Intrusive thoughts 2

Intrusive thoughts

– Acceptance is often confused with resignation
– Acceptance is about recognising things for the way they are

– Acceptance of intrusive thoughts involves accepting that they are a problem that you wish to deal with
– This is important because people often worry that they may point to/mean something more sinister
– Accept intrusions – Remember you cannot force yourself not to have intrusive thoughts (In fact, all people have thoughts which pop into their head as they from nowhere)
– Accept that many people will try to help by offering what is really Unhelpful advice like “try not to worry about it”, “just be strong” or “don’t do it”
– Instead focus on helping yourself rather than worrying about what others think

– Remember having intrusive thoughts does not mean anything about who you are as a person
– All people think and feel bad things and good things

Exercise: Gives you a healthy platform for living a healthy life; Exercise also impacts your mood by releasing endorphins- the chemicals that make you feel more energised and happier

– Remember you have no control over what pops into your mind
– Intrusive thoughts, doubts, images and urges are completely normal
– As such, they are not the problem
– Rather, it is the fear, guilt, shame and other forms of discomfort that are the issue
– Another issue is the amount of time consumed, and the rituals and avoidance that you may engage with respect to the intrusive thoughts, doubts, images and urges

The way forward therefore is:
– To work on improving your behaviours
– To work on improving your emotional responses
– And to allow mental events to come and go (without fighting them, but rather letting them take care of themselves without any need of control on your part)

Changing your attitude towards your thoughts
– All mental compulsions or responses maintain the problem
– To change, you need to respond differently
– Give up the idea that certain intrusive thoughts are bad or wrong
– Instead, see them for what they are – just thoughts
– Experiment with responding to the thoughts as if you believe they do not mean anything
– In time, you will start to convince yourself that this is actually the case

Practising detached mindfulness
– This is about learning how to do nothing with your intrusive thoughts
– This is about accepting them – not trying to control them or push them away
– It involves three steps:
1) Being aware of the intrusive thought (& the judgments you once used to make about such thoughts being good or bad or meaning something strange bout you)
2) Stepping back from the thought and becoming a passive observer of the thought (Recognising that these are just internal events of the mind) – It is a bit like being a spectator at a football match rather than being the referee – You do not need to do anything – you just watch | Over time – When you get really good at being a spectator you will become more like a caretaker at the football stadium – getting on with the job you are doing at the time without really noticing the match taking place at all
– This is all about separating our thoughts and seeing out thoughts as being separate from our self as a person
3) Disengagement – Ceasing unhelpful responses like attaching meaning, thought control, avoidance, reassurance seeking etc

Remember: Intrusive thoughts are merely simple internal events that have no particular meaning | What we are asking you to do is to respond to them in the same way as you respond to all your other random automatic thoughts (which is by not responding at all)

Note: Detached mindfulness is not about having a blank mind! It is about letting the thoughts be there and doing nothing with them. It does not involve trying to alter the thoughts or get rid of them, but rather changing how you relate & respond to them.

– Appraisals and most commonly made up of two parts:
1) an idea that you should not have thoughts
2) I believe that having them must mean something bad

Remember: And intrusive thought is just a thought that pops into your head randomly. It does not necessarily mean anything. A thought is just a thought, whatever the content.

Why do we avoid putting a positive spin on your thoughts?
– The answer is: The ultimate aim of treatment is to help enable you to barely notice these random thoughts coming in and out of your mind, and to cease to care when you do notice them [This is a bit like not paying much attention to a song that suddenly pops into your head]
– If you put a positive spin on the automatic thought you are still giving it attention
– Intrusive thoughts thrive on this attention (This is called reinforcement in psychology)
– Positive appraisal can also become a way of trying to reassure yourself
– Instead, what we are trying to do is to allow these thoughts to come and go and allow them to take care of themselves without responding (& in the process be reinforced in our mind as requiring a response

