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

by Sally M. Winston PsyD

The simple truth is that what you resist tends to persist. This is the basic paradox—the ironic process—at work in making unwanted intrusive thoughts so persistent. Thoughts stick because of the energy you expend to fight them.

So the content of unwanted intrusive thoughts is the opposite of what you want to be thinking about. It is the opposite of your values, the opposite of your wishes, and the opposite of your character. It is the opposite of you.

Helpful Fact: Unwanted intrusive thoughts get stuck because you inadvertently fuel them by trying to push them away.

Unwanted intrusive thoughts fluctuate in frequency and intensity. As you understand that intrusive thoughts are thoughts that are stuck in your mind, then you realize that this is most likely to occur when your mind is especially “sticky.” There are a host of factors—some psychological and others physiological—that affect thought “stickiness.” You might have already discovered some of the factors. People are much more prone to unwanted intrusive thoughts when they are fatigued, have slept poorly, or are in a bad mood (anxious, crabby, irritable, feeling down or blue). If you are a woman who is menstruating, hormonal changes during your cycle can increase the frequency and intensity of your unwanted intrusive thoughts. Certain drugs, such as caffeine, over-the-counter drugs, and physician-prescribed medications, such as steroids and asthma medications, can as well. The day after consuming alcohol is usually a sticky day for most people. And some kinds of marijuana produce instant stickiness. Stickiness can fluctuate during the day, and often is the worst in the morning (almost as soon as you are awake) and when you are lying down to sleep.

Any situation that is uncertain and has “high stakes” is a perfect place for stickiness of the mind to increase. As soon as it seems important to know something 100 percent for sure, that is where the unwanted intrusive thoughts will find their opening.

that. Sensitization can be compared to an allergy. An allergic person has a strong reaction to substances that cause little response in others. In the same way, you react with great intensity to certain thoughts that others don’t. And, just as you try to avoid things you are allergic to, sensitized thoughts push you to work hard to avoid, crowd out, and try to banish your own intrusive thoughts. Since thoughts stick and start to feel like impulses in direct proportion to the effort you use to keep them from your mind, then, of course, media reports can intensify your own unwanted thoughts.

Toxic worry, on the other hand, involves trying to solve an issue where the outcome is uncertain or unknowable and there is no good answer to form an action plan. So you start to “solve” the problem once and can’t seem to come up with any good answer. So the worry returns, and then the entire process continues to repeat. It becomes stuck. Toxic worry starts with a what-if and continues in an endless loop of unsatisfactory “solutions.” Attempts to solve the problem in order to reassure yourself fail. Toxic worry can be about ordinary things like friendships, money, and scheduling—or it can be about highly unlikely things like rare illnesses and catastrophic events. What defines toxic worry is not what the worrying is about, but how the worries behave—they get stuck, repeat, escalate, and preoccupy. They don’t subside and take a back seat when no solution can be found. So you are trying to engage in mental problem solving, but all you come up with are other possible negative outcomes (Borkovec et al. 1983). In other words, no matter what False Comfort might say to Worried Voice, no matter how sensible or reassuring or distracting, Worried Voice has something else to come back with that keeps the what-if questions coming. There are three types of toxic worry: single-topic, multi-topic, and meta-worry (worry about worry). Helpful Fact: Toxic worry is not defined by the worry topic, but how the worry thoughts behave.

If you get involved in multiple-thought toxic worry, your thoughts often involve a chain of catastrophic or negative possibilities that seem to force themselves into your awareness. Most people feel that they are uncontrollable.

I’m sick of worrying all the time. I’m such a downer, and I know I’ve lost friends and boyfriends because of my worrying. People don’t want to be with someone like me, and I can’t blame them. I always see something that could go wrong, and I need to make sure everything is just right. I have no joy in my life, and I suck it from everyone around me.

When I lie down to sleep, I can’t stop the thoughts. I review everything I did that day and look for my mistakes. Or I am planning for tomorrow. Or I have to get up to urinate—or at least I think I do—and I watch the clock. Then I start thinking, Oh no. I only have three or four hours left to sleep, and I have to sleep. If I can’t sleep, I will not be able to work tomorrow, then more clock watching and worrying about sleeping tomorrow night.

When I lie in bed trying to sleep, I feel like I have to pee, even if I just did a few minutes ago. Then I think I won’t be able to sleep unless I go again. This can go on for hours and hours.

And remember that it’s not the sound itself, but the way you react to the sound that makes it feel so irritating and dangerous. Worried Voice: How will allowing it to be there possibly help? Wise Mind: Give it a try. Clearly your way is not working. Helpful Fact: Most of your distress is caused not by what you think or feel, but how you feel about and react to what you think or feel.

