Those Damn Unwanted Thoughts!

[Daniel E.]

Those Damn Unwanted Thoughts!
By Robert L. Leahy, Ph.D.
Psychology Today blog: Anxiety Files

June 1, 2009

Have you ever felt plagued by thoughts and images that you just couldn't stand? Perhaps it's the nagging thought, "I made a mistake" or "I think I have cancer" or "I'm going to lose control". These thoughts seem to intrude on your mind and you try to block them out. You think about your thought and you say (to yourself) something like the following:

• I'm having that thought again.
• What's wrong with me that I'm thinking that?
• It must mean something-about me.
• I have to do something--- make sure it doesn't become a reality
• I have to stop having that thought.

You have begun noticing that thought and you are interpreting it over and over as something really significant-something about you. Maybe it "means" you are going crazy, you're evil, you're going to have a panic attack, you're going to attack someone. You are running around thinking your mind is your enemy. You feel out of control and wonder, "Why am I having these crazy thoughts?"

You are battling your mind. You think, "Normal people don't have these thoughts". You are afraid of the thought, embarrassed, and you think that the thought predicts something about the future. Maybe the thought means you are dangerous or be punished by God.

Welcome to the world of "intrusive thoughts". Cognitive therapy can help you. Your problem is not that you have having intrusive thoughts. Your problem is how you are evaluating them, how you are trying to suppress them and how you avoid situations that evoke them. The problem is not the thought-it's what you try to do about the thought.

Thinking about your thoughts

Three rules are important.

1. Everyone has crazy and disgusting thoughts
2. Thoughts are not the same thing as reality
3. Thought-suppression doesn't work.

Research on people without anxiety disorders shows that almost 90% of them have "bizarre" thoughts---thoughts about contamination, harm, religious impropriety, losing control, sexual "perversion"---you name it, we all have thought about it before. So, your "weird" thoughts might mean nothing about you. Join the crowd. We are all a little weird. I like to think of this as "we all have an imagination".

Thoughts and reality are not the same. If they were, you'd be rich. Try to think about a pot of gold. Think about it all day. Wish for it. Pray for it. At the end of the day, all you will have are a lot of thoughts. You can't take your thoughts to the bank.

Your idea that thoughts=reality is what Jack Rachman of the University of British Columbia called "thought-action fusion". People with obsessive compulsive disorder think, "If I think I will lose control, I will" or "If I think that Satan might possess me, he will". Sorry, it's just a thought.

Also, thought suppression doesn't work. Perhaps someone told you, "Snap a rubber band on your wrist every time you have that (BAD) thought". It doesn't work. The thought keeps coming back. Leon Tolstoy described a game he played when he was a kid in Russia. They would stand in a corner and try not to think about a white bear. Years later, Harvard psychologist Dan Wegner showed that people instructed not to think about a white bear were more likely to think about white bears. Thought suppression leads to thought rebound.

Cognitive therapists have been interested in how we evaluate our intrusive thoughts. For example, Canadian psychologists Christine Purdon and David Clark have reviewed the research on intrusive thoughts. They find that evaluations and thought-control strategies for intrusive thoughts and images are a core feature of all of the anxiety disorders. People with OCD try to suppress and neutralize thoughts and images---often with compulsive rituals. People with social anxiety disorder treat their intrusive thoughts about "appearing anxious" as the equivalent of being humiliated. And people with PTSD treat their intrusive images and sensations as evidence that the trauma is happening now. It's like we are running away from our minds.

It's like trying to run away from your hips. No matter how fast you run, they're always there.

Robert L. Leahy, Ph.D., is the author of Anxiety Free and The Worry Cure.

 

[forgetmenot]

Thanks Daniel " It is like were trying to run away from our minds" exactly but there is no where to run to!

 

[Daniel E.]

Why Thought Suppression is Counter-Productive
May 2009
Source: PsyBlog

How pushing a thought out of consciousness can bring it back with a vengeance.

