When Intrusive Thoughts Aren’t Just Cognitive: A Somatic Perspective for Black Women
Intro: Recognition, Not Diagnosis
If you’re a capable, thoughtful Black woman who gets things done—and yet feels mentally exhausted—you’re not alone. You may move through work, relationships, and responsibility with precision, while privately managing intrusive thoughts that won’t quiet down. Thoughts that loop, alarm, or demand certainty. Thoughts that feel out of proportion, yet impossible to ignore.
Many women I work with across California tell me they’ve tried reasoning with these thoughts, analyzing them, or pushing past them. They know the thoughts don’t fully make sense—and still, their body reacts as if something urgent or dangerous is happening. This isn’t a failure of logic or insight. It’s a nervous-system response.
Intrusive thoughts—sometimes described as Pure O or OCD-related anxiety—aren’t just about what you’re thinking. They’re about how your body has learned to stay on alert in environments that require vigilance, performance, and constant self-monitoring. When you live under pressure, visibility, or real consequences, your nervous system adapts to protect you. Over time, that protection can turn inward.
This post isn’t about diagnosing you or telling you what you “have.” It’s about understanding why intrusive thoughts feel so convincing—and why approaches like ERP-informed therapy, when paired with somatic care, focus on the body as much as the mind.
Intrusive thoughts don’t start as ideas—they start as physiological alarms.
A thought appears, and before you’ve had time to assess it, your nervous system reacts. Heart rate increases. Muscles tighten. Attention narrows. The body moves into urgency. This sequence happens fast, beneath conscious awareness, and it’s driven by survival systems designed to detect threat.
That’s why logic alone rarely helps. You can understand a thought intellectually, remind yourself that it’s unlikely or irrational, and still feel unsettled. Reassurance may help briefly, but the relief doesn’t last—because the body hasn’t received the signal that it’s safe.
For Black women, this is especially important to name. Many intrusive thoughts emerge in contexts where risk has not been imaginary: workplaces shaped by surveillance, environments that demand perfection, or systems where mistakes carry heavier consequences. When the nervous system has learned that vigilance is necessary, it doesn’t stand down just because a thought can be explained away.
This is where intrusive thoughts differ from ordinary worry. The distress isn’t maintained by a lack of insight—it’s maintained by a body that has learned to respond quickly, intensely, and repeatedly. Until that physiological loop is addressed, the mind keeps getting pulled back into managing the alarm.
Understanding intrusive thoughts as nervous-system driven doesn’t minimize their impact. It explains why so many thoughtful, competent women feel stuck—and why approaches that work with the body, not just cognition, can create meaningful change.
Why This Often Goes Unrecognized as OCD
Many people don’t see themselves in common descriptions of OCD—and that makes sense. When OCD is discussed publicly, it’s often framed around visible behaviors: repeated hand washing, checking the stove, counting rituals, or obvious compulsions. If you’re not doing those things, it’s easy to assume OCD doesn’t apply.
But for many adults—especially thoughtful, high-functioning women—the compulsions happen internally. This is sometimes referred to as Pure O, though the experience is very real even if the behaviors are less visible. Instead of outward rituals, the nervous system relies on mental strategies to manage threat.
This can look like:
Constant mental reviewing or replaying conversations
An urge to “figure it out” until something feels certain
Scanning for what could go wrong
Quietly reassuring yourself over and over
Trying to think the right thought to neutralize discomfort
Because these strategies happen in the mind, they’re often mistaken for anxiety, overthinking, or even diligence. In high-responsibility environments, they may be rewarded. Being careful, vigilant, and self-monitoring can look like competence—especially for Black women navigating workplaces and systems where the margin for error is small.
Over time, though, these internal compulsions keep the nervous system locked in threat-monitoring mode. The body doesn’t get the chance to learn that it can tolerate uncertainty or let a thought pass without responding to it. The loop stays active—not because you’re doing something wrong, but because your system learned that mental engagement was the safest option.
This is why many people arrive in therapy feeling unseen or misunderstood. They’re told they seem “fine,” or that they just need better coping skills, when what’s actually happening is a physiological pattern that hasn’t been named yet.
Recognizing this pattern isn’t about labeling yourself. It’s about understanding why managing thoughts has felt so exhausting—and why approaches that work directly with the nervous system can offer a different kind of relief.
Two Gentle Somatic Practices You Can Try Now
These practices aren’t meant to fix intrusive thoughts or make them disappear. They’re small ways to help your nervous system experience safety and choice—often a necessary foundation before deeper work can happen. You can stop at any point. Nothing here requires pushing, forcing, or doing it “right.”
Somatic Practice #1: Orienting to Safety
What this supports:
This helps reduce baseline threat by reminding the nervous system that, in this moment, you are not in danger.
You might try:
Letting your eyes slowly notice a few neutral or pleasant things in the room
Feeling where your body makes contact with the chair, floor, or ground
Taking one or two natural breaths without changing them
This practice isn’t about calming down. It’s about letting the body register where you are now, rather than staying oriented to threat.
Somatic Practice #2: Noticing Sensation Without Solving
What this supports:
This helps interrupt the habit of mentally engaging with intrusive thoughts.
If a thought arises, you might:
Notice what happens in your body (tightness, heat, pressure, urgency)
Stay with the sensation briefly—without analyzing the thought
Stop as soon as it feels like enough
There’s no need to understand the sensation or make it go away. Even a few seconds of noticing builds the capacity that deeper nervous-system work relies on.
Why These Practices Help — and Where They Stop
The practices above help build awareness and tolerance. They give your nervous system small experiences of safety, choice, and presence—often for the first time in a long while. That matters.
At the same time, self-practices have limits.
Intrusive thoughts and OCD-related anxiety aren’t sustained by a lack of insight or effort. They’re sustained by learned nervous-system patterns that often require relational, paced support to shift. While noticing sensations and orienting to safety can reduce reactivity, many people find that the body continues to pull them back into threat-monitoring mode without guidance.
This isn’t a personal failure. It’s how nervous systems learn.
For many people, especially those who have lived under long-term pressure or vigilance, change happens most reliably when the nervous system can learn—over time, and in relationship—that it doesn’t have to stay on high alert.
When Therapy Helps — and an Invitation
When intrusive thoughts feel like they run your body rather than your mind, somatic, ERP-informed therapy offers a way to work with that pattern gradually and sustainably.
In therapy, the work is paced, collaborative, and grounded in nervous-system readiness. Rather than pushing for certainty or symptom elimination, the focus is on helping your body experience activation—and settling—without relying on mental compulsions.
ERP-informed therapy for intrusive thoughts and OCD-related anxiety
If you’re in California and curious about whether this kind of work might support you, that page offers more detail about how I work and what to expect.