Thoughts are what pass through your mind. When thoughts just happen, it is not your choice. There is no place for issues of character when there is no chance for choice. A thought is not a fact or a statement about yourself. Character is about the choices you make in life, not what pops into your mind.

Worried Voice: Every day I take the train to work, and every day I have the thought that I could push someone under the train. What does it mean about me that I have such bad thoughts? Maybe my unconscious mind will make me do it. False Comfort: Tell yourself that you would never do anything violent. Don’t let those thoughts take over. Distract yourself, and think about something else. Pray for relief. Worried Voice: I try, but I keep on having the thoughts. Here False Comfort is trying hard to reassure Worried Voice and offers coping skills to handle the disturbing thoughts. While coping skills might provide temporary relief, they don’t work for long. Unfortunately, they both believe this myth, that such thoughts are meaningful bits of the unconscious mind and require a response. Another example of this myth is believing that thoughts of doubt are messages, signals, or warnings from the wiser more perceptive unconscious. Some of you may be plagued by doubts about a decision and then believe it means that you made a mistake, and therefore, there is some important issue you need to address. This myth suggests that a doubting thought is a message from your unconscious that repeats itself because it is telling you to reconsider what you did or what you plan to do.

Your attention may be hijacked by junk. This is especially true if you believe the intrusive thought is really important or if you believe that you have been issued a message or a signal or a warning sign. In cases like this, you can get stuck, and the thought will keep recycling through your mind, asking for your attention. In truth, all minds are chock full of junk thoughts not worth taking seriously. If we wander into junk thoughts and they are not granted meaning, they just pass on by. Helpful Fact: Your attention may be hijacked by junk.

Remember the theme that “what you resist persists” and the carrot exercise in chapter 1? This is actually how your brain works. When we invest energy in any thought, it builds up the neural connections and makes the thought more likely to happen (Pittman and Karle 2015). This works with any thought; it has nothing to do with the importance of it. The simple fact is that your attempts to keep certain thoughts from coming into your mind is what makes them come round again and feel stuck. One example of this is what happens when you try to stop thinking when falling asleep. Everyone has the experience of watching thoughts amplify, elaborate, and repeat the harder we try to banish them and attempt to “stop thinking.” We have to be willing to let the mind wander and not fight with it in order to fall asleep naturally.

Remember that anxiety loves ignorance, and the more facts you know about stuck thoughts, the better equipped you will be to deal with them.

Remember that sticky thoughts are the opposite of wishes. They become sticky and intrusive precisely because you reject them and fight with them. They are not pleasurable fantasies. They are not unconscious desires. They do not indicate truths about you that need to be explored.

Remember that your anxiety is maintained and reinforced by avoidance.

Even though unwanted intrusive thoughts are signs of overcontrol and not impulsivity, you may actually feel that you have to put a lot of effort to keep yourself from acting on the thoughts. This is an illusion. They feel like impulses even though they are not.

When we are startled or surprised, or when something happens that tricks us into thinking there is danger, the alarm system part of our brain called the amygdala sends out a danger signal. It instantly makes many things happen in the body that enable us to run away or fight if there were a real danger. You may know this reaction as the fight-or-flight response. This happens automatically, whether the alarm is false or indicates a true danger. The amygdala is not very smart and cannot judge true danger from a false alarm. It just responds to a trigger—real or imagined—with the only thing it can do. It sends out an alarm. If we are startled by a thought and our amygdala automatically sends out such a danger signal, then we react emotionally as if there is danger. The sensations in our body make the thought seem dangerous, impulsive, or important. We discuss this further in chapter 5. But our brain has a second mechanism located in the higher brain or cortex that has the capacity to say, “Wait a minute—this is just a thought.” The cortex is where we think, reason, and judge. The problem is that the message from the higher brain gets there about a half of a second after the first automatic alarm has sounded. So you are feeling like you are in danger, even before your higher brain has the chance to step in.

Think of Worried Voice as representing a false danger signal from the amygdala. False Comfort falls for the trick and tries to figure out what to do about it, as if the danger is real. It is Wise Mind who knows it is a false alarm and that no response is needed. Why do I have to fight these thoughts all the time? Here is the really great news: you don’t! That’s right. Not only do you not have to fight these thoughts, but fighting the thoughts is a major reason why they become stuck and cause so much psychological misery in the first place. Remember, you try to block the thoughts because their message feels so unacceptable. And as you continue to fight, they become more persistent and more anxiety-arousing. (This is the ironic process once again.)

