Overcoming Unwanted Intrusive Thoughts: A CBT-Based Guide to Getting Over Frightening, Obsessive, or Disturbing Thoughts

by Sally M. Winston PsyD

Neither thoughts nor feelings are facts.

“Sticky” mind is a term we use to describe the experience of having thoughts that should normally fly just once through your mind, but instead keep coming back, or repeat. Each time they return, they draw undue and undeserved attention, and feel stuck.

There are two factors that lead to it. One is genetic—this tendency runs in families and is associated with various inheritable traits and conditions relating to brain circuits and biochemistry. Most people with a sticky mind can identify other members of their families who have it as well, whether they own up to it or not. The second factor is stress. Minds tend to get stickier when they are fatigued, overwhelmed by good or bad

events, and dealing with illness, stressful situations, or conflicting emotions.

Stickiness can feel uncomfortable, but it is not dangerous or meaningful. And the really great news is that no matter what the causes (genetic or stress) are, you can learn to change your brain to become less sticky.

You have certainly noticed something very strange and frustrating about your unwanted thoughts: the harder you try to not think them, the louder and more insistent they become. Effort seems to work backward. We have previously described this as the ironic effect—what happens when we try to control what is in our mind—but the more general principle is called “paradoxical effort.” If sticky mind can be compared to flypaper in the mind, then paradoxical effort can be seen as the old Chinese finger trap.

Entanglement with a thought means that you have created an inner dialogue about the aggressive, sexual, nonsensical, or otherwise bewildering content running through your mind. You are judging it, arguing with it, or trying to reassure yourself about it.

Entanglement can happen in a variety of ways, but most often, answering back or arguing with an intrusion is what keeps it going. Getting involved and entangled with unwanted intrusive thoughts makes them stronger and more insistent.

We become entangled with thoughts when we take their message at face value. If we can see their message as junk, then it is much easier to ignore the content of the thought and focus instead on the meaning behind the content.

Entanglement is a major factor in keeping intrusive thoughts going.

God grant me the serenity to accept the things I cannot change; courage to change the things I can; and the wisdom to know the difference. In this case, what cannot be changed is the arrival of the unwanted thought—it just happens—and the first fear or initial jolt of emotion is what arrives with it. Our consistent message is that what can be changed is your reaction to that experience.

Coping is not the goal here. Coping does not provide lasting recovery

Our goal is much more enduring and profound than mere coping. We want you to reach the point where you do not care whether the thoughts come or not. We would like you to turn off the alarm system in reaction to these thoughts so your amygdala no longer needs to warn of danger. We want you to change your relationship with the thoughts so they no longer cause distress. This reduces dread and stickiness so ultimately the thoughts will cease to bother you at all.

You have already learned that your old methods of coping are not helpful in the long run because they usually involve trying to avoid, reassure, justify, or argue with the thoughts. And each one of these techniques empowers the thought and makes it more potent and scary the next time.

R: recognize J: just thoughts A: accept and allow F: float and feel T: let time pass P: proceed.

Step 1: Recognize Pause and label. Say to yourself something like, “Right now I am having a thought that intrudes into my awareness. This is an intrusive thought. It has caught my attention because of how it feels.”

Step 2: Just Thoughts Remind yourself: dig up the information you already know—that these thoughts are automatic and you can safely leave them alone. Say lightly to yourself, “These thoughts are automatic and are best left alone.”

Step 3: Accept and Allow Accept and allow the thoughts in your mind. Do not try to push them away. This is a complicated suggestion, and many people ask questions about it and find it difficult to comprehend. We will talk about this later in more detail, but for the present, your job is not to distract, not to engage, and not to reason away.

Don’t allow yourself to start exploring the ideas or content of your thoughts. Don’t try to come up with a plan or solve any problem that appears to be created by your thought. When you do this, you are trying to figure out the answer to a problem that has no answer.