Learning to let go of using your feelings as a guide
– People often use how they feel emotionally or physically as a guide for assessing an intrusive or pop-up thought
– For example: If you feel anxious (And have feelings of anxiety in the body), You charge that it is a sign that the thought has value and that something must be wrong or that some danger is pending. If you feel disgust, you assume something needs avoiding at all costs. If you feel guilt, you assume you must’ve done something bad.
– In such cases, our natural fight/flight response system starts to over function and ceases to serve a useful purpose
– To reset the balance, you need to train yourself not to respond to these emotions instead of using them to add meaning and importance to your automatic thoughts

Understanding why intrusive thoughts focus on out of character ideas
– When the content of an automatic thought is out of character, people are more likely to notice it as an intrusive thought
– People are also more likely to attach an unhelpful negative appraisal instead of just seeing the thought as a common mental occurrence
– Intrusive thoughts like to get you where it hurts
– When people have particularly strong beliefs about things like cleanliness, order, religion etc., their intrusive thoughts have content related to these beliefs
– This connection is likely because the out of character thought sticks out because it goes directly against everything the person holds true, and therefore the person attaches a meaning to it – For example:
– I shouldn’t have these thoughts
– Having these thoughts must mean something bad
[You are going to be on the lookout for any further thoughts with such content; And the more you look for the thoughts, the more likely you are to find them and engage in unhelpful responses therefore further reinforcing the vicious cycle
– In other words, you are likely to worry most about thoughts which are furthest away from your beliefs or values as a person

Remember: Automatic thoughts are just thoughts, ideas or images that pop into the mind on a regular basis without you deliberately trying to think them

Remember: Everyone experiences automatic thoughts (usually many times a day) But that they are largely unnoticed because most of the time they are so common and unremarkable that they just pop in and pop out of the mind without a trace

Intrusive thoughts
– These too are automatic, pop-up thoughts
– The difference between intrusive thoughts and automatic thoughts is that intrusive thoughts tend to catch your attention because their content is unusual, weird or alarming because they are so out of character
– Intrusive thoughts may also be images (Such as loved ones dying in an accident)
– Intrusive thoughts may also be feelings (A sense that something is not right)
– Intrusive thoughts may also be urges (To jump off something or yell out)
– They often carry a sense of foreboding – warning you something is wrong or making you doubt yourself (coupled with the urge to remove the uncertainty)
– The other difference between automatic and intrusive thoughts is that people tend to react differently to intrusive thoughts because of the meaning they attach to them

Normalising intrusive thoughts
– Pop-up and intrusive thoughts are an every day occurrence for everyone
– It is part of being human
– Everyone has them
– Intrusions can be on any subject matter that a person finds alarming or out of character
– What is intrusive for one person may be dismissed as an automatic thought by another

Some typical subjects for intrusive thoughts include:
– Blinking
– Violence
– Causing harm accidentally or deliberately
– Contamination of self or others
– Illness and death
– order
– Sexuality
– Superstition

Response thoughts
– These are the thoughts or thinking that you do it in response to your intrusive thoughts
– The psychological term is metacognition or thinking about your thinking
– It’s like a second level of thinking
– Response thoughts differ from automatic thoughts in that they are less random and more within your control
– It is helpful for you to be able to differentiate between intrusive thoughts and response thoughts so that you know which ones you can and cannot control

Remember, Intrusive thoughts:
– Pop into the head unbidden
– Often appear to pop-up randomly
– Are uncontrollable
– Can be on any subject (particularly about subjects important to you)

Whereas, Response thoughts:
– usually come as a response to an automatic thought
– Attach meaning to automatic thoughts
– You’re able to choose not to engage in having a response thought

Remember: Intrusive thoughts often try to persuade you that – on this occasion – the intrusive thought is really important and needs responding to
– Intrusive thoughts play on doubt, your need for certainty, and often your need for being perfect

An intrusive thought – whatever the content or however out of character it may be, is not an obsession – It is simply an unasked for automatic event in your mind – It is only when you attach a meaning or importance to a thought – which in turn leads you to react differently – that it becomes an obsession (This equally applies to intrusive urges, doubts, feelings or physical sensations)