What is wrong with me? What is wrong with you is that you have unwanted intrusive thoughts—nothing more and nothing less. Psychologists know that about nine out of ten people experience intrusive thoughts at least occasionally. So you are one of the nine out of ten. What has gone wrong in your situation is that you have taken your thoughts too seriously and believed that the content of your thoughts meant something important about the person you are or the sort of behaviors that you might commit.

The suffering over your thoughts actually lies in the way you evaluate them and react to them, not the content of the thoughts themselves. Trying hard to avoid the thoughts will prevent you from learning this.

There is an OCD cycle that consists of unwanted thoughts that raise anxiety and continuous attempts to lower anxiety by means of compulsions. The compulsions in OCD may be obvious behavioral rituals that feel driven—like washing, checking, ordering, and counting. But there are also compulsions that are entirely in the mind and consist of giving oneself repeated reassurances or ways to discount, undo, or avoid the obsessive thoughts. People with OCD give their thoughts more power than they deserve. If you have OCD, you probably have the tendency to feel very uncomfortable with uncertainty. And, you may have noticed something about Worried Voice and False Comfort. Worried Voice is the one with unwanted intrusive thoughts, many of which are technically obsessions. And False Comfort is the one who tries unsuccessfully to calm Worried Voice down or make Worried Voice stop thinking. Many of the things False Comfort suggests are actually forms of compulsions.

Here is an example: How would you respond to someone who asked you for the best method of bloodletting to cure a person of their fever? You would, of course, say that bloodletting isn’t a way to cure a fever. There was a time in the past when people erroneously believed it to cure people. But that was five hundred years ago. So answering the question would just contribute to that old myth. In the same way, talking about root causes in this context also contributes to an old myth about human emotions. When you think of a root cause, you probably get an image of digging down deep and pulling out every single bit of the problem so that it is eliminated or extinguished from your psyche. This concept was widely accepted fifty years ago, but now we know that this is not how our minds and brains work. Instead, we now know that most psychological issues are a complicated interaction of what you inherit (genetics), plus maturational processes that go on throughout your life, plus your own personal history, which can include the way you were raised, the important events that occur, the stresses you encounter, and more. More importantly, we now know that determining the historical factors that contribute to unwanted intrusive thoughts are absolutely no help in getting rid of them. That’s right. Learning about why you have intrusive thoughts will not help you stop them nor reduce your distress. However, learning how you inadvertently keep intrusive thoughts going and what you can do t...

The key is not to try harder to stop thoughts; it is in changing your relationship with the thoughts and your beliefs about them. Then, they don’t need to be stopped and are no longer fed the energy that maintains them. The same can be said for distraction techniques. Here is the issue with them: When you try to distract yourself from intrusive thoughts, you are reinforcing the idea that you need to keep away from them. That implies that they are somehow dangerous and might lead to something no good. That is the wrong way to look at them. Furthermore, when you distract yourself, although it may help temporarily, you devote a portion of your mind to barring the door and scanning the mind to make sure they don’t return. And it is the high-alert, internal monitor that actually invites them back. It is much more helpful—and much more consistent with what we now know about thoughts—to pay attention to the fact that intrusive thoughts may feel terrible but aren’t dangerous. So, instead of learning how to distract yourself from the thoughts, your goal is to learn how to reduce the distress they trigger. Thoughts that don’t matter have no power.

It is also not possible to meditate away or to intentionally clear the mind of unwanted intrusive thoughts using meditation. A mindful attitude (nonjudgmental, curious, self-observational) is certainly part of the solution, but using meditation as a technique for banishing thoughts will not be effective. A regular practice of meditation can—like exercise—be helpful in many ways, but it is not a technique for conquering thoughts.

The part of your brain that was originally designed to keep you safe during times of danger can become confused and misdirected. It can become so befuddled, in fact, that it can start to misidentify safe things as dangerous. We call this anxiety—when you react to and worry about something quite safe as if it is objectively dangerous. When your brain inadvertently reacts to thoughts as if they were dangerous, it sets the stage for unwanted intrusive thoughts to take hold.

We know that the brain learns as a result of experiences. Fearful experiences are remembered and stored in particularly vivid ways. When fearful pathways are triggered frequently, they become automatic. (Neurologists like to say, “Nerves that fire together, wire together.”) Just as we associate two things together, like “up and down” and “left and right,” a well-worn pathway in the brain associates two things that follow each other, and they become connected (what psychologists call “conditioned”). If a thought is followed by an anxious experience, the pathway from thought to fear gets established. When this happens repeatedly, your brain becomes conditioned to react anxiously and automatically to that thought. This sets up the conditions for unwanted intrusive thoughts to take hold. The good news, however, is that scientists have recently learned that it is far easier for your brain to learn new pathways than previously thought and that new reactions can overtake old ones. In other words, don’t believe the adage that you can’t teach old dogs new tricks! The age of the dog is irrelevant—any brain can learn.