It sometimes feels like our minds are not on the same team as us. I want to go to sleep, but it wants to keep me awake rerunning events from my childhood. I want to forget the lyrics from that stupid 80s pop song but it wants to repeat them over and over again ad nauseam.

This internal battle can be anything from the attempt to suppress an occasional minor irritation (did I turn off the cooker?) to a near-constant obstacle to everyday life. Perpetual thoughts of food drive people to obesity, persistent negative thoughts cue depression and traumatic events push back into consciousness to be relived over and over again.

The classic response to this mental wrangling -- whether relatively trivial or deadly serious -- is to try and forget about it, push it to the back of our minds or some other variation on the theme. Unfortunately counter to our intuition about what should work, psychological research has discovered in the last twenty years that this approach is not just wrong, but has the potential to make the situation worse.

Thought rebound
In the study that kicked off research in this area Professor Daniel Wegner and colleagues investigated the effects of thought suppression (Wegner et al., 1987). Participants were first asked to try not to think about a white bear for 5 minutes, then for the next 5 minutes asked to think about a white bear. Throughout the experiment participants verbalised whatever thoughts they were having and, each time they thought of a white bear, rang a bell.

Participants who first tried to suppress their thoughts rang the bell almost twice as often as participants in a control group. It appeared that the very act of first trying to suppress a thought made it fight back all the stronger.

This effect has subsequently been replicated by other researchers using different types of experiments and appears to be relatively robust (Wenzlaff & Wegner, 2000). The same results are even found when people are not directly instructed to suppress certain thoughts, but are merely encouraged to do so through subtle forms of manipulation. It has been dubbed the 'post-suppression rebound effect' and may well be crucial to many aspects of our everyday experience.

Suppressing emotions
Since the discovery of the rebound effect researchers have probed the situations in which it occurs, especially how suppression interacts with emotions. Unsurprisingly thoughts more emotionally laden than white bears are particularly vulnerable to the rebound effect. In one study participants were asked to write about either an emotional or nonemotional everyday event (Petrie et al., 1998). It was the emotional events that were hardest for participants to suppress. It's as if the emotional content of a thought makes it even more likely to push back against the attempt to suppress it.

But even if emotional events are particularly susceptible to the rebound effect, perhaps we get better at suppressing particular thoughts with practice? Maybe the reason people find it difficult to suppress the idea of a white bear is that it's an unusual thought. Studies have, therefore, looked at how people manage when they are suppressing thoughts they are used to suppressing.

Wegner and Gold (1995) examined emotional suppression by delving into people's romantic pasts using a neat comparison between 'hot flames' and 'cold flames'. A 'hot flame' is a previous partner who still fires the imagination, while a 'cold flame' is a previous partner for whom the thrill is gone. In theory the 'hot flame' should produce more intrusive thoughts so people should have more practice suppressing them. Meanwhile because the cold flame doesn't produce intrusive thoughts, people should have less practice suppressing them.

The results revealed exactly the expected pattern: people found it harder to to suppress thoughts about cold flames presumably because they had less practice.

Suppressing thoughts in the lab is one thing, though, suppressing them in real life, over a period of time, is quite another. To get an idea about suppression over longer time-frames, Trinder and Salkovskis (1994) asked people to monitor intrusive thoughts over four days. Compared with a control group, participants who tried to suppress negative intrusive thoughts found it more uncomfortable and moreover experienced more of the thoughts they were trying to suppress. It seems that even with practice thought suppression is likely to lead to the rebound effect in the long-run.

