“I can’t stand these intrusive thoughts any longer. I don’t care if they’re obsessions, symptoms of OCD – whatever. I just want ’em gone. And right now!”
I know. I truly get it. At one time I was stuck – and scared – smack-dab in the middle of intrusive thoughts. It was awful. But I gotta’ tell ya’ from the get-go – if your mission is to aggressively force your intrusive thoughts out the door, you’re only asking for more. Yes, tough news to swallow; however, truth.
We began this two-part series on intrusive thoughts (ITs) a week ago with “Intrusive Thoughts | ‘My God, How Can I Be Thinking These Things?‘” We learned that ITs are unwelcome thoughts, images, or unpleasant ideas of an aggressive, sexual, or religious/blasphemous nature. Naturally, one is terrified they’ll act on them; which ramps-up existing guilt, shame, and despair.
Well, let’s get right to work as we chat what can be done about ITs. By the way, you’re gonna’ get your money’s worth here. So get comfy, k?
Exposure and response prevention (ERP) – a behavioral therapy – is the treatment of choice for ITs. Relief makes the scene when we face those nasty thoughts and work toward preventing the traditional response(s). Simply, ERP is the practice of staying in an anxiety-provoking or feared situation (in this case, the IT – which may be an obsession) until the distress or anxiety diminishes (side-stepping a compulsion, such as avoidance).
The goal? To reduce the fear reaction generated by the IT.
Now, that ain’t exactly easy, given the shame, fear, guilt, and assorted ick that accompany an IT. But engaging in activities to prevent the feared outcome of the IT only serves to strengthen it. See, it’s all about something known as negative reinforcement – your mind learning that the only way to avoid a thought or feeling is to engage in a reactive – compulsive – thought and/or behavior.
And so relief ultimately comes through opening the door to the IT, without then turning to the compulsive side of the fence.
Here are three examples of ERP strategy for an IT pertaining to harming or sexually abusing children…
- Resist examining past events, or asking others, to determine if you actually behaved unacceptably.
- Agree with thoughts of harming the child/children in question, instead of analyzing or studying them.
- Spend time around the child/children while holding weapon-like objects (if harming in a like manner has been an IT).
News flash! ERP will not totally eliminate ITs. But millions (including me) endure “undesirable” thoughts and consider them nothing more than an occasional annoyance. And that’s where we want to go – to a point of management, eliminating life interference.
Okay, some general tips on managing ITs…
- Do all you can not to engage the thoughts or attempt to push them out of your mind.
- Learn to rate your anxiety level (1-10) and monitor its fluctuation in the immediate. Then move-on to management (say, working on your breathing).
- Forget about the supposed meaning of the thoughts.
- Don’t waste your time trying to convince yourself you won’t act on the thoughts.
- Don’t change any of your behaviors in an effort to avoid acting on the thoughts.
And now to the all-important matter of deeply believing you’ll act on an IT. Keep in mind that thought content doesn’t matter. Yep! Having a specific thought has zippo impact on what you’ll actually do. Absolutely, a thought is not an impulse!
Okay, so I’d be remiss if I didn’t mention meds interventions. If psychotherapy isn’t cutting it, the selective serotonin reuptake inhibitor (SSRI) antidepressants, as well as the tricyclic antidepressant (TCA) clomipramine (Anafranil) may be worth a look-see. Interestingly enough, there’s evidence that the vitamin-like substance Inositol may provide relief.
Well, let’s wrap-up our hard work with a soothing point-of-view. In Part 1, I quoted therapist Sheryl Paul, MA from her article “The Architecture of Anxiety and Intrusive Thoughts.” In the piece, Ms. Paul mentions Elizabeth Lesser’s book Broken Open: How Difficult Times Can Help Us Grow. Featured in the book is a quotation from the late Chogyam Trungpa, a Buddhist meditation master. Excerpts…
Going beyond fear begins when we examine our fear: our anxiety, concern, nervousness, and restlessness. If we look into our fear, if we look beneath the veneer, the first thing we find is sadness, beneath the nervousness. Nervousness is cranking up, vibrating all the time. When we slow down, when we relax with our fear, we find sadness, which is calm and gentle.
Before you cry there is a feeling in your chest and then, after that, you produce tears in your eyes…This is the first tip of fearlessness, and the first sign of real warriorship. You might think that, when you experience fearlessness, you will hear the opening to Beethoven’s Fifth Symphony or see a great explosion in the sky, but it doesn’t happen that way. Discovering fearlessness comes from working with the softness of the human heart.
Supposes Ms. Paul, and I couldn’t agree more – maybe, just maybe, ITs are our mind’s way of trying to get our attention so we’ll slow down and tune-in. And once we start paying attention to our feelings – and trust we can handle our emotional experiences – the ITs begin to diminish. After all, they’ve accomplished their mission, so they have no reason to exist.
How ’bout this? Next time an IT strikes, ask questions such as “What am I trying to control, avoid, or fill-up?” or “What is this thought trying to protect me from feeling?” Allow these questions to take you to your heart, connecting some life-giving dots. Yes, what treasures you’ll discover!
Be they obsessions, symptoms of OCD – whatever. What to do about intrusive thoughts? Open the door and warmly invite them in…
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