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Anxiety

Those Damn Unwanted Thoughts

The uncomfortable realm of "intrusive thoughts."

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 to 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, or 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 it predicts something about your future. Maybe the thought means you are dangerous or that you will be punished by God.

Welcome to the world of "intrusive thoughts." Your problem is not that you are 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 therapy can help you.

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 percent 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 equal reality is what Jack Rachman of the University of British Columbia called "thought-action fusion." People with obsessive compulsive disorder may 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 won'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. Canadian psychologists Christine Purdon and David Clark, for example, 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.

Trying to escape these thoughts is like trying to run away from your hips: No matter how fast you run, they're always there.

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More from Robert L. Leahy Ph.D.
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