Help Me Stop These Thoughts?

Sometimes people come to therapy hoping to make any and all negative thoughts and feelings stop. Just stop. One of the most common questions mental health professionals get is this: “How can I stop thinking about _______?

Ruminating and worrying about the same things over and over can interfere with plans, disrupt conversations, and add difficulty and negativity to an otherwise beautiful day. As a result, it’s no surprise that the question is a common one, not only in my own practice but in many other practices as well.

So, what can be done to help?

Ruminating and worrying

Before we discuss what can be done to change our thoughts, first let's define a couple of types of repetitive thinking.

An intrusive thought is an unwanted thought that lets itself into your head, often with repetition. Intrusive thoughts can be associated with certain mental health conditions such as Obsessive Compulsive Disorder and Post-Traumatic Stress Disorder, they can also occur in those without significant mental health disorders.

When people are depressed, they tend to ruminate – about the past, about self-critical thoughts, about losses or failures. Ironically it is these very thoughts that people want to get rid of, yet people find themselves going over and over these types of thoughts. These thoughts make people spiral into worse depression. Then people start to cope by isolating themselves and avoiding doing things they used to enjoy.

When people are anxious, they tend to worry – about how things might go wrong, about future mistakes or failures, about exposure to something they fear. Anxiety involves dreading the worst-case scenario, expecting failure, and believing that something is a threat to safety or well-being. When people have these thoughts, just as with depression, people start to avoid doing things out of fear. They let rules about what they think will happen to dictate what they do. For example, “I can’t risk stuttering during the presentation because people will think I’m stupid, therefore I just won’t do a presentation”. Or: “If I invite SoAndSo to get coffee they might not like me”.

To some extent, everyone ruminates and worries. We cannot completely control what we think or when, and from time to time unpleasant thoughts happen when we’re facing a loss or doing some kind of high-stakes activity. Ruminating and worrying becomes a problem when they become repetitive to the extent that they start to affect your functioning in significant ways in everyday life OR when they start to become dangerous.

Changing negative thoughts may take into account the potential cause. Or, the approach may need to just focus on the here and how. It is different for different people.

Treatment Approaches

Acceptance and Commitment Therapy

The primary approach I use is Acceptance and Commitment Therapy. This approach helps you reduce the extent to which you believe your thoughts, helps you look at your thoughts instead of from them, and helps you not get tangled up with those thoughts in the same way you have in the past.

As mentioned before, not all ruminating or worrying requires professional intervention. Many times the symptoms are mild enough to use effective self-intervention. Try these steps the next time you’re ruminating or worrying.

Step 1: Acknowledge the Thoughts. The first step is to acknowledge the thought is a thought, not a fact. Don’t ignore it, don’t hide it, don’t justify it. Simply think to yourself “I’m having the thought that _________.”

Step 2: Allow them Space. Paradoxically, trying to stop thoughts and avoid them can make things worse. This may work temporarily but they will just come back, often with veracity and the extra fear we’ve started to associate with them every time we don’t allow them space. Once you’ve acknowledged the thought just leave it be.

Step 3: Use Defusion. Techniques Give some kind of physical image or label to the whole of your thoughts, such as “This is the Monster showing up again” or “This is The Maze I’m in again”. Or try distancing from the thoughts by singing them in a silly voice to help reduce their power. Write a brief version of your thoughts on one side of an index card and on the flip side write what is really important to you.

Step 4: Try Journaling. For at least 20 minutes 3 times per week, sit down and write about your deepest thoughts and feelings about what you’re going through. There is extensive research evidence that this approach to what’s called Expressive Writing helps people feel better and improves even physical health.

Schema Therapy

Another approach I use for repeating, long-term thought patterns that really affect how we relate to people is Schema Therapy.  This involves identifying beliefs and thought patterns you developed growing up, that came about as a result of continually not having important needs met.  Then we look at the modes of coping you use to deal with these thoughts and work towards developing healthy adult modes of coping. 

Keep in mind that we cannot make negative thoughts and feelings go away entirely  

It’s important to understand that sometimes managing chronic depression or anxiety is like managing a chronic physical illness.  There will be flare-ups.  We say “it is a dead person’s goal” to expect to never have negative thoughts or feelings because as long as you are alive these thoughts and feelings are going to show up. The goal of living a happy and fulfilling life with these thoughts is learning how to live WITH them and develop different ways of responding and coping.

If you’re struggling with these steps or feel you’d benefit from some professional advice and you’re in the Houston area, I would welcome the chance to work with you.  Online scheduling is available with me, Dr. Carrie Dodrill.