Overcoming Unwated Intrusive Thoughts Page 3

  Worried Voice:Carrots make me think about sex. Anything shaped like that does. What kind of person thinks like that? I’m disgusting.

  False Comfort:This is supposed to be a neutral topic. Think about something neutral.

  Worried Voice:I can’t help it.

  False Comfort:Just distract yourself. Put your mind on another topic.

  Worried Voice:I have these thoughts all the time, you know. Maybe I truly am a disgusting person.

  False Comfort:Why am I stuck with you? Why won’t you just shut up and listen to me?

  False Comfort would like Worried Voice to just stop offering unwanted intrusive thoughts. It tries to help Worried Voice stop, but it doesn’t work. False Comfort objects to every one of those thoughts. But Worried Voice just can’t help where its mind goes.

  Helpful Fact: Thoughts stick because of the energy you expend to fight them.

  Thoughts That Get Stuck

  The thoughts you most do not want to have are the ones that get stuck. Of course! That makes so much sense. So we find that people who are struggling with violent thoughts are people who value gentleness, find violence abhorrent, and live nonviolent caring lives. People who have felt assaulted by thoughts of hurting others are loving people. That is why these thoughts are fought—and then become stuck. Similarly, people who believe that all vulnerable people and living things should be protected are people who fight common intrusive thoughts that sometimes involve actions like abusing children, throwing cats out windows, and dropping babies. These are the thoughts you fight—and because you fight them, they stick. If you are someone with strong religious beliefs, you sometimes come up with blasphemous thoughts and worry thoughts about not being faithful. These are the thoughts you fight…and they stick.

  Thoughts about chairs and fruit salad and trees don’t stick because they are neutral thoughts. Neutral thoughts are not fought because no one cares about them—so they don’t stick.

  So the content of unwanted intrusive thoughts is the opposite of what you want to be thinking about. It is the opposite of your values, the opposite of your wishes, and the opposite of your character. It is the opposite of you.

  Helpful Fact: Unwanted intrusive thoughts get stuck because you inadvertently fuel them by trying to push them away.

  Intrusive Thoughts Versus Impulses

  You might be afraid that you are going to act on your intrusive thoughts and actually do the things that run through your mind. Because unwanted intrusive thoughts tend to get stuck and repeat when you struggle with them, they increase in intensity. Every time you fight them, they fight back, so there is a very intense feeling that goes with them—a whoosh of fear—and sometimes shame, disgust, or anger. This can make them feel like impulses—as if somehow you were being pushed, impelled, or provoked to do something out of control, ridiculous, or dangerous. This feeling can be very disturbing, but you need not worry: it is an illusion, a paper tiger, a false alarm. Your brain is issuing warnings where none are needed.

  Suffering about unwanted intrusive thoughts is a disorder of overcontrol, not undercontrol. (Undercontrol disorders are sometimes known as impulsivity.) Disorders of overcontrol are usually accompanied by a problem with doubt or uncertainty. Put the two together—trying to control those things that you cannot control (in this case, your thoughts) and wanting to be absolutely, 100 percent sure that nothing bad will happen—and you have the formula for unwanted intrusive thoughts.

  People who are impulsive act first and think later. People with unwanted intrusive thoughts are over-thinkers. The problem is that unwanted intrusive thoughts may well be experienced as if they were impulses, and you might even feel that you have to work hard to control yourself. We will address this issue later on, when we discuss anxious thinking and the altered state of consciousness it brings about. For now, however, you can rest assured that impulses and intrusive thoughts are opposite sides of a continuum: they just can’t be any more different, despite how they might feel.

  Helpful Fact: Despite how they might feel, impulses and intrusive thoughts couldn’t be more different.

  When Intrusive Thoughts Are Likely to Happen

  Unwanted intrusive thoughts fluctuate in frequency and intensity. As you understand that intrusive thoughts are thoughts that are stuck in your mind, then you realize that this is most likely to occur when your mind is especially “sticky.” There are a host of factors—some psychological and others physiological—that affect thought “stickiness.”

  You might have already discovered some of the factors. People are much more prone to unwanted intrusive thoughts when they are fatigued, have slept poorly, or are in a bad mood (anxious, crabby, irritable, feeling down or blue). If you are a woman who is menstruating, hormonal changes during your cycle can increase the frequency and intensity of your unwanted intrusive thoughts. Certain drugs, such as caffeine, over-the-counter drugs, and physician-prescribed medications, such as steroids and asthma medications, can as well. The day after consuming alcohol is usually a sticky day for most people. And some kinds of marijuana produce instant stickiness. Stickiness can fluctuate during the day, and often is the worst in the morning (almost as soon as you are awake) and when you are lying down to sleep.

  Worried Voice:Oh, no! I drank too much last night and feel hungover. This is not a good day to go shopping. What if I have those awful thoughts about the people in the store? I have a headache, so I think I will stay home and avoid being around people.

  False Comfort:That’s okay. Why add stress when you feel bad? We can go tomorrow.

