Yes, it very well might be a part of the issue. There is evidence that a significant number of people who suffer from unwanted intrusive thoughts are also affected by OCD. And there are some good reasons why this is true.
People with OCD experience obsessions, which are thoughts that arrive with a whoosh of emotion, feel dangerous or unacceptable, cause considerable distress, and are accompanied by a strong need to be neutralized or banished. Obsessions are one kind of repeating unwanted intrusive thoughts. There is an OCD cycle that consists of unwanted thoughts that raise anxiety and continuous attempts to lower anxiety by means of compulsions. The compulsions in OCD may be obvious behavioral rituals that feel driven—like washing, checking, ordering, and counting. But there are also compulsions that are entirely in the mind and consist of giving oneself repeated reassurances or ways to discount, undo, or avoid the obsessive thoughts. People with OCD give their thoughts more power than they deserve. If you have OCD, you probably have the tendency to feel very uncomfortable with uncertainty. And, you may have noticed something about Worried Voice and False Comfort. Worried Voice is the one with unwanted intrusive thoughts, many of which are technically obsessions. And False Comfort is the one who tries unsuccessfully to calm Worried Voice down or make Worried Voice stop thinking. Many of the things False Comfort suggests are actually forms of compulsions.
Do people go crazy when thoughts get stuck? Or does this mean that I am already crazy?
Of course not! People probably get the erroneous idea that they can go crazy from how miserable stuck thoughts can make them because they don’t understand what is happening. Stuck thoughts do not drive people to psychosis, and having a stuck thought certainly does not mean that someone is crazy.
However, unwanted intrusive thoughts can be so persistent, so anxiety producing, so frustrating, and so shameful that people sometimes say that their thoughts are “driving them crazy.” Of course, the phrase here means the same as, for example, when your children are annoying, frustrating, and unwilling to listen to you, and you tell them that they are “driving you crazy.” In this case, the phrase means that your kids are getting you frustrated, being uncooperative, and requiring a lot of your energy to keep them in line. (Sounds a lot like unwanted intrusive thoughts, doesn’t it?)
Plus, the content of some intrusive thoughts can seem so bizarre (e.g., thinking that you might drink the dog’s stale water rather than spilling it out) that you might wonder if these “crazy” thoughts mean that you are, indeed, going crazy. But please remember that stuck thoughts have nothing to do with psychosis, and you know that odd, weird, and crazy-sounding stuck thoughts are just that—odd, weird, and crazy-sounding.
What are the root causes of this problem?
The real problem here is the question because the question is based on false assumptions.
Here is an example: How would you respond to someone who asked you for the best method of bloodletting to cure a person of their fever? You would, of course, say that bloodletting isn’t a way to cure a fever. There was a time in the past when people erroneously believed it to cure people. But that was five hundred years ago. So answering the question would just contribute to that old myth.
In the same way, talking about root causes in this context also contributes to an old myth about human emotions. When you think of a root cause, you probably get an image of digging down deep and pulling out every single bit of the problem so that it is eliminated or extinguished from your psyche. This concept was widely accepted fifty years ago, but now we know that this is not how our minds and brains work.
Instead, we now know that most psychological issues are a complicated interaction of what you inherit (genetics), plus maturational processes that go on throughout your life, plus your own personal history, which can include the way you were raised, the important events that occur, the stresses you encounter, and more. More importantly, we now know that determining the historical factors that contribute to unwanted intrusive thoughts are absolutely no help in getting rid of them.
That’s right. Learning about why you have intrusive thoughts will not help you stop them nor reduce your distress. However, learning how you inadvertently keep intrusive thoughts going and what you can do to change this will be significant steps toward recovery. In other words, we need to keep our focus on the hows and the whats, and less on the whys.
I honestly and genuinely love life and like the life I’m leading. So why do I have these persistent thoughts about suicide?
Remember that unwanted intrusive thoughts get stuck precisely because you don’t want them or agree with them. In the same way that gentle people are offended by and fight with, and therefore end up accidentally getting stuck on, violent thoughts, people who value their lives also accidentally reinforce thoughts they don’t agree with. Believe it or not, the momentary idea of killing oneself crosses ordinary people’s minds at random moments. Here are examples: That knife could do real damage—could I slice myself up? Imagine if I just jumped off this ledge. What if I suddenly just yanked the steering wheel and careened into ongoing traffic? If Robin Williams hung himself, could I impulsively do the same?
Most people pay no attention to such passing thoughts, and the thoughts pass right on. But if you are anxious or worried about yourself, or feel extremely responsible for the care of someone else, and you think such a thought must be attended to, then harmless thoughts like these may suddenly feel threatening or abnormal. This sets up a struggle to resist the thoughts, and this is why they persist.
So it is quite possible for someone who is neither suicidal, depressed, nor crazy to have so-called suicidal thoughts. We prefer to call them unwanted intrusive thoughts instead of suicidal thoughts because that is all they are.