– Thoughts don’t make you do things
– you choose whether to on your thoughts
– For example: the thought I don’t feel like going to work today may pop into your head, but you still go to work
– When intrusive thoughts have developed into an obsession, you can easily forget that you still have a choice to respond
– Remembering this can help you see that intrusive thoughts are just thoughts & help you realise that they are less threatening than originally thought

If I think it – it is more likely to happen
– To believe this suggests that your thoughts alone have the power to impact events

– Tell yourself repeatedly that you are going to win the lottery
– Yourself that you are going to win
– Buy a lottery ticket and keep thinking that you have the winning ticket
– Then see if your thoughts influenced the lottery results

If I think about it – I am responsible for preventing it
– This is a very common thinking error for people who suffer with intrusive thoughts & obsessions
– It is also likely to keep you worring

Instead, recognise that you cannot control what pops into your head
– Remember, this is true for everyone
– This is why they are called automatic thoughts

– Close your eyes and try very hard not to think about a pink elephant for one minute
– You must not think about the pink elephant in any way, shape or form
– What happened?
– Did you push the thoughts away?
– did you tell yourself not to think about the pink elephant?
– Did you try hard to think about something else? (Which in a way us also linked to the thought you are not “supposed” to have because you are trying to keep it out of mind)
– Usually, when you try hard not to think about something, you are more likely to think about it for the following reasons:
1) “Priming” yourself to think it
2) Placing yourself on red alert to notice the thought, you are much more likely to notice it
3) You attach importance to whether you think the thought, which means that you are more likely to notice you are thinking it

But I should be able to control my thoughts
– If you believe this, you will keep trying to do so
– This is like trying to achieve the impossible
– This is why it is so tiring and frustrating
– You are also adding fuel to the fire something is wrong with you and/or your mind

The vicious cycle of trying to control your thoughts:
1) I should be able to control my thoughts
2) Attempt to suppress or alter thoughts
3) Increase in importance of thoughts
4) Pay greater attention to thoughts
5) Thoughts appear more prevalent
[That is, the more you try to control the thoughts, the worse the problem is likely to become; think – How long have you been trying to control your intrusive thoughts and has this given you any short-term relief?]

Magical thinking
– Often, people believe that thoughts only influence things in a negative way
– That is, a bad thought can make something bad happen

Tolerance of uncertainty
– The problem with this is – the more you seek certainty & to feel absolutely certain, the less certain you feel in the long term
– the seeking of certainty is therefore counter-productive

– The more uncertain you feel, and the more you do not respond to – or try to resolve – your intrusive thoughts – the more you are helping yourself learn that you do not need certainty
– And the less you demand certainty, the more certain you will feel

– When you lose your sense of humour, everything feels like a struggle
– Instead observe your daily life, & ask yourself whether there is enough humour in it

remember: One of the biggest maintaining factors for obsessions is taking your thoughts, feelings and urges too seriously
– instead try to laugh & see the humour in them

Good quality sleep
– Don’t underestimate the importance of a healthy sleep routine
– Changing our relationship to our thoughts is even harder when you are tired

Healthy eating is also important for our body & our mood

Engage in activities you enjoy, rather than thinking over & over about your intrusive thoughts & obsessions

Our thinking about Intrusive thoughts
– If we have a “bad” thought, it means we are a “bad” or dangerous person
– if We have a thought about harm coming to someone we love, it means we are responsible for preventing that harm

– Intrusive thoughts are the product of normal doubts/urges
– What makes them intrusive thoughts is that we misinterpret their importance
– We also take excessive responsibility for them
– Also we frequently are intolerant of uncertainty & develop rituals to manage our obsessions
– we Place too much importance on thoughts/images
– We like trust/ confidence in our own judgement

What we need to do:
– Take opposite action – that is, do the exact opposite of what the intrusive thoughts want us to do
– In the process, you begin to gradually prove to yourself that you can cope with the habituated feelings of distress

Source: d’Ath & Wilson (2016)


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