  Worried Voice:I just know I am going to get stuck in a line and start having those terrible thoughts about the person in front of me. It always happens on days like this. I will wait till tomorrow.

  Wise Mind:You know that some days our mind is stickier than other days, and it is easy to get worried about having sticky thoughts on those days. But avoiding makes the mind even stickier. It suggests that you are fragile or impaired on “sticky mind” days. You feel resentful, and you miss out on things. And you give yourself a message that somehow sticky thoughts are more dangerous on those days. Go on out. Shopping thoughts are just thoughts even in sticky times.

  Any situation that is uncertain and has “high stakes” is a perfect place for stickiness of the mind to increase. As soon as it seems important to know something 100 percent for sure, that is where the unwanted intrusive thoughts will find their opening.

  For example, if, while cleaning, you have an intrusive thought that you may pour cleaning fluid into the flower pot, the worst that can happen is a dead plant. Take that same intrusive thought and imagine that you might feed the cleaning fluid to your baby. Now the stakes are instantly higher, and the chance for the thought to get stuck increases. For the same reason, the mind can be stickier on an airplane than at home.

  In this example, Worried Voice has an intrusive thought about something that is very unlikely to happen, but whose stakes are very high. That scares False Comfort. They begin to argue. Wise Mind adds a few thoughts.

  Worried Voice:Maybe I should wash my hands after shaking that guy’s hand. I don’t know him. Oh God, he looks like he’s an international traveler. Maybe he picked up dengue fever, or maybe even Ebola!

  False Comfort:I hadn’t even thought of it. But it’s always a safe thing to wash your hands. I don’t think he has Ebola—I thought it was eliminated. The outbreak is over. And he looks okay. And I don’t think dengue can get here unless a mosquito goes on the plane. What would be the chances of that?

  Worried Voice:You never know. I realize now I have a sore on my hand. What if the virus got into me?

  False Comfort:That is so unlikely! There is almost no chance of that happening.

  Worried Voice:And if it does?

  False Comfort:You are making me nervous. Just stop it! Try to think of something else. Or wash once and be done with it!

  Worried Voice:But we don’t want to get sick, and Ebola is a killer! Why risk that?<
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  Wise Mind:Look, you guys, nothing in life is risk-free—really, nothing. You can live with it or drive yourselves nuts around it. It’s up to you.

  Wise Mind is providing the voice of acceptance and surrender to these thoughts. It points out that seeking a perfect, 100 percent risk-free world is useless and self-defeating and that both Worried Voice and False Comfort could lead happier lives if they stopped fighting and allowed their thoughts to exist without debate.

  Trigger: Personal Experiences

  Of course, if you personally experience a really awful event, that high-impact event can trigger the emergence of unwanted intrusive thoughts. Here is an example:

  We were horrified this past March with the shocking suicide of my younger sister. She seemed to be the most upbeat person you could ever imagine, with everything going for her, and seemed perfectly “normal” to us. I think this is where my intrusive thoughts, Oh God if she did this, maybe I will too, came from. I found myself doing everything I could to make sure that would not happen. This had been counterproductive for my anxiety. I found myself looking at YouTube videos about suicide to make sure I would never do anything like that. That was a great mistake.

  Here is how Worried and False Comfort might react to a personal tragedy. Notice how their dialogue just continues to increase distress.

  Worried Voice:Dad just died of a heart attack. He was only sixty-three. That could be us. Look how out of breath we are. That could be a sign.

  False Comfort:We just went to the cardiologist. She said everything is fine.

  Worried Voice:But things can happen suddenly. Look at that runner who died while he was in a race.

  False Comfort:We can’t be going to the doctor all the time. She already thinks we are hypochondriacs. Let’s just take our pulse and blood pressure at home every day. We feel better when it is okay.

  Worried Voice:How can we be sure the machine is working right? I think maybe several times a day.

  False Comfort:Don’t be silly! Of course it is working. Okay, let’s do it twice a day.

  Worried Voice:Don’t just humor me. This is important, we could die.

  False Comfort:You just need to trust things will be okay.

  Worried Voice:There must be a reason I keep thinking about death. I can’t just trust anyone. What if I have a sixth sense?

  Highly upsetting, shocking, or dramatic events can raise the level of anxiety and even seem to change the probabilities of unrelated bad things happening. Events like these can make terrible occurrences seem more likely, and so you work even harder to make sure they never happen to you.

  Traumatic events can be major triggers of unwanted intrusive thoughts, and we will speak about this in chapter 2 when we discuss the types of unwanted intrusive thoughts.

  Trigger: The Media and Current Events

  It is commonplace for people to have outbreaks of intrusive thoughts after the media report a human-caused disaster. Whenever there is a report of an event that is awful, we all gain an increased sense that horrible events really do occur, and it is not uncommon to wonder if perhaps we could do something similar. These wonderings may even include imagining it happening.