My therapist told me about thought-stopping. Why doesn’t it work? What about distraction? The thoughts just come back. I also have tried to meditate, to find a peaceful place, and to not have these thoughts, but I can’t do that either.
Like most professionals, your therapist is probably not a specialist in this particular problem and can’t keep up with all the latest findings about how your brain works and how to help you recover from unwanted intrusive thoughts. Most of the so-called anxiety management techniques and coping skills that have been popular in the past just aren’t helpful for people with intrusive thoughts.
Thought-stopping doesn’t work for one huge reason: it’s the opposite of what you should be doing. Thought-stopping asks you to do exactly the wrong thing. Using thought-stopping to control intrusive thoughts is something like this: “Okay, you have been trying without success to keep these thoughts out of your mind. In fact, your efforts are a big part of the reason why your thoughts are stuck. So you are now going to try yet another way to stop your thoughts—this time you are going to banish them with thought-stopping.” It didn’t work in the past, it isn’t working in the present, so why in the world would anyone think that it will work if you now try it this way? The answer: it won’t. It doesn’t work, it has never worked, and it won’t work in the future. You are probably doing your thought-stopping exercises just like you were told. The problem isn’t you—the problem is that the approach is wrong.
The key is not to try harder to stop thoughts; it is in changing your relationship with the thoughts and your beliefs about them. Then, they don’t need to be stopped and are no longer fed the energy that maintains them.
The same can be said for distraction techniques. Here is the issue with them: When you try to distract yourself from intrusive thoughts, you are reinforcing the idea that you need to keep away from them. That implies that they are somehow dangerous and might lead to something no good. That is the wrong way to look at them. Furthermore, when you distract yourself, although it may help temporarily, you devote a portion of your mind to barring the door and scanning the mind to make sure they don’t return. And it is the high-alert, internal monitor that actually invites them back. It is much more helpful—and much more consistent with what we
now know about thoughts—to pay attention to the fact that intrusive thoughts may feel terrible but aren’t dangerous. So, instead of learning how to distract yourself from the thoughts, your goal is to learn how to reduce the distress they trigger. Thoughts that don’t matter have no power.
It is also not possible to meditate away or to intentionally clear the mind of unwanted intrusive thoughts using meditation. A mindful attitude (nonjudgmental, curious, self-observational) is certainly part of the solution, but using meditation as a technique for banishing thoughts will not be effective. A regular practice of meditation can—like exercise—be helpful in many ways, but it is not a technique for conquering thoughts.
How can it be that the content of my thoughts is irrelevant? That seems impossible.
We know how odd this sounds, but the fact is that the content of your thoughts is quite important most of the time, yet entirely irrelevant at other times. You will learn how to distinguish regular thoughts from seemingly important unwanted intrusive stuck thoughts. You will learn how to use the way a thought feels and acts as a method of distinguishing between thoughts worth thinking about and meaningless thoughts that have become stuck. You will learn not to rely on the content of the thought—what the thought seems to be about—at all.
It is also important to understand that everyone has intrusive thoughts not worth thinking about. In fact, a great deal of everyone’s wandering mind is made up of uninteresting passing observations, reactions, musings, bits and pieces of memories, conditioned associations, and planning. Some of the thinking seems to be what we are deliberately trying to focus on or think about, but a great deal of it is just mental wandering. Sometimes a thought from one part of the mind (we like to call them channels) intrudes into another and temporarily diverts our attention. All of this is normal. Usually, if we do not focus on the content of the intrusion, it passes because it is simply not worth thinking about. But if one of these intrusive thoughts becomes a stuck, repeating, unwanted, rejected, resisted thought, then suddenly the content falsely appears to be important.
In the next chapter, we provide you with another perspective on the most bewildering and upsetting issues you face: why these thoughts are so persistent, why they feel like impulses, and why they engender such great anxiety and guilt. We are going take a neurological perspective and explain what happens to your brain and mind when you have an unwanted intrusive thought, showing why much of what happens lies outside of your control and why your efforts can so easily backfire.
Chapter 5
How the Brain Creates Unwanted Intrusive Thoughts
Imagine—without any warning at all—a friend jumps behind you and yells, “Boo!” You would probably jump or be startled, and experience a whoosh of fright. And then, after you realized that there was nothing to really fear, the shakes and rapid heartbeat would stop and you would start to calm down. After a few minutes, it would be as if it didn’t happen.
This chapter talks about what happens in the brain when you get frightened like this and how you calm down. In addition, we explain what happens in your brain when you become frightened and don’t calm down right away. This will help you understand why your best efforts to calm yourself haven’t been nearly as effective as you would like.
The Neurology of Anxious Arousal
Let’s take a closer look at the neurological engine that keeps unwanted intrusive thoughts going. There is an understandable reason why your brain tells you these thoughts are dangerous and why the thoughts can sometimes feel so much like impulses.
There was a time—not long ago, unfortunately—when people with unwanted intrusive thoughts were called weak, crazy, or out of control, or said to be lacking willpower. Now we know it is nothing of the sort, but your brain has inadvertently been programmed to keep these thoughts going. And the best news is that we know how to rewire your brain to end them.
