy in New York, to appear in videos.

While Harvey has no plans to make money off the site, he does believe online mental health resources could become more vibrant and user-friendly with increased entrepreneurialism in the space.

"I think there’s an opportunity to change the experience to improve [people's] lives," he says. "There's a million reasons why it would be hard for people to get the right type of information."

Szymanski says sites like Harvey's and The Other OCD, which is similarly dedicated to intrusive thoughts, do important work in "shedding light" on the disorder's subtype.

People's willingness to discuss their own experiences, he adds, has grown rapidly in the past few years, creating increased awareness of the disorder while undermining the stigma that has prevented many from reaching out.

Like many who've publicly shared their struggle with OCD and created an internet resource to help others, Harvey believes he uniquely understands a common process of recovery.

"I'm trying to create that resource for me 22 years ago," he says, reflecting on the first time he experienced a violent intrusive thought. "If I can save someone 20 years or 40 years [of anxiety] or prevent them in high school from thinking they’re crazy ... there's a million different things I could have a positive impact on."

To find therapists, clinics, treatment programs, support groups, and organizations that specialize in OCD, visit the International OCD Foundation. If you want to talk to someone or are experiencing suicidal thoughts, text the Crisis Text Line at 741-741 or call the National Suicide Prevention Lifeline at 1-800-273-8255. For international resources, this list is a good place to start.