Back with a vengeance
Spurred on by these findings of the paradoxical effects of thought suppression, psychologists have uncovered this rebound effect in all sorts of other contexts. Here are some examples discussed by Wenzlaff and Wegner (2000):

• Substance cravings. For those on a diet or trying to quit smoking, thought suppression may be counter-productive. One study found that smokers trying to suppress thoughts about smoking were found to have higher cravings than those who had not tried to suppress their thoughts (Salkovkis & Reynolds, 1994). Distraction emerged as a better technique.
• Intrusive memories. Just like trying not to think about food or cigarettes, memories also seem to come back stronger when they are intentionally suppressed. But only some aspects of memory seem to be enhanced, with suppression sometimes interfering with the order in which events are recalled.
• Depression. Depression manifests itself as a pattern of negative thinking where the worst is seen in almost everything. Simply trying to suppress these thoughts may bring them back stronger, with psychological distress redoubled. Consequently some psychologists have suggested an acceptance-based model of treatment (e.g. Marcks & Woods, 2005).

These are just a few examples, studies have also looked at people's attempts to suppress traumatic incidents, their prejudices, their physical pain and their obsessions. A familiar pattern emerges in many studies: the attempt to push away thoughts about pain, trauma or obsession brings them back with a vengeance.

Our disobedient minds
So what is it about our minds that makes them so disobedient? Why, when we want to get rid of a thought from our heads does it come back stronger? Professor Daniel Wegner provides a neat explanation called ironic processes theory. This argues that the post-suppression rebound effect isn't just some random consequence of how the brain is wired, but an integral part of the process of suppression itself (Wegner, 1994).

According to this theory, here's what happens when I want to stop a recurrent thought in its tracks: First I distract myself by intentionally thinking about something else. Secondly, and here comes the irony, my mind starts an unconscious monitoring process to check if I'm still thinking about the thing I'm not supposed to be thinking about - you know, to check if the conscious process is working or not.

The trouble comes when I consciously stop trying to distract myself and the unconscious process carries on looking out for the thing I was trying to suppress. Anything it sees that looks vaguely like the target triggers the thought again and round I go in another loop of thinking the same thought I was desperately trying to forget about.

The irony of thought suppression, then, is that actively trying to manage our own minds can sometimes do more harm than good. Although it makes perfect intuitive sense to try and suppress unwanted thoughts, unfortunately the very process we use to do this contains the seeds of its own destruction. The more we try and push intrusive thoughts down, the more they pop back up, stronger than ever.

 

[Mashka]

Whenever I would have a thought like this, I would always describe it to my old counselor, or the one other person who knew about the thoughts, as "it" because the thoughts were so disgusting and demeaning that I couldn't mentally handle saying "I thought"-I always had to say "and then it told me" or "and then the thought came"

 

[Daniel E.]

From a new blog post that is related to the articles above:

One technique that can be helpful is to make friends with the thought....

Imagine that your mind is a house in the woods, you are all alone and there is a guest that shows up uninvited...

Your intrusive thoughts are like this. They only want your company for a short time. When you hear an intrusive obsession do not fear it, do not run away, do not shut the door. Simply say to your thought, "Ah, you are back again. Welcome. Sit for a while and rest. I have my other things to do, but I know that you need to come in out of the cold".

Having a New Relationship to Your Obsessions: Welcome to the Guest House

 

[oscartheman]

Surprise guys this time my post isn't to ask for help about stupid situations lol.

Well I also seemed to have this problem some while ago. Obvious, since EVERYONE has this. For example if I was doing something like lets say cooking I'd get randomly: I can't do this. While I obviously don't want to think that way. It happened with a lot of things. Like walking in the street: "I look stupid walking in the street". It was maybe a little true, but if you take it seriously, then you have a problem. In a zen book, I read something about "second toughts". Zen ideas are nice! They said that the mind is naturally calm, that is, if you don't mess around with it, it will become calm. "Don't try to stop your thinking, let it stop by itself". The only way to calm your mind is to leave it as it is, to let the water still by itself. It's like muddy water, you have to let the mud fall by itself. They said that trying to stop toughts with toughts is like washing blood with blood, no matter what you try to think to make your mind calmer, it won't work. "The mind is like a clean mirror, reflecting everything". They say that even if it's the strongest tought in the world, the "zen student" as they said has to understand that it's just a temporary tought construction, just let it be, and these toughts become harmless, no matter how strongly they appear in your mind. Did I make sence? I think that reading some zen and doing some meditation while having major waves of intruding toughts has got to be the coolest thing EVER!! And it will help, 100% guarantee.

