I have this too. From what I have read online it is not that uncommon. I have only talked to a few people about it, my husband, my doctor and my brother who has depression. For some reason it is usually violent images and thoughts, or sexually extreme or taboo thoughts that you have no interest in doing but they come into your mind unbidden. It also includes thinking of impulsive actions that you would not do, like the car swerving example or standing up and swearing in church, stabbing someone, hurting a child, etc. The difference from compulsions is that you would never do them, and in fact they are very disturbing to you. I had this very bad in the past. The thing that really wears me out however, is the intrusive thoughts I have after social interactions. I can come home from a gathering and feel like it was fun and in a few hours I have memories forming that I embarrassed myself by saying stupid and insensitive things, had weird mannerisms, and then complete self-loathing takes over. My husband assures me that everything was totally fine and that my friends love me and think I am smart, funny, sensitive and that I acted completely appropriate. But it does not match with my internal version. I had a job interview on Friday that immediately after I thought went great, I celebrated on Friday night and then spent all weekend crying because of thinking of things I said or did that were stupid and embarrassing in the interview. I feel like I don't even care if I get the job or not, all I care about is if they thought I seemed ridiculous and stupid. (I have a 30 year career in a professional field and a master's degree!) My thinking is so distorted I cannot trust my perceptions or instincts at all.