Obsessive thoughts, also known as automatic negative thoughts (PAN), are common in anxiety disorders and major depression, although they also occur in people without emotional problems.
They involve a huge investment of cognitive effort and can generate a physiological response similar to what would be observed in the event that the fact that is feared was actually happening.
Most of the people who refer to experiencing them attribute to them the ability to persist despite the deliberate effort to eliminate them, which creates despair and further worries.
In this article we will offer several tips on how to manage obsessive thoughts , all based on current scientific knowledge.
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What is an obsessive thought?
An obsessive thought is a mental content that is presented in the form of words or images, the nature of which is threatening and that accesses the mind automatically and unwanted . It can take the form of concern for a future event or re-experiencing of an event located in the past, which is accompanied by very difficult emotions whose intensity can exhaust affective resources.
The threatening content often implies a physiological fear response, with the difference that the stimulus that provokes it is not really present, but rather wanders somewhere between the future and the past. The sympathetic nervous system (one of the branches that make up the autonomic nervous system) interprets the situation analogously to that of direct experience, putting in place all the resources to fight or flee (anxiety).
How to manage obsessive thoughts
There are data that demonstrate the existence of strategies to manage obsessive thoughts appropriately, which we proceed to describe in the following lines.
1. Concern about a problem that really is solvable
The problems, in general, are divided into two large groups: those that can be solved and those that cannot . Each of them requires a different approach, otherwise our efforts may be unsuccessful or counterproductive. The first step that we should carry out is to analyze the possible cause of our obsessive thoughts, because perhaps they are associated with an objective situation that can be modified in its very essence.
It is not uncommon for people, when they are embarrassed by a host of stressful situations or by a particularly difficult specific event, tend to postpone the problem or consider that its avoidance will end up bringing with them the desired solution. Scientific evidence tells us that, under modifiable circumstances, assuming a passive attitude is related to worse consequences on emotional health in the medium and long term.
To avoid this circumstance, there are specific procedures designed to solve problems, such as the one proposed by Nezu and D’Zurilla. It consists of five well-defined steps, in sequence: description of the problem (write it in a simple and operational way), generation of alternatives (numerous, varied and delaying judgment), exploration of the feasibility of the different alternatives (considering the positive consequences or negatives that may occur in the medium or long term) and implementation of the best of all possible solutions.
This model, known as Decision Making Training (DTE), has been the subject of numerous investigations with the purpose of verifying its effectiveness in very diverse contexts and problems, demonstrating its potential as a therapeutic tool.
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2. Time out and distraction
A procedure that is useful to many people is known as “time out.” Since obsessive thoughts can last for many hours each day, those with it may end up immersed in it most of the time. The procedure we are talking about has the purpose of establishing in advance a specific moment of the day in which this type of thoughts will be authorized , limiting it in the rest.
This procedure has the advantage that the person does not try to eliminate his negative thoughts, but rather reserves for them a space in which to exist, and dedicates the rest of the time to productive activities. It is not, therefore, a form of experiential avoidance; but simply a different management of your resources. Evidence indicates that encapsulating worry reduces the intensity of thoughts by an underlying process of satiation and by an increase in the subjective feeling of control.
3. Stop thinking
Thought-stopping techniques do not enjoy sufficient evidence, so this tip is directed at your questioning their usefulness. We now know that when a person struggles with a thought that he considers inappropriate, a paradoxical effect occurs : it increases not only quantitatively, but also qualitatively (intensity and frequency). And it is that trying not to think about something is enough for it to knock insistently on the doors of our brain.
When a thought comes to mind, the brain cannot identify if what we want is to avoid or remember it. It simply activates a synapse pattern that evokes sensations and emotions directly related to it, increasing its availability to consciousness.
Some procedures, such as Acceptance and Commitment Therapy , highlight the capacity of this experiential avoidance to contribute to the development and maintenance of emotional problems.
4. Mindfulness
Mindfulness is not a relaxation exercise, but a meditative practice . It comes from the Buddhist monastic traditions, although it has been devoid of its religious overtones to be used as a therapeutic procedure that guides its focus to the active maintenance of an attentive conscience. This form of attention allows focusing on the present moment, avoiding judgment on the facts and the tendency to wander between the past and the future.