The Alarm Response To understand how unwanted intrusive thoughts work, we start with the alarm response that is built into everyone’s brain. This response is sometimes called the stress response, the fight-or-flight response, or—most accurately—the fight, flight, or freeze response. It sets up your body to go through a whole series of arousals—all of which are helpful when you are in danger. These responses include release of adrenaline, increased heart rate, changes in breathing, hypervigilance to possible danger, tunnel vision, and a host of other perceptual changes. You feel this as a whoosh of fear or terror. The alarm response is centered in the amygdala, which consists of two walnut-sized structures in your brain. The amygdala can be either on or off: it either triggers the alarm response or it doesn’t. The alarm response is wordless—think of it like a clanging danger-warning bell. There are no partial responses or other subtleties. Because it is designed to alert you to danger, your amygdala is triggered by just the merest hint of a possible danger. Its job is to protect you—not to keep you comfortable—so it would rather set off a thousand false alarms and create a thousand whooshes of fear when there is no problem at all than miss one that is real. It was originally designed for primitive survival. Clanging the alarm when there is no danger is called a false positive. Remaining silent when there is a real danger is a false negative. Your amygdala sends out many, ma...

In other words, your amygdala will set off a whoosh of fear in response to triggers that constitute no real danger. Psychologists call this conditioned learning. In this manner, fear responses can become habits of the brain. People with unwanted intrusive thoughts have an amygdala that has learned to become afraid (i.e., clang the danger-warning bell) of certain thoughts. You were not born with a fear of these thoughts, and there is no objective reason to be afraid of them, but your amygdala has been conditioned to react when they appear in your mind. And, in our complicated world, there are a host of situations that aren’t objectively dangerous, but can seem or feel dangerous. If your amygdala sets off the alarm in response to a harmless thought, you get a false alarm of danger: the bell clangs, you get an instant whoosh of fear, and it is very easy to think that there is real danger. The result is that thoughts feel dangerous, you try to fight them, and—of course!—they become stuck. First Fear: The Amygdala’s Automatic Alarm The whoosh of fear triggered by your amygdala is sometimes called first fear, a term introduced by Claire Weekes (1969) in the 1950s.

Fear-Increasing Cycle Let’s look more closely at how your inner voices work in the brain. First, remember that all three voices (Worried Voice, False Comfort, and Wise Mind) reside in the thinking part of your brain—the cortex. None of your voices have any role in the creation of the first whoosh of fear—what we call first fear. However, all three characters feel the whoosh of first fear. True to form, Worried Voice is always duped. It believes immediately that where there is whoosh, there is danger. It does not cross Worried Voice’s mind that most alarms are false alarms and that there are comparatively few real emergencies in life. Worried Voice automatically takes every alarm seriously whether it sounded in response to a creak in the attic, a skip of the heartbeat, or an intrusive thought. Every time Worried Voice thinks of something else that could be amiss, the amygdala sends out another alarm. And, as long as Worried Voice asks the “What if (fill in something awful) is happening?” question, your amygdala continues to produce whooshes of fear. As soon as this happens, False Comfort steps forward to try to silence Worried Voice. False Comfort tries by minimizing, pretending, explaining away, calming, and making a plan “just in case.” But this only confirms for Worried Voice that the alarm was legitimate and needs to be dealt with. As we pointed out earlier, when False Comfort engages Worried Voice, then Worried Voice raises what-ifs once again. There is no getting away...

The best way to avoid second fear is to end the fear-increasing cycle by allowing Wise Mind to take over. It is only Wise Mind who realizes that the amygdala is just doing its job, that the thought is actually only a thought, and that the alarm is likely a false positive, needing only time to pass until it stops.

Thought-action fusion makes it seem that there is little difference between thinking about something and it actually happening. Thoughts no longer feel like a safe way to rehearse actions without consequences. What-ifs are not experienced as guesses or imaginings, they feel like visions of the actual future. Thoughts actually feel predictive.

All Risks Seem Unreasonable When your amygdala is not triggering the alarm response, you understand that nothing in life is risk-free. Your actions in life are filled with what feels like reasonable risks. In contrast, your anxious thinking cannot accept any risks because thinking about something gives it a high probability of happening. What-if catastrophic thoughts seem likely to occur. Any thought that triggers the alarm makes ordinary risks feel unreasonable. Anxious thinking requires an absolute guarantee that a disastrous experience you might think about won’t occur