Rob Willson - Cognitive Behavioural Therapy For Dummies

Not all suicidal ideas are to be ignored. If you find yourself becoming increasingly preoccupied with ideas of harming yourself or ending your life, seek help immediately. This advice is especially important if you’ve begun to develop a plan and find your suicidal thoughts comforting. Talk to your doctor, a family member or friend or take yourself to the psychiatric emergency unit at your nearest hospital. Chapter 12deals with depression. You can also read Chapter 23for valuable information about seeking professional help.

People with OCD (more on this disorder in Chapter 14) often experience intrusive thoughts and images. The content of these thoughts and mental pictures can vary widely, but they’re frequently about harming people you love or acting in a way that dramatically violates your moral code. Other emotional or anxiety problems can also give rise to a host of nightmarish ideas and images. Some classics may include the following:

Losing control of your bladder or bowels in public

Blurting out something really offensive

Behaving in a sexually inappropriate manner

Jumping on to a train track

Driving your car recklessly

Harming an animal

Harming yourself or another person (a child or loved one)

Having a panic attack in a public place

Making a bad decision which results in irreparable consequences

Being harshly rejected or humiliated

Experiencing thoughts and images about death or violence (to self and others)

When you have such unsolicited ghoulish mental activity, it’s very understandable that you want to get rid of it. Typically however, the harder you try to rid yourself of such thoughts and images, the more they take hold. This is because your attempts to eliminate, avoid or neutralise unwelcome thoughts are driven by the fundamental rule:

‘I must not have such thoughts; they’re unacceptable and mean something dreadful.’

When you put effort into preventing or eliminating a certain thought, you’re inadvertently focusing more attention on it. If you regard certain kinds of mental activity as taboo, then you increase your fears of it occurring. Paradoxically, you may end up increasing the frequency of intrusive images and thoughts plus elevating your disturbance in response to them. Everyone has intrusive thoughts and images from time to time. Even if you’re not in any form of psychological or emotional distress, you’re not immune to the occasional gruesome mental image. People without anxiety or depression, however, are more readily able to dismiss the thought or image as unpleasant (or even shocking) but of ultimately no real importance. You can begin to tolerate unpleasant thoughts by adopting the following attitude:

‘I don’t like these thoughts, but they aren’t abnormal or important. They don’t mean something bad about me.’

Because the content of these types of thoughts is so abhorrent to you, they can feel terribly important. You might assume that they mean you’re more likely to do some horrendous deed or that something terrible is now going to happen to a loved one because you thought them. More accurately, these types of thoughts are merely a reflection of what you hold dear and value. Rather cruelly, you tend to get afflicted by the kind of thoughts that run counter to your true character and value system.

You can try to think of intrusive thoughts and images as ‘waking nightmares’. When you have a nasty dream you probably shake it off pretty quickly because you just think, ‘Yuck; oh well, it was just a bad dream’. You probably don’t usually give the content of your dreams much credence. Do the same with unpleasant images that come when you’re awake. Just because you’re awake doesn’t make them any more valid or important.

Even though some thoughts and images are uncomfortable, you can tolerate them. As you increase your tolerance for unwelcome mental images, you simultaneously reduce your fear of them. Disliking specific kinds of thought is okay, but remind yourself that thoughts are all they are.

Worrying and upsetting thoughts and images won’t last forever. If you do nothing, they’ll eventually fade away. As we’ve already mentioned, trying to control unwelcome thoughts rarely works for long. The key is treating these thoughts as though they’re of no importance. When something is of little or no importance, you tend to ignore it or give it little attention. Instead of fighting against these trivial (though tormenting) thoughts, do nothing. Take off the boxing gloves and just let your mind move onto other more neutral images and thoughts naturally. Doing so sounds pretty simple and straightforward, but just letting go can be hard to master. Your feelings of anxiety, disgust or horror about intrusive thoughts can compel you to action. Resist the pull of your feelings.

Try these tips:

Let unwelcome thoughts play out in the background as though they were just noise. Think of these thoughts like static on the radio or street noise outside your office window. You can filter them out and refocus your attention onto a task.

Get your mind busy doing something else more interesting or compelling. Pick up the phone and make some important calls, do a crossword puzzle or go for a walk.

Raise your heart rate. Going for a run, playing a sport or vacuuming vigorously can help relieve anxiety and clear your mind.

As you pay less attention to unwelcome thoughts, you’ll probably find that your adverse feelings about them become less intense. Eventually, just allowing your thoughts to extinguish will become much easier because you’ll have reduced their emotional impact.

It may be tempting to ask for reassurance from friends (or even your CBT therapist) that your thoughts are not dangerous. This can be a slippery slope since you unwittingly reinforce fear and intolerance of unwanted thought content. Instead of repeatedly seeking reassurance, remember to treat thoughts of this ilk as unimportant. You probably don’t dwell on or talk incessantly about unimportant things – so practise the same policy in this instance.

Part 2

IN THIS PART …

Find out how to clearly name your emotions and work out the difference between helpful and unhelpful emotions.

Discover what you want to change in your life and realise how some of your current solutions to problems may not be benefiting you in the long run.

Work toward setting and achieving important goals in your life.

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