Furthermore, it is not a problem! What does it mean to accept and allow the thoughts? Accept does not mean “I am stuck forever with these thoughts and the misery around them, so I just have to put up with them.” It also does not mean “I have to accept the content of these thoughts that says I am bad, crazy, or flawed.” Accept and allow means that you are actively allowing the thoughts to be there, not wishing they were gone, because this attitude helps you grasp that the thoughts are unimportant. They do not require any attention or response.

Step 4: Float and Feel Float above the fray and allow the feelings to just stay there. Return to the present whenever you notice you are out front in an imagined future. Move from all that thinking into your current senses. (What can you see, hear, smell, and touch?) Concentrate on what is as opposed to what if. Surrender the struggle.

Step 5: Let Time Pass Allow time to pass. Don’t urge it on. Observe your anxiety and distress from a curious, disinterested point of view. Do not keep checking to see if this is working; just let the thoughts be there. They are thoughts. There is no hurry.

Step 6: Proceed Even while you are having the thoughts, continue whatever you were doing prior to the intrusive thought.

Imagine that unwanted intrusive thoughts are terrorists of the mind. Just as terrorists work by making people change the way they live, feeling compelled to abandon what you are doing is giving power to the message of terror. Even if you are feeling afraid (that’s your amygdala doing what it is supposed to do) and even if your intrusions return, your most powerful response is to continue with your life as if nothing has happened.

It is simply not true that we can control what pops into our mind. We can control what we choose to do, but not the automatic thoughts that just show up.

You are sitting comfortably and peacefully on a lawn chair on a ledge behind a waterfall. You can feel a little light spray, but you are perfectly safe. As you watch the water cascading in front of you, you can see some debris from upstream, and something goes by that looks like it might be valuable. But you know if you reach for it, you will have to forgo the pleasure of this experience, strain yourself to catch it, and it might not be of any worth at all. You might even lose your footing. So you just watch it go by. This illustrates that the natural flow of the mind has debris that may sometimes feel important, but is not worth examining. In these cases, letting it go by is the best strategy. Not every thought we think is important or worth retrieving. Floating behind the waterfall and just observing is a way of understanding step 4, float and feel.

The inhibitory-learning model (Craske et al. 2008) of exposure says that people don’t really unlearn old, fearful responses. Instead, what happens is that new pathways are created in the brain that compete with the old, fearful response. The more new pathways that are created, the greater the chance that a nonfearful path will be chosen. If you practice it enough, you create many nonfearful responses that inhibit the scary one. A nonfearful response then becomes the default response, and you are no longer afraid.

Eventually you will discover that the thoughts you invite in—with acceptance, deliberateness, and willingness—change how they feel and how they act. They lose their power to frighten you, disgust you, upset you, or even deter you from doing whatever you wish. They lose their illusion of being meaningful and important. You feel more free. When you do these planned exposures, you are disentangling from them and disempowering them with your attitude of acceptance. The more you practice, the faster this happens. You take back control by refusing to control, and you regain composure and self-respect by allowing the natural course of your mind to proceed. You deprive the thoughts of the fuel of paradoxical effort, and they dwindle in importance and, eventually, in strength. Recovery occurs when it no longer matters whether the thoughts happen or not.

Acceptance is when you actually don’t care whether the thoughts are there or not because they are not important or worthy of attention and because they do not matter.

When you know that intrusive thoughts are likely to return, you are less likely to fall back on old ways of reacting. This can include shock, annoyance, and anger, which then escalate the problem. Part of your job is to remember that thoughts can return at any time, from weeks to years or even decades after they have petered out. But unless you lead an utterly charmed life with no stress, conflict, nights of poor sleep, and no excitement, change, or boredom, there will be a time when the brain just becomes temporarily sticky and old pathways in the brain circuitry are accidentally reactivated.

If you do not expect this, then the natural responses to the unwelcome return of thoughts are (1) demoralization (Oh no, not this again), (2) anger (I was sold a bill of goods, or Why me?), (3) fear (I must be really a sick or bad person), or (4) hopelessness (That method works for some people but not for me; it is hopeless for me). If you understand that this temporary return of thoughts tends to happen to everyone in recovery, then it is far easier to greet it as an opportunity to practice the attitudes and anti-avoidance skills that may have become rusty over time.