The part of your brain that was originally designed to keep you safe during times of danger can become confused and misdirected. It can become so befuddled, in fact, that it can start to misidentify safe things as dangerous. We call this anxiety—when you react to and worry about something quite safe as if it is objectively dangerous. When your brain inadvertently reacts to thoughts as if they were dangerous, it sets the stage for unwanted intrusive thoughts to take hold. As we have shown in earlier chapters, thoughts themselves are never dangerous—they are just thoughts. But the brain can become programmed to fear thoughts anyway. And this can happen to anyone.
We know that the brain learns as a result of experiences. Fearful experiences are remembered and stored in particularly vivid ways. When fearful pathways are triggered frequently, they become automatic. (Neurologists like to say, “Nerves that fire together, wire together.”) Just as we associate two things together, like “up and down” and “left and right,” a well-worn pathway in the brain associates two things that follow each other, and they become connected (what psychologists call “conditioned”). If a thought is followed by an anxious experience, the pathway from thought to fear gets established. When this happens repeatedly, your brain becomes conditioned to react anxiously and automatically to that thought. This sets up the conditions for unwanted intrusive thoughts to take hold.
The good news, however, is that scientists have recently learned that it is far easier for your brain to learn new pathways than previously thought and that new reactions can overtake old ones. In other words, don’t believe the adage that you can’t teach old dogs new tricks! The age of the dog is irrelevant—any brain can learn. Getting over unwanted intrusive thoughts involves creating new pathways that are not fearful. This chapter lays the groundwork for understanding how this happens.
The Alarm Response
To understand how unwanted intrusive thoughts work, we start with the alarm response that is built into everyone’s brain. This response is sometimes called the stress response, the fight-or-flight response, or—most accurately—the fight, flight, or freeze response. It sets up your body to go through a whole series of arousals—all of which are helpful when you are in danger. These responses include release of adrenaline, increased heart rate, changes in breathing, hypervigilance to possible danger, tunnel vision, and a host of other perceptual changes. You feel this as a whoosh of fear or terror. The alarm response is centered in the amygdala, which consists of two walnut-sized structures in your brain. The amygdala can be either on or off: it either triggers the alarm response or it doesn’t. The alarm response is wordless—think of it like a clanging danger-warning bell. There are no partial responses or other subtleties.
Because it is designed to alert you to danger, your amygdala is triggered by just the merest hint of a possible danger. Its job is to protect you—not to keep you comfortable—so it would rather set off a thousand false alarms and create a thousand whooshes of fear when there is no problem at all than miss one that is real. It was originally designed for primitive survival. Clanging the alarm when there is no danger is called a false positive. Remaining silent when there is a real danger is a false negative. Your amygdala sends out many, many false positive responses because it never wants to risk a false negative.
In situations of real danger, such as a car swerving toward you on the highway or a falling rock, the rapid reaction time, muscle strength, and increased blood circulation that are part of your alarm system serve you well. The immediate change in your breathing is what you need for emergency sprinting. Even sweating helps air-condition you as you heat up while running. Your amygdala is designed to save your life, and so it responds very rapidly to protect you from threats.
Figure 1 shows the whoosh of fear people feel when the amygdala is triggered. The trigger might be the car coming toward you or the sudden sound of your friend yelling “Boo!” The whoosh response happens very, very quickly.
Figure 1: A whoosh of fear results from the trigger.
The Amygdala Learns to be Fearful
The amygdala learns to be fearful very easily, since its purpose
is to protect you. When you were born, there were relatively few triggers that set off the alarm—loud noises and loss of support are two of the inborn fear triggers. Babies do not yet fear hot stoves, but the adult amygdala has learned to. As you mature, your amygdala learns to set off this alarm in response to a huge variety of triggers. You learn to be fearful of real dangers and to try to avoid them. This is the natural, normal, protective mechanism present in everyone.
In addition, for many people, certain animals, locations, voice tones, social situations, and means of transportation can develop the capacity to also set off this alarm, even though they may represent no objective danger on their own. Even emotional reactions like feeling trapped, anticipating rejection, or having doubts can set off alarms. In other words, your amygdala will set off a whoosh of fear in response to triggers that constitute no real danger. Psychologists call this conditioned learning. In this manner, fear responses can become habits of the brain.
People with unwanted intrusive thoughts have an amygdala that has learned to become afraid (i.e., clang the danger-warning bell) of certain thoughts. You were not born with a fear of these thoughts, and there is no objective reason to be afraid of them, but your amygdala has been conditioned to react when they appear in your mind. And, in our complicated world, there are a host of situations that aren’t objectively dangerous, but can seem or feel dangerous. If your amygdala sets off the alarm in response to a harmless thought, you get a false alarm of danger: the bell clangs, you get an instant whoosh of fear, and it is very easy to think that there is real danger. The result is that thoughts feel dangerous, you try to fight them, and—of course!—they become stuck.
Overcoming Unwated Intrusive Thoughts Page 8