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12 Things Your Therapist* Wants You to Know About Negative, Intrusive, Scary Thoughts


These points refer to therapists who have been specially trained to treat perinatal depression and anxiety.

If you do not feel like you are in the presence of a therapist you can trust or if you find yourself questioning his or her level of expertise in this area, please find yourself another therapist.

We can help you do that.

  1. I know it is hard to talk about the anxiety racing through your mind right now. I know it is difficult to distinguish between what is problematic and what is normal. I can help you figure that out.

  2. If your thoughts are about suicide, you need to tell me that so I can help keep you safe. If your thoughts are about harm coming to your baby, this is more common than you might know and if you feel too anxious to talk about it now, you might feel better talking about it at a later time.

  3. Did you know that approximately 75-91 percent* of new mothers report having negative, intrusive, unwanted thoughts about harm coming to their babies?

  4. You might be surprised to discover that you feel better after you tell me what is worrying you.

  5. Negative thoughts and images that worry you will not worry me.

  6. No matter how scary, how intrusive, how overwhelming your thoughts are, I have probably heard worse and nothing you say will alarm me.

  7. Scary thoughts that are really scary are not diagnostically more serious than any other scary thought. The only thing bad about scary thoughts that are anxiety-driven is that they feel so bad to you.

  8. I know it can feel like you are going mad. Your high level of distress is an important indicator that what you are experiencing is anxiety, not psychosis.

  9. Do not let feelings of shame, embarrassment or guilt interfere with what you want to tell me. It will be okay.

  10. Scary thoughts do not lead to actions.

  11. Nothing bad will happen if you tell me what you are thinking.

  12. You will not be judged here.

Take a deep breath. Decide what is best for you.

Try to put words to your resistance and fear. Believe that I can help you with this so you can start to get some relief.


*Abramowitz, J. (2003; 2006),


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