 

[Daniel E.]

Yeah, it's one reason I have been attracted to self-help DBT, which is basically zen/mindfulness + CBT:

http://forum.psychlinks.ca/therapy-and-therapists/15420-dialectical-behaviour-therapy.html

 

[Daniel E.]

Welcome to the world of "intrusive thoughts". Cognitive therapy can help you. Your problem is not that you have having intrusive thoughts. Your problem is how you are evaluating them, how you are trying to suppress them and how you avoid situations that evoke them. The problem is not the thought-it's what you try to do about the thought...

Cognitive therapists have been interested in how we evaluate our intrusive thoughts. For example, Canadian psychologists Christine Purdon and David Clark have reviewed the research on intrusive thoughts. They find that evaluations and thought-control strategies for intrusive thoughts and images are a core feature of all of the anxiety disorders. People with OCD try to suppress and neutralize thoughts and images---often with compulsive rituals. People with social anxiety disorder treat their intrusive thoughts about "appearing anxious" as the equivalent of being humiliated. And people with PTSD treat their intrusive images and sensations as evidence that the trauma is happening now. It's like we are running away from our minds.

The excerpt above (from the article I posted by Dr. Leahy) is reiterated here:

Clark points out that OCD patients must learn to view their unwanted thoughts as insignificant, meaningless, and requiring no control efforts. Following this concept of normalizing obsessive thoughts, I would suggest that referring to obsessive thoughts as “intrusive” is illogical and counter-therapeutic. The word “intrusive” has a pathological connotation, but most thoughts are intrusive, that is, they come to the thinker unbidden. Very few thoughts are produced intentionally. Pointing this out to patients and not referring the obsessive thoughts as “intrusive” helps to normalize patients’ appraisals of their thoughts and of themselves. Instead of referring to unwanted thoughts as “intrusive,” I refer to them as “silly.” This adjective is more benign that “intrusive,” further helping to depathologize unwanted thoughts.

David Clark's Cognitive Approach to OCD

 

[Daniel E.]

How Do Obsessive Compulsive People Think?
by Robert Leahy, PhD

In a previous post Those Damn Unwanted Thoughts I indicated how your anxiety often is a result of your fear of your thoughts and sensations. Let's say that you are obsessive and you have the recurring thought, "Maybe I have cancer". But you don't. You've seen the doctor, she tells you that you are fine, you go home and begin thinking again, "Maybe she's wrong. Maybe I have cancer". Then you think, "The fact that I'm thinking that must mean that there is something to worry about. I need to know for sure. I need to do something." So you Google endlessly every possible cancer and expect to see your pretty face appear on the screen.

People with Obsessive Compulsive Disorder have intrusive thoughts (or images) that bother them. These can be thoughts about making mistakes, harming someone, contamination, disease, religious preoccupation, fears of impulses or desires, or just about anything that you might consider dangerous, disgusting or dirty. Examples of obsessions are, "I made a mistake at work and it will blow up on me", "I touched the chair and it's contaminated", "I had a violent fantasy and now I will lose control", "I left the gas on (the doors unlocked, the cat in the washing machine)" or "I did something that God will punish me for". Once you have the intrusive thought you begin looking for more examples of these thoughts. "Oh God! I just had that thought again." You now are watching yourself, totally self-conscious, fearing every possible thought or intrusion that does not reflect a pure and good mind. Your theory of your mind is that you should only have certain thoughts. Everything else is bad or dangerous.

So what do you do when you have these unwanted intrusive thoughts? Do you shout at yourself, STOP? Do you try to get reassurance from someone, "Does this look like cancer to you?" Perhaps you pray for peace, or you have a drink, or you binge eat. Or maybe you ruminate, thinking over and over, "Why am I having these damn thoughts? Am I going crazy?"

