I start by expressing my appreciation to Sally Winston, my coauthor. Sally has been my friend and colleague for many years, and co-writing this book with her has been a delightful task as we discussed, disputed, and edited each other’s words and ideas. I am fortunate that she has granted me access to her steady, thoughtful, inquisitive, and knowledgeable mind. Next, it is almost de rigeur to thank one’s clients at this point, but this book would never have been conceived without the input of so many of you who suffer from UITs. I thank Ron Doctor for our long term friendship and Reid Wilson for openly sharing his findings on how to help people understand the riddle of anxiety. Finally, I am indebted to those no longer with us who taught me that anxiety need not restrict my life: Manny Zane, Herb Fensterheim, Jerilyn Ross, Sabe Basescu, Isadore From.
—Martin Seif
Appendix:
A Recipe for Unwanted Intrusive Thoughts (What Not to Do)
It isn’t easy to create an unwanted intrusive thought. It takes vigilance, effort, and a relentless desire to think the right thoughts. Amazingly, almost all the energy you pour into making sure that your thought doesn’t get stuck goes right into ensuring that it happens. What is interesting, however, is that with the right ingredients, anyone can create one. You will notice as you read this recipe that it illustrates all the concepts we have introduced. So let’s look closely and see how your best intentions go so wrong!
A Recipe for Creating an Unwanted Intrusive Thought
Time required:Varies from less than one day to several weeks
Difficulty:Three of five stars
Effort:Five of five stars
Ingredients
one (or more) myths about thoughts (see chapter 3)
awareness of the passing intrusive thoughts, which everyone has
vigilance to make sure you don’t have those thoughts
a desire to fight any thought that is at odds with your belief about yourself
one amygdala (the alarm part of the brain, which everyone has)
being bluffed by the altered state of awareness called “anxious thinking”
willingness to struggle to keep a sticky thought from getting more stuck
a demand for certainty when none is possible
the belief that surrendering the struggle is losing the fight
attempts to avoid, distract, push away, and argue with your stuck thought
feeling guilty about having the thought, even after it is over, and then asking others for forgiveness or confirmation of your value and goodness as a person
and, finally, reassurance (from yourself or others) that you would never do anything like your thought
optional additional ingredients—anxiety (these are starter ingredients): fatigue, hunger, or a hangover
family or personal history of anxiety
Directions
Choose one or more myths from chapter 3. Our personal favorites are the myth that your thoughts are under your control and the myth that your thoughts speak to your character or underlying intentions. When you combine them together, you have a solid basis for creating some unwanted intrusive thoughts. However, any combination of myths can yield an excellent unwanted intrusive thought.
The next part is probably the easiest and requires very little effort. Just go about living your life, feeling everyday feelings, and having everyday thoughts. Enjoy this part, because it won’t go on for all that long. Here is why.
Worried Voice:It’s not good to have me in the kitchen. I could pick up a knife and stab you!
False Comfort:You are scaring me, Worried Voice. Do you want me to lock the drawers and hide the knives?
Worried Voice:Well, it would make me feel better, but this rolling pin—I could just bash you in the head with it!
False Comfort:Maybe I should get out of your way? Am I far enough from you? We could just not cook today.
Wise Mind:What’s all this fuss about? Thoughts are thoughts. They are bluffing you. Get on with the recipe, knives and all. I’m hungry.
Soon, in the course of living your life, you will have a passing intrusive thought. We know this will happen because everyone has passing intrusive thoughts. This just happens; it is not under your control.
Now is the time to add ingredients. This part is up to you, but don’t worry. Anyone using this recipe will be able to produce an unwanted intrusive thought. You have to latch on to this thought. You have to notice it and see if this thought can possibly mean something bad about your character or underlying intentions. (We are referring to the two myths mentioned above.)
Here is where your mental effort and your belief system start to work together. If this passing thought can mean something about you and if you honestly believe that the content of your thought doesn’t fit with your sense of the sort of person you are, then you will begin to wonder and doubt yourself. And you will enter a very uncomfortable zone of uncertainty. Psychologists call this a form of “cognitive dissonance,” where your thoughts and your feelings seem uncomfortably different.
And if that possibility exists (and of course it is impossible to absolutely prove that it doesn’t), you then have to make sure that the thought doesn’t come back again. Because if it intrudes again, then it reinforces that there is something bad about your character or intentions. And you believe with all your heart that this is not true. So those thoughts better stay away, and it feels as if your job is to make sure that happens.
For this next step, the struggle starts in earnest. You are fighting the thoughts, but they continue to return. You are encountering the ironic effect: the more you try to keep these thoughts from your mind, the more they intrude. The more they intrude, the more frustrated and anxious you become. You start to wonder if perhaps you aren’t as good a person as you had believed. After all, how could a good person have such a twisted mind? Remember, if you are going to be successful at creating a stuck intrusive thought, you have to react to an ordinary passing thought with distress, alarm, and upset. Otherwise it will just pass, you will forget it or laugh about it, and the recipe will be ruined.
