Thankfully, many of you have been reading the book Overcoming Unwanted Intrusive Thoughts, going over past newsletters, and emailing your questions about unwanted intrusive thoughts.
Over the past few months, the majority of emails I receive revolve around a similar question: you describe what you are experiencing, and then ask, “Is this an intrusive thought?” Sometimes you haven’t read the book, and you want to know if you should buy it. Others have read the book, and still wonder because your particular form of Unwanted Intrusive Thought wasn’t explicitly mentioned. There are also some who find that your Unwanted Intrusive Thoughts have morphed into another type of thought or intrusion. You were clear that the original intrusions were Unwanted Intrusive Thoughts, but now you aren’t entirely sure. And then there is also a group who think that you have an Unwanted Intrusive Thought, but aren’t sure, and therefore have persistent doubts about whether or not you are dealing with an intrusion.
I’ve addressed this topic in previous newsletters. In fact, this was the topic of the previous newsletter, but clearly lots of you are still confused. So, let’s review and then go over some of your questions.
First the review: We start with the statement that the content of your thought does not matter. I know that’s an odd and weird idea, but it’s essential to see that the important thing is not the content of your thoughts, but rather how you react to that thought. Why is that? It’s because thoughts are just thoughts.
We are sometimes startled and horrified by the content of our own particular thoughts, but we have no problem reading the same sort of thoughts in a novel, or some horror show on TV. (Has anyone read some of the really creepy–and exciting and extremely successful!–novels of Stephen King?). He makes millions on those thoughts and yet–if we have thoughts like that–we worry that our minds are out of kilter!
If content doesn’t matter, then what is important? Only two things: how the thought feels and how it acts. Let me explain.
- First, it feels awful. It often comes with a whoosh, and it scares or embarrasses or disgusts or irritates you. You want to get rid of it, and you want to get rid of the feeling that comes along with it.
- Second, it repeats. It comes back again and again. It feels stuck. It may morph for a while to something somewhat different, but then it might come right back to the original thought. In other words, intrusions stay stuck. The thoughts and feelings don’t progress. They don’t get washed away in the normal stream of consciousness.
Remember that intrusions are thoughts–or sensory experiences–that are perceived as unacceptable, irritating, annoying or just plain awful. The focus here is on thoughts, and thoughts (including thoughts about unwanted sensations) are fundamentally different from the goings on in the real world. Sometimes it helps to illustrate this with a thought experiment: Think something really awful, such as, “What if I lose my job? The content of this thought is terrible, but it is still a thought that is being created by your mind. It doesn’t exist in the real world. And if you get stuck on that thought, it will go round and round.
But in real life if you did lose your job–which would indeed be a huge loss–you would do your best to cope with it, check out finances, look for work, perhaps consider relocating, maybe start that business you had thought about, apply for unemployment or other assistance, cut down on unnecessary expenditures, and try to get on with your life. You might feel angry, sad, or even excited. You might take the time to train for a marathon you want to run. But you wouldn’t be stuck. Getting stuck is reserved for unacceptable thoughts.
Thoughts get stuck. Life goes on.
Interestingly–and as an aside– people who are highly anxious often do very well in real crises. That is because they are forced by each crisis to focus on “what is” as opposed to “what if?” And, every Unwanted Intrusive Thought can be viewed as a form of a “what if?” thought that gets stuck.
Now, if we apply the two step Intrusive Thought test, (They feel awful and they stick), it becomes easier to identify Unwanted Intrusive Thoughts.
Still, lots of people write and say something like, “I had an Unwanted Intrusive Thought, and I’ve been working on it with some success, and now I keep on thinking that I don’t deserve to live. But I really don’t want to kill myself.”
Guess what? This is new the Unwanted Intrusive Thought to deal with. It has morphed. This happens a lot, and you need to be aware of it happening.
Here is another example of a common morph: “I keep on thinking that I really don’t want to get over this.” or, “I deserve to have these Unwanted Intrusive Thoughts.” These, too, are Unwanted Intrusive Thoughts that need to be handled in the same way.
There are also questions about intrusive sensations that frighten or bother some of you. Here is a typical question: “I used to have intrusive thoughts about harming little children. Now, I have sensations around my groin that remind me of those thoughts, and make me think, ‘maybe I have some weird attraction to them’. Does this mean I really could hurt children?”
Let’s use the two step test for Intrusions: Does it feel awful? Yes! Is it stuck? Yes! Therefore, this is an Intrusion. It really is that simple.
Others ask, “I have this thought that my OCD is tricking me, and I really want to yell out a blasphemy in church. Is this an intrusive thought?” Answer: The two step test says, yes it is!
Finally, there are lots of questions centered on the theme, “How can I know for sure that this is an Unwanted Intrusive Thought?” And the answer to this has a short version and a longer one.
The short version is that you can’t know for sure that you have an Unwanted Intrusive Thought. That is, because, in real life, there is almost nothing that you can know for sure.
The longer answer is that asking for certainty is an aspect of the whole issue of Unwanted Intrusive Thoughts. Wanting to abolish uncertainty is working in exactly the wrong way to overcome Unwanted Intrusive Thoughts. It is a form of paradoxical effort, which is an engine that drives the next Unwanted Intrusive Thought. David Carbonell says it is like trying to put out a fire by pouring gasoline on it. The effort used to be absolutely, positively, sure just inflames the situation and makes it worse.
Instead of asking for certainty, your job is to make your best guess. That is how you make most decisions in your life. You assume that your car has brakes that work. You don’t know that for sure. You assume the bridge you drive over won’t collapse, but you don’t know that for sure. Here are some other things you can’t know for sure: A car could swerve off the pavement and hit you as you are walking on the sidewalk; a flowerpot could fall off a building you are walking by and hit you on the head; the floor you are standing on could collapse; a person near you could start shooting.
My purpose is not to scare or depress you with these (very remote) possibilities. Instead, I want you to see that you implicitly face very slight risks every day, all day, and you make some determination that you will be okay even with that risk. In fact, most of us don’t even think about the condition of our brakes, or whether or not the floor will collapse beneath us. If you insisted on zero risk, you would be immobilized.
If I try to list things in life that are totally risk free, I can’t think of anything.
Making your best guess is the way you make decisions in your life, and this is the best way to decide about Unwanted Intrusive Thoughts as well. You make your best guess. You abandon the hope of being absolutely, positively, certain about it. You allow for the uncertainty and its discomfort, and you cope with the Unwanted Intrusive Thought as we suggest in the book.
Remember the two step Intrusive Thought Test: Does it feel bad, and does it stick?
I hope this answers some of your questions.
Martin N. Seif, Ph.D., ABPP