Transcription
Hey there everybody and welcome to this brief presentation on how to stop intrusive thoughts. I'm your host, Dr. Don Donnelly Snipes. So let's start out by defining what intrusive thoughts are. Intrusive thoughts, think intruder. They are like thoughts that you have that you don't want to have, and they can be a variety of different flavors, if you will.
According to the Anxiety and Depression Association of America, intrusive thoughts are involuntary, often have no bearing on reality, and are perceived by the person having those thoughts as unacceptable. You have this thought and it's just like, "Oh no, I would never do that," but it keeps coming back. Or you're having this thought that you don't want to have. It's a thought that you want to get rid of.
Intrusive thoughts are often triggered by stress, anxiety, insomnia, or even hormone fluctuations. Even in males, they are often totally random. Now, it's important to recognize that intrusive thoughts can be an aspect of anxiety, depression, postpartum depression, PTSD, or obsessive-compulsive disorder. So if you are having a lot of intrusive thoughts, or if your intrusive thoughts are impairing your quality of life, it's important to talk to your doctor or talk to your therapist, who can help you identify strategies in order to be able to better handle them.
This presentation is just going to hit the highlights of some techniques that might be able to be used in the moment in order to help quiet some of those intrusive thoughts. Types of intrusive thoughts that people have. They can be negative thoughts like, "I'm an idiot and I have no business doing this," or "Pretty soon somebody will see that I am a total fraud." Or they could be violent thoughts of hurting your child or failing to protect them.
Now, it's important to recognize here, a lot of women have intrusive thoughts or unwanted thoughts during the postpartum period, and it does not mean they have postpartum psychosis. If they have these thoughts and they are appalled by them, being appalled by them is a good sign. It means they recognize this is not something they want to do. Postpartum psychosis is when they have these thoughts and those thoughts make total sense to them, and they're not appalled by those thoughts at all. It's important if you're in the postpartum period and you're starting to have intrusive thoughts to develop a support system and talk to your OB-GYN or your pediatrician if if you're having these thoughts and they are bothersome, because there are strategies that can be used to help you deal with them more than what I'm going to go into here.
Other violent thoughts can be thoughts of a fire breaking out or a burglar breaking in when you go to sleep. Some people lay down and they feel very unsafe. Or you can have compulsive thoughts like, "I need to have that last piece of pizza," "That chocolate cake is calling my name," or "I need to have a cigarette or a drink or something else." Those are compulsive thoughts or cravings, which still fall in that intrusive thought category because they're thoughts you don't want to have, but they're thoughts that seem to not go away sometimes.
So how can we handle them? Well, I encourage you to think of intrusive thoughts like a salesman. And we've all had the occasion where we have encountered sales people that have been very, um, persistent, if you will. So think of these intrusive thoughts like a salesman trying to get you to buy into something that you don't believe, and their claims really have no basis in reality. You know, you watch these infomercials and they say, "This pan will never stick," and you get it home and it sticks. Or, "This cream will make you look 30 years younger," and you know good and well there's no cream in the world that's going to make you look 30 years younger. So you know their claims have no basis in reality, but they're still trying to convince you of that. Well, do you argue with them? Do you buy into them? Or do you say, "No, not worth my energy. I'm gonna move on"?
Remember, giving them any attention makes them stay around longer. If you acknowledge them, if you make eye contact with them, then they may have a hook, and then they'll start to try to, um, connect with you, and they'll they'll stay around longer. So instead of connecting with them, ignore them. And it goes against the very fiber of my being to ignore a person who's trying to talk to me, but I found that, for example, at the at the mall, when you're walking past kiosks and people are trying to get you to check out their products, if you make eye contact, if you acknowledge them at all, it's even harder to break away. Attention makes them stay around longer. Same thing for your thoughts.