  If you are already disturbed by your thoughts and working hard to keep them out of your mind, reading about a mother who murders her children or a gunman who shoots innocent children can very well trigger an intense spike of anxiety. This is because you are sensitized to that thought, not because you are going to do that. Sensitization can be compared to an allergy. An allergic person has a strong reaction to substances that cause little response in others. In the same way, you react with great intensity to certain thoughts that others don’t. And, just as you try to avoid things you are allergic to, sensitized thoughts push you to work hard to avoid, crowd out, and try to banish your own intrusive thoughts. Since thoughts stick and start to feel like impulses in direct proportion to the effort you use to keep them from your mind, then, of course, media reports can intensify your own unwanted thoughts. Sensitization has a normal biological basis, which we will explain later.

  If your stuck thought concerns the possibility of doing something impulsive and dangerous while driving, then reading about a mother who caused a fatal accident by driving the wrong way on a highway will start the process that makes your own thoughts feel all the more dangerous. Remember that your fearful reaction to reading about an incident initiates the process of trying to fight the thought, and the ironic process of the mind can take over and increase your disturbing thoughts dramatically.

  So, if a suicidal pilot takes down a plane full of passengers and your intrusive thoughts have concerned a sudden impulsive suicide that seems contrary to your own wishes, you might redouble your efforts to stop the unwanted intrusions. You might even start to hide ropes and knives, even though you are not actually suicidal.

  If you are plagued by thoughts of bad things that could happen and your need to prepare for them or watch for them—however unlikely—then reports of rare but scary events, like plane crashes or shark attacks, can trigger more unwanted thoughts and more attempts to control those thoughts. Fears of fatal or serious diseases, like Ebola or AIDS, work in a similar way. You are trying to keep those thoughts out of your mind, and when the news reports are filled with descriptions of the disease—and especially the way it can be transmitted despite rigorous infection control attempts—anxious distress increases. Then you try to fight the thoughts with even more effort, and your what-if, stuck thoughts begin to feel more and more like real possibilities.

  And of, course, we are most afraid of things that would be terrible if they did happen, regardless of how unlikely or even virtually impossible they may be. This is another time when anxious people confuse the difference between stakes and odds. So if the stakes are high (like death, humiliation, or jail), then it really doesn’t seem to matter how unlikely it might be. And, of course, the media tend to focus on those events that are awful, dramatic, and traumatic.

  There are people who report that they started having unwanted intrusive thoughts while watching a movie such as The Exorcist or The Matrix. Here is what usually happens: You are watching the movie, and, suddenly, out of the blue, you get a terrifying thought related to the movie that scares the heck out of you. The thought keeps coming back and triggering more fear, so you become involved in an ongoing and repeated battle with your thoughts. And, as we have already said, fighting with your thoughts that way is the same as handing them a victory.

  But the fight seems natural and necessary, and so you keep it up. After all, you don’t know any other way to act, and you feel an automatic sense of fear and dread and frustration.

  Here are Worried Voice and False Comfort at it again. Wise Mind is not around.

  Worried Voice:Maybe I am possessed? What if that is the reason I keep coming up with these terrible thoughts?

  False Comfort:Don’t be silly. Possession is just in the movies.

  Worried Voice:No, some churches really do believe souls can be possessed. Who is to say they are not right?

  False Comfort:This is just an idea the movie put in your head. Stop thinking about it! You know how it upsets me.

  Worried Voice:Yeah, well, you never know. It could be. You can’t prove it.

  With movies like The Matrix, people sometimes get stuck on the thoughts that maybe reality isn’t at all what it seems and that it’s impossible to know the nature of reality for other people. It can seem like suddenly everything about reality is not certain at all, and you may even have the thought that you are losing touch with reality. It triggers fears that keep on returning. With movies like The Exorcist, the thought might be about the possibility of being possessed by evil and wondering if that could happen, if it could already be happening, and if you could possibly harm the people you love. Since these ideas feel so frightening to you, you fight them as well. And—as you probably have already guessed—this ensures that they become stuck in your mind.

  The answer here is no
t to avoid the possibility of this happening by avoiding media—although that is often the first instinct of people struggling with unwanted intrusive thoughts. We will show you how to enjoy movies, TV, and the Internet, whether or not they temporarily stimulate intrusive thoughts.

  Helpful Fact: Contrary to common sense, reducing your effort to avoid intrusive thoughts will often lead to less distress.

  In this chapter, we have reviewed some important facts about unwanted intrusive thoughts that may have calmed some of your fears and already started you on the road to recovery. Intrusive thoughts, however weird or scary, are universal and unimportant. Unwanted intrusive thoughts get stuck because you inadvertently fuel them by trying to banish them. They fluctuate in intensity and frequency based on the fuel they receive—triggering events in the real world or the stickiness of your mind due to fatigue, mood, or anxiety—and, ironically, by the amount of effort you expend to try to counteract, avoid, or suppress them. Most importantly, they are not impulses, and you are not out of control.

  In the next chapter, we will describe the different types of unwanted intrusive thoughts.

  Chapter 2