Lead chalcogenides such as PbS, PbSe, and PbTe are of interest for their exceptional thermoelectric properties and strongly anharmonic lattice dynamics. Although PbTe has received the most attention, PbSe has a lower thermal conductivity despite being stiffer, a trend that prior first-principles calculations have not reproduced. Here, we use ab-initio calculations that explicitly account for strong anharmonicity to identify the origin of this low thermal conductivity as an anomalously large anharmonic interaction, exceeding in strength that in PbTe, between the transverse optic and longitudinal acoustic branches. The strong anharmonicity is reflected in the striking observation of an intrinsic localized mode that forms in the acoustic frequencies. Our work shows the deep insights into thermal phonons that can be obtained from ab-initio calculations that are not confined to the weak limit of anharmonicity.