So don't overthink. Don't start thinking, "I wonder why I'm having this thought. I wonder what this thought means." You can go down this whole rabbit hole of thinking about your thought, and that's not going to get you anywhere, and it's going to strengthen the memory pathways to that thought. We want to break them down, not strengthen them. So instead of overthinking, instead of wondering why you're having it, or if it has any basis in reality, or any of those questions, just distract yourself. Distract, don't react. Do something to turn your attention to something else. You may do sit-ups, you may walk around, you may call a friend. There are a variety of things you can do instead of giving that attention. Just like a salesman, the thoughts may come back. Just like you did the first time, it's important not to give them extra attention. Don't talk back. Distract, don't react.
The next technique I'm going to talk to you about is unhooking. Recognize thoughts are merely words and bits of images. They don't have to result in actions. Thoughts are kind of like a bad movie. These intrusive thoughts, you don't have to sit there and keep watching it. It's not forcing you to sit there and keep watching it. You can change the channel. And with intrusive thoughts, you want to change the channel. What else would you rather watch in your mind right now? You can also unhook from your thoughts by saying to yourself, "I'm having the thought that," instead of saying, "I am in danger." Saying, "I'm having the thought that I am in danger," assuming you're not, of course. Um, "I'm having the thought that I'm an idiot. I'm having the thought that, um, I'm going to make a fool of myself." Okay, you're having this thought. Pack it up. Put it into a thought box. Pack it up and put it over here on a shelf. If for some reason that I can't foresee, but if for some reason you need it, it's over there on the shelf, but it's not with you anymore. You put it in storage, and that can be helpful in the moment.
If you continue to have that thought again, you may want to talk to a therapist who can help you figure out ways to deal with it. But a lot of times these random thoughts, we just pack them up and put them over on the shelf and we forget all about them, kind of like some of the sweaters that I have in my closet. Develop a guided imagery script or think about something else. You can't think about two things simultaneously. I cannot think about writing a PowerPoint and what I'm going to make for dinner at the same exact time. So if you're thinking about something else, if you turn your attention, and sometimes you have to forcibly turn your attention and say, "No, I'm going to think about my vacation that's coming up. I'm going to think about what I'm going to do tomorrow. I'm going to think about something else." But that can help you turn your attention away from the distressful thought.
Guided imagery can be used if you develop a an image of being safe and feeling empowered. If you have a particular image for, um, for example, that can protect you from one particular thought, that may be something that you call upon when you start having that thought. And it's also important to note successes, or what I call proof negative. When after I had my son, I had really bad postpartum depression and I had a lot of intrusive thoughts, and it was terrifying to be alone with him, um, for for quite a while, and I didn't understand what's going what was going on, and I didn't understand all this stuff about intrusive thoughts at that point. So I was, you know, stressed out being alone with him. And I would take it sometimes minute by minute, sometimes hour by hour, noting, "Hey, I went an hour and everything's fine. I went two hours and didn't have this thought."
When I would start having those thoughts, I had distraction techniques. I would call a friend, or I would call my husband, or I would put the baby in a stroller and we would go out on a walk. I had a variety of different things that I could do in order to get out of that situation, break that thought loop. But then I would start looking back over it and recognize how many days that I had had him in my life that things had gone just fine. You know, I'd had those thoughts come and go, hadn't acted on them. That was proof negative for me. That was proof to me that I could have these thoughts and I wasn't going to act on them. So then I started feeling more empowered in what I was doing.
But proof negative can also apply to negative thoughts. If you tell yourself that, "I'm a screw-up and I shouldn't be doing this because I have no business being here," noticing when you do whatever it is you do, you know, maybe you're an electrician or a therapist or a resident, and you have a good day, you notice that, "Hey, I did a good thing." Noticing, um, proof to the contrary of those intrusive thoughts can also be helpful. Forcing yourself to focus on all of the things that you do right, instead of the one mistake you made, can be helpful at preventing those intrusive thoughts.
If the thoughts keep coming back or you can't seem to extinguish them, it may be a sign that you're also dealing with something more than just a random intrusive thought. You may be dealing with, as I mentioned before, anxiety, depression, PTSD, or obsessive-compulsive disorder. Any of these have a lot of treatments that can be very effective. So talk with your doctor or your therapist about the thoughts you're having and about strategies in order to deal with them.