Learning About Intrusive Thoughts
1 What are intrusive thoughts? They are
thoughts that come to mind, that we would like not to be thinking, but that are
hard to get out of our minds. Often intrusive thoughts are made up of visual
images and sounds, like those in a movie. While these are going on, we often
are thinking other types of thoughts, called self-talk. These are things that
we say to ourselves, in words.
Suppose
that someone has an intrusive thought in which he sees in his mind himself
purposely causing a bad traffic accident while he is driving. He thinks,
"I shouldn't be thinking this. I need to get this thought out of my mind
quickly!" Which is the visual image, and which is the self-talk?
A. Seeing the crash is the visual
image, and the self-talk is "I shouldn't be thinking this. I need to get
this thought out of my mind quickly!"
or
B. Seeing the crash is the self-talk,
and "I shouldn't be thinking this. I need to get this thought out of my
mind quickly!" is the visual image.
2. The intrusive thoughts we're talking
about here are almost always about things that we would very strongly want NOT
to happen. They often are images of doing things we would be very ashamed or
embarrassed or horrified to actually do. If this is true, which of the
following is more likely to an intrusive thought?
A. Someone has a thought about an
airplane safely taking off.
or
B. A mother has a thought of hurting
her baby.
3. The first thing to know about the
problem of intrusive thoughts is that it can be solved. Very many people have
been able to make intrusive thoughts no longer a problem for them, by learning
and practicing. The purpose of this pamphlet is to tell you what they have
learned and what they have practiced, in order to solve this problem.
This is meant to tell you about
strategies for solving the problem of intrusive thoughts by
A. medication,
or
B. learning and practice?
4. Why do some people get intrusive
thoughts, in the first place? People who get intrusive thoughts sometimes feel
like bad people -- that the images of doing bad or embarrassing things mean
that there is something bad about their personality or character. I think that
it's more likely the case that people who get intrusive thoughts tend to have
more active consciences than other people. They are more likely to be shocked
and upset by having images of forbidden behaviors occur to them, and that's
what starts them trying hard to get the images out of their minds. As we're
going to discuss more, trying very hard to get the images out of the mind tends
to keep them coming.
What's a summary of this section?
A. Rather than being bad people, people
with intrusive thoughts tend to have more active consciences than average.
or
B. Being able to relax is a skill that
can be cultivated with practice.
5. Intrusive thoughts are very often
part of what's called OCD, which is short for obsessive-compulsive-disorder.
"Obsessions" is another word for intrusive thoughts.
"Compulsions" is another part of OCD; they are the tendency to have
to do certain things over and over in some certain way to make things feel
comfortable or right or clean or safe. You can learn more about them in another
pamphlet called "Learning about Compulsions." Some people with OCD
have intrusive thoughts without compulsions, some have compulsions only, and
some have both.
What does this section tell us?
A. Intrusive thoughts often go along
with compulsions, to make up a problem called OCD.
or
B. One way of relaxing involves getting
the muscles as loose and limp as possible.
6. People with OCD often appear to have
what I call "cautiousness genes" -- a tendency to avoid harm, to be
careful, to watch out for danger, to feel scared about dangers. Having this can
be very useful! Protecting yourself from danger is one of the most important
things to do. Without the urge to protect yourself from danger, you wouldn't
have reason to avoid walking over cliffs, walking in front of speeding trucks,
and so forth! But people with very active cautiousness genes sometimes get false
alarms. It seems as if things are very dangerous when they really aren't. In
that case, fortunately, it's possible to teach your brain to get comfortable
with things that at first make you very scared, but aren't really dangerous.
What's a summary of this?
A. It's very good to be cautious.
People who inherit a large tendency to be cautious often need to teach their
brains that certain things that appear dangerous aren't really dangerous.
or
B. Monitoring your heart rate as you
relax can give you interesting information on what is happening to your body as
you use certain techniques.
7. Part of what scares people about
intrusive thoughts is the very frightening idea, "Maybe I will really act
out the images of bad behavior that are going through my mind." But people
with OCD tend to be cautious, and to have active consciences, and they are
probably less likely to do harm than other people are.
What's the message of this section?
A.Being
able to get yourself into a relaxed state is very helpful, and there are a
number of relaxation strategies worth practicing.
or
B.
Intrusive thoughts do not mean that there is a danger of doing the
behaviors that come into the imagination.
8. The fact that intrusive thoughts are
so often about things that we have very strong feelings against, brings up a
very important idea, that is very useful in dealing with intrusive thoughts.
Here's the idea:
Intrusive thoughts are hard to get rid
of, precisely because we are trying so hard to get rid of them!
What's another way of saying the
"very important idea"?
A. Trying very hard to get thoughts out
of your mind seems to bring them to mind.
or
B. When you say to yourself, "I'm
really glad this lucky thing happened," that thought is an example of
"celebrating luck."
9. The idea that when you try hard NOT
to think of something, you seldom succeed right away, has been noticed for a
long time. This has been called the "white bear problem." The writer,
Leo Tolstoy, described a challenge that his older brother gave to him when he
was a child: stand in a certain place without once thinking about a white bear.
He found that the thought of a white bear always came to mind! (The phrase
"white bear" instead of "polar bear" came from Tolstoy.)
When Leo Tolstoy tried very hard not to
think of a white bear, he found that
A. All sorts of other wonderful images
came to mind, instead of a white bear,
or
B. The image of the white bear kept
coming back to mind.