How to Understand Your OCD
The diagram ...(which, I admit, is a little obsessive itself) is from my book, Anxiety Free: Unravel Your Fears Before they Unravel You. It lays out a detailed schematic on the nature of OCD. Let's take a look at each step.

1. Triggers: These are the events or stimuli that set you off. It could be touching something (contamination), leaving the house (something is unlocked, the gas is on), driving at night (I ran over something), thinking of sex (God will punish me, I will lose control).
2. Odd thoughts or images: You have some thoughts or sensations that you don't like. "Why am I having those bizarre, sick, disgusting, unwanted thoughts?"
3. Negative evaluation of thoughts: You think there is something wrong with your thinking-as if you should only have pure and good thoughts and feelings. You have a lot of "shoulds" about the way you should think and feel. You think that now that you have the thought, you have a responsibility to get reassurance, get control or get rid of it. Having the thought is equivalent to being SENT ON A MISSION. You have become THE THOUGHT POLICE.
4. Self-monitoring: You watch yourself like a hawk-looking for those thoughts. Of course, simply because you have to think about what you are looking for ("I am looking for that disgusting and dangerous thought"), you always have to find it. It's like holding up a mirror to yourself and saying, "I am looking for a mirror. OH MY GOD! THERE IT IS!!!!"
5. Demand for certainty: You think you should know for sure whether you will act out, lose control, or are contaminated. Nothing short of perfection and certainty will suffice.
6. Thought-action fusion: You equate having a thought with committing an action. "If I think I will get violent, I will". Or, a thought is the same thing as reality. "If I think I have cancer, then I must be a dead man". Thoughts, actions and reality are all one. All in your mind.
7. Thought-suppression: Your first line of "defense" is to try to stop having these thoughts. You tell yourself, "Don't think that". It works, for three minutes. But your failure to permanently suppress these thoughts leads you to believe
8. "I've lost control": You now equate control in your life to eliminating unwanted thoughts. Now you feel more out of control as you desperately try to control your thoughts more and more. It's like slapping the water and drowning.
9. Compulsions: You now perform some neutralizing ritual. Perhaps you wash your hands excessively, pray, repeat "No", walk a certain way, wash a certain way, arrange things, go back and check, check again. You find yourself frenetically doing these things until you have a
10. Felt sense of completion: You say, "I can stop now because I feel I have done enough. This felt sense of completion now becomes your new rulebook for rituals. "I need to do them until I feel I did enough". You are hooked on your rituals.
11. Avoidance of triggers. You remind yourself, I wouldn't have any of these thoughts if I simply avoided the triggers. So you avoid touching things, avoid public restrooms, avoid shaking hands, avoid movies with Satan, avoid people that make you have feelings that are bad and disgusting feelings. Avoid, avoid and avoid. You are running away from the world.

This is how you think. All in the name of being responsible, conscientious---all in the name of avoiding losing control, going crazy or becoming irresponsible. All because you need to be in control. And it doesn't work. Take a look at the schematic and let us know where you see yourself. In a later post, we will discuss what you can do.
But the first step is understanding how your OCD makes "sense" to you.

None of these techniques will help for very long. So what can you do?

In my recent book, Anxiety Free: Unravel Your Fears Before they Unravel You, I lay out a number of things that you can do when you have obsessive thoughts.

----

Followup posts by the same author:

Overcoming Your Obsessive Compulsive Disorder

Having a New Relationship to Your Obsessions: Welcome to the Guest House

Practicing Your Obsessions: The Boredom Cure

Why Thought Stopping Doesn't Work

---------- Post added at 03:46 PM ---------- Previous post was at 03:05 PM ----------

In his self-help book for anxiety, most of the chapter on OCD is freely available online:

Anxiety Free: Unravel Your Fears ... - L. Leahy, Ph.D., Robert, Ph D Robert L Leahy - Google Books