Monday, August 16, 2010

Unhelpful Strategies: Thought Stopping for OCD

Stop and Think

This strategy has been around a long time, and never seems to go away. The premise is that you snap a rubber band on your wrist, or imagine a giant stop sign, or shout "stop", whenever you have an intrusive thought.

I have an early memory of being 8 or 9 and trying to stop thinking. I held my breath. I stood still. But I couldn't stop. I was baffled by this phenomenon. No matter how much I tried to make my mind blank, I could hear my thoughts of "Stop thinking. Have I stopped yet? Why am I still thinking?"

Thought Stopping sounds logical on the face of it. You have an intrusive thought. It makes you anxious. You want it to go away. You stop it. Except that I couldn't stop. It wasn't that I didn't try hard enough. It was that I tried too hard. Every time I jumped in to push the thoughts out, through figuring them out, rationalizing, analyzing, confessing them, researching them, websearching and other forms of distraction, cueing my relaxation exercises, my deep breathing or reassuring myself that it would be ok, the thoughts rebounded and came back even stronger.

If Thought Stopping worked, would anyone have OCD intrusive thoughts? We could just make them vanish with the snap on the wrist. Our minds are immensely creative and generative. All sorts of thoughts pop in, and if we just let them alone, they tend to pass. But if you have OCD it's a struggle to let them pass, and the initial wrestling with them does give a hit of anxiety relief, but then it's like signaling your brain that this thought is truly dangerous, so if it comes back, try to kill it, and the cycle continues.

I reclaimed a lot of my life back by doing Exposure and Response Prevention Therapy. I recorded scripts of the thoughts, and listened to them repeatedly until my anxiety level came down on its own. I had a therapist helping me to do this.

For More Information:

Am I Still Anxious? Does this Still Bother Me?
Talking to OCD: The Hazards of Talk Therapy
Freedom from Obsessive Compulsive Disorder by Jonathan Grayson


Hayes and his Action and Commitment Therapy colleagues have been researching the phenomenon of trying to make thoughts go away, and how it doesn't work.
For a useful summary of ACT, Dr. Russell Smith has a good article:
Simple Overview of ACT: To download a simple, non-technical, easy-to-read overview of ACT ( called 'Embracing Your Demons', an article he wrote for Psychotherapy Australia magazine) click here.

8 comments:

  1. Thanks for posting this! In therapy, I recently brought up some OCD thoughts that had been giving me a lot of problems lately and I asked my therapist what to do about it. She told me that to treat intrusive thoughts, you just stop thinking about them. WTF?! I didn't understand at all. If I could just stop thinking about them, I would have done that years ago. I asked her about it again at my next session, asked her to explain it because I just didn't get it. She did and I still don't understand. It sounds easy, but it has been completely impossible for me to do thus far.

    She also told me about doing recordings. She seemed to think stopping my thoughts would work better, but I'm disagreeing. I think I'm going to try recording a script soon and see if that helps. Any advice?

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  2. Hey Elly,
    I'm sorry you are getting the Thought Stopping treatment--good for you for asking your therapist her rationale. If there's any way you can find a therapist who specializes in Exposure Therapy, that would be very helpful. Also check out Jonathan Grayson's book Freedom from OCD--he has a lot about how to write scripts. Seriously, this book really helped me understand why I needed to listen to scripts, even when they scared me, and I started getting better.

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  3. Hi expwoman, thank you again for yet another concise and well-written post about another commonly offered unhelpful strategy! I always look forward to reading what you have to say! I can also remember trying to "stop my thoughts" when I was just 8 or 9. At that time I struggled with a lot of intrusive thoughts and images relating to fatal illness and death, as well as a bit of religious scrupulosity, and I too, can attest to the fact that just trying to stop those thoughts is not very effective!

    Have you heard of the book, "White Bears and Other Unwanted Thoughts" by Daniel Wegner? I got it a few months ago after my therapist mentioned it, and I have found what I've read so far intriguing. Though it is not specifically about OCD per se, this book is almost entirely devoted to the topic of "thought-stopping" and why, in reality, we just don't seem to be capable of such a thing, which is definitely a subject pertinent and helpful to understanding OCD!

    Elly - That does sound frustrating! If only just "stopping" our thoughts were that simple. Then we probably wouldn't need help in the first place! I second expwoman's recommendation of Jonathon Grayson's book - it is one of my favorites and was one of the first books my own therapist suggested I read. He does a thorough and very insightful job of addressing a lot of different aspects of OCD and how to overcome them!

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  4. Okay, I will put in my 2 cents here since I recently wrote about this on my blog. I use the rubber band for what I call "fleeting thoughts" versus intrusive thoughts that are caught in a loop. I agree wholeheartedly that trying not to think about an intrusive thought is not going to make it go away.

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  5. Fellow Sufferer--I believe Hayes talks about the White Bears and Unwanted Thoughts book--I will have to check it out.

    Beth--Thanks for chiming in. I'd be very interested to hear more about your experiences with the rubber band and fleeting thoughts--I have learned so much from reading other people's strategies for dealing with OCD.

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  6. For anyone else reading, Bakker (2009) published an interesting article which suggests that thought stopping might work for OCD if it is used to stop mental compulsions rather than obsessions. In this way, he claims it is not thought suppression but rather, a form of exposure--let yourself think the obsessive thought, but stop the compulsive thought.

    Restricted, but here's the abstract and preview: http://www.tandfonline.com/doi/abs/10.1080/13284200902810452#preview

    I thought I would put this here in case anyone comes by as I did wanting to know more.

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    1. Thank you Eva. This is interesting. It makes me think of something Jon Hershfield said about not "unwrapping a thought"--the tendency with mental obsessions to dig into a thought, analyze it, open it up and generate many more thoughts in the process. Mental rituals are harder for me to notice, but when I do, that is the first step to not "unwrapping" them.

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  7. The therapist must have confused "compulsions stopping" (possible) and "obsessions stopping" (impossible).

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