10. Here's an explanation the white
bear problem. Suppose we are trying to balance on one foot, run as fast as
possible, play a song on a musical instrument, or be very polite to someone. As
we try to meet that challenge, it's natural to frequently think, "How am I
doing?" We evaluate our own performance by comparing what we've done, to
an image of doing the job well. And this checking our own performance, which is
called self-monitoring, often helps us succeed.
But
how do we self-monitor whether we are succeeding at getting an intrusive
thought out of the mind? We compare whatever we've been thinking, to the image
we're trying not to think, to see whether we've thought it or not. But this
brings the intrusive thought to mind! As an example of this, when someone is
trying hard not to think about a white bear, they might naturally think,
"How am I doing? I'll compare the images going through my mind with the
image of a white bear... Oops! That brought the image of the bear to my
mind."
What's a summary of this?
A. Self-monitoring is usually a good
idea when you are working toward a goal.
or
B. Checking to see whether you've
succeeded in getting a certain image out of your mind tends to bring it back to
mind!
11. So rather than "Try to get it
out of your mind," what people have found works better is to "Let it
run its course." That is, you don't try to stop the intrusive image, and
you don't try to keep it going, either. You just let it do what it's going to
do.
Which of the following two strategies
usually works better for intrusive thoughts?
A. Try to get it out of your mind.
or
B. Let it run its course.
12. What do you do while you are
letting the intrusive thought run its course? There is a type of self-talk
called "celebrating luck." It's a very lucky thing that when a mental
movie comes into our minds, we are not obligated to act out that movie! People
can have the image of all sorts of different behaviors come to mind, without
doing any of them. For example, right now I'm sitting with a bunch of people
near me whom I've never met. I imagine getting up, greeting all the people
nearby, one by one, and then singing a song. But I'm not doing it! You might
try a similar experiment. The ability to imagine things without doing them is
called the "thought-behavior distinction." So
while letting an intrusive thought run its course, I recommend self-talk of
something like, "Hooray for the thought-behavior distinction!"
What is the thought-behavior
distinction?
A. The fact that you can imagine
behaviors without acting them out.
or
B. The fact that both your thoughts and
your behaviors can be very distinguished.
13. What else is recommended to do
while an intrusive thought is running its course? I recommend trying to figure
out something worthwhile that you can do during that time.
"Worthwhile" means either useful, smart, good, or fun, or some
combination of those. It could be worthwhile just to sit back and observe the
intrusive thoughts, and get used to them. Or: Chatting with someone, being a
good listener, cleaning up and organizing, doing some schoolwork, doing a chore
in the house, catching up on other work, reading something, exercising,
practicing music, practicing a relaxation technique, building something, taking
a dog for a walk, writing a thank-you note or saying thank-you or complimenting
someone -- there are so many possible worthwhile things to do. One clue might
be the answer to the question, "What would I like to be doing if this
intrusive thought were not running in the background?" Another clue might
be the answer to the question, "What is my best use of time right
now?" This second question is a good one to ask often, whether or not
there are intrusive thoughts!
What does this text unit recommend
doing while an intrusive thought is running its course?
A. Asking yourself what you can do that
would be your best use of time, and doing it.
or
B. First exercising and then practicing
something you want to get better at.
14. As soon as you are able to start
something worthwhile despite having the intrusive thought run through your
mind, then it's time for another type of self-talk, called "celebrating
your own choice." It's a nice accomplishment to make a good choice of what
to try to do, and another big accomplishment to do that thing, even partly! So it's good to be able to say some self-talk like,
"Hooray for me! I have been able to do something good! That's a good
accomplishment!"
What does this section recommend?
A. Eating meals with lots of vegetables
in them.
or
B. Celebrating when you have been able
to do something good, especially if you did it despite an intrusive thought
running in the background.
15. So let's
summarize some steps that are good to go through when intrusive thoughts
intrude.
1. Remind yourself of the
thought-behavior distinction, and celebrate that it exists!
2. Plan not to try to get rid of the
intrusive thoughts, and not to try to bring them on, but to "Let them run
their course."
3. Make a choice about what worthwhile
thing you'd like to do next.
4. If you are able to do that thing,
celebrate that you chose to to do it and that you
have been able to do it!
What's a summary of this section?
A. Celebrate the thought-behavior
distinction, plan to let the thoughts run their course, decide what worthwhile
thing to do, celebrate being able to do it.
or
B. An example of a compulsion is having
to check the same thing over and over.
16. You can practice this sequence of
thoughts, even when you are not troubled by intrusive thoughts. You just
imagine that some intrusive thoughts have come. You don't have to go into
detail about what they are. Then you imagine going through the four steps
listed above. You're imagining yourself celebrating luck (about the
thought-behavior distinction), planning to let the thoughts run their course,
figuring out what you want to do, and celebrating that you are able to do it.
This section advises
A. Practicing relaxing, just about
every day.
or
B. Practicing in imagination the
sequence of thoughts that goes: "Hooray for the thought-behavior
distinction. I'll let these thoughts run their course. What do I want to do
now? I'll choose this. Hooray, I'm able to do something worthwhile!"
Answers:
1. a
2. b
3. b
4. a
5. a
6. a
7. b
8. a
9. b
10. b
11. b
12. a
13. a
14. b
15. a
16. b