There are many studies that, using functional and structural neuroimaging techniques, detect subtle changes in the structure and function of the brain as a result of continued practice of Mindfulness. The areas on which an effect is seen are related to functions such as the processing of emotional experience and the regulation of the flow of thoughts, thereby facilitating a “witness mind” on the internal experience.
Today there are numerous Mindfulness-based techniques, many of which can be practiced in a multitude of real-life situations (from eating to walking). In the case of anxiety, it may be necessary to consult a specialist before practicing it, since the orientation of attention towards certain bodily processes (such as breathing) can accentuate the symptoms when they are interpreted in a catastrophic way.
This last detail is extended to diaphragmatic breathing and progressive muscle relaxation , which involves the coordinated tension and distension of large muscle groups in a logical sequence (always accompanied by inspiration and expiration). There is ample evidence surrounding its favorable action on the physiological and cognitive components of anxiety, but it may also require prior consultation with a mental health specialist.
5. Breakdown of dynamics
The presence of obsessive thoughts tends to divert attention to our own mental processes , causing us to excessively evade those things that surround us. This self-absorption tends to be resolved, occasionally, by modifying the activity in which we are immersed.
It is possible that something as simple as changing rooms, or embarking on a walk through an unaccustomed area, redirects attentional processes abroad.
6. Exposure
Many negative and repetitive thoughts are associated with fear of events that may take place in the future, but that rarely occur. This phenomenon is common in Generalized Anxiety Disorder , where concern becomes more prominent as it is considered an effective coping strategy (a kind of mechanism to reduce the risk that their fears will manifest). It is also common in some phobias, such as agoraphobia and social phobia.
There is evidence that the best approach to fears, which are often the root from which many automatic negative thoughts spread, lies in exposure techniques. These can be very varied, from the one that involves direct contact with what is feared (in vivo) to the one that uses the imagination to make possible a series of successive approaches to the phobic stimulus, and there are even procedures using virtual reality techniques.
While it is true that when we avoid what we fear we feel immediate relief, this effect harbors the trap of perpetuating emotion and even accentuating it on successive occasions when we can meet again with the feared situation or stimulus. Standing up to the monster that we have created with our hands, from perpetual flight, can cause some anxiety; but each firm step is erected as an achievement that endows us with better self-efficacy and fuels our options for success.
7. Dedramatization
Obsessive thoughts are often credited enormously. There are people who even feel tremendously unhappy due to the isolated fact of having experienced them, which together with the loss of control that these generate, only exacerbate their feelings of anguish and helplessness. The truth is that mental contents of this nature do not pose any danger to the person who lives them , and that there are also effective ways to address them.
Catastrophization (belief that the occurrence of a fact would be impossible to tolerate), polarization (expression of thoughts in absolute and dichotomous terms) or “should” (imposition of necessity on what really is a desire); They constitute habitual cognitive distortions in many people, since they are erected as heuristics through which we interpret reality when it exceeds the cognitive resources that our species has.
There are four criteria from which we can assess whether a thought is irrational, namely: it lacks objective foundations (we do not have evidence to prove its veracity), it generates overflowing emotions, it is useless in adaptive terms and it is constructed in lapidary or absolutists . In all these cases, there are specific cognitive restructuring techniques that have been shown to be effective in the hands of a good therapist.
When to Seek Professional Help
Some obsessive thoughts occur in the context of major mental disorders , such as Obsessive-Compulsive Disorder . In these cases the person is overwhelmed by thoughts over which he has no control, which are alleviated by putting into practice a compulsion (counting, washing hands, etc.). The connection between obsession and compulsion tends to be clearly illogical and, although the person recognizes it as such, it has enormous difficulties to break it.
Thoughts of this nature may also exist in cases of major depression (especially focused on past events or a very strong pessimism about the future), as well as post-traumatic stress disorder or generalized anxiety disorder. These assumptions should be evaluated by a mental health professional, so you should not hesitate to consult with one if you suspect that you could be suffering from any of them.