Here are a variety of kitchen hints you may use to ensure that the thoughts will become stuck, repetitive, and distressing. Some of them are probably already familiar to you.
Try hard to think of an explanation for these thoughts.
Use your rational mind to counteract the product of your irrational mind.
Think of how much better things would be if only you hadn’t done something, gone someplace, watched some TV show, or whatever that seemed to trigger the thought.
Imagine how awful you would feel or what terrible things would happen, if you actually acted on your intrusive thought.
Be stern with yourself as a way to make sure you keep disciplined and don’t let the thought creep in. Criticize yourself strongly if they do.
Think about how much easier it would be if you only could be certain that you would never act on your awful thought!
As you work even harder, you experience the fact that your effort appears to work backward. Your energy seems to give power to the thought, and, in contrast, you begin to feel much less powerful, almost as if there were a strong impulse forcing you to act against your will. Your brain and body are in alarm mode, and you are primed for danger.
You can be sure you are in alarm mode by noticing the enormous feeling of whoosh that starts low down in your belly and rushes up to your head. That whoosh is the best indication that you are correctly following directions to this point. If there is no whoosh of distress, pick another passing thought or work harder at fighting or being appalled by it.
You now enter the altered state of awareness that we call anxious thinking. Anxious thinking is what happens to everyone when the alarm system in their brain goes off. Think of this as your adrenaline surge. The part of your brain that triggers this alarm—the amygdala—starts responding with its fight, flight, or freeze response. (This reaction has a number of names, including, “stress reaction” and “danger
reaction.”)
The perceptual changes that are part of anxious thinking contribute to the increasing belief that the intrusive thoughts mean more than ordinary thoughts. They start to feel like impulses that need to be resisted.
At this point, your body is in alarm mode, and you are experiencing a range of physical sensations indicating what psychologists call “high autonomic arousal.” In regular words, it means that your entire nervous system is primed for danger, and you are doing whatever you can to keep yourself safe. You are at a critical point in the recipe, so don’t even think of stopping! Imagine that you are making a soufflé. There is a point in every soufflé recipe when you have to go with your feelings so the soufflé doesn’t fall, yet doesn’t overbake. In a similar manner, it is just as important to the success of this recipe that you go with your feelings, whether they are fear, disgust, shame, or shock and listen to what your alarm system is telling you. You must allow yourself to believe that the alarm sounded by your amygdala and felt in your body is a true alarm—a message of warning not to be ignored. If you don’t and if you start thinking it might be silly or is overreacting or a false alarm, it will result in a failed attempt. So be sure to take your amygdala seriously.
You can now congratulate yourself. Merely by following these simple directions, you have created an unwanted intrusive thought from a completely ordinary passing thought. And, if you want, you are ready to sit down at the table and serve your recipe to others.
But wait! There’s more!
For added touches that ensure that your unwanted intrusive thought won’t fade away prior to getting maximum suffering, you can include the following:
Feel guilty and ask others for forgiveness.
Explain that you are not the type of person who wants to do the things in your intrusion. Ask for reassurance that you would never do something like that.
Check with others to determine if you seem weird or odd, and whether your behavior caused them discomfort.
Condiments might include a few sprigs of shame and a dollop of anger.
To ensure misery and distress, repeat this recipe as often as possible. Daily practice is preferable, although some people need to start slow with only the occasional effort and pick up speed and frequency over time. Once you are practiced at this recipe, you eventually find it possible to easily ruin a good day. Merely follow the steps above, which become quite automatic.
Now that you know how unwanted intrusive thoughts are created, refer back to chapter 6 to remind yourself why you feel so frustrated.
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Sally M. Winston, PsyD, founded and codirects the Anxiety and Stress Disorders Institute of Maryland in Towson, MD. She served as the first chair of the Clinical Advisory Board of the Anxiety and Depression Association of America (ADAA), and received their prestigious Jerilyn Ross Clinician Advocate Award. She is a master clinician who has given sought-after workshops for therapists for decades. She is coauthor of What Every Therapist Needs to Know About Anxiety Disorders.
Martin N. Seif, PhD, cofounded the Anxiety and Depression Association of America, and was a member of its board of directors from 1977 through 1991. Seif is associate director of The Anxiety and Phobia Treatment Center at White Plains Hospital, a faculty member of NewYork-Presbyterian Hospital, and is board certified in cognitive behavioral psychology from the American Board of Professional Psychology. He maintains a private practice in New York, NY, and Greenwich, CT, and is coauthor of What Every Therapist Needs to Know About Anxiety Disorders.
Overcoming Unwated Intrusive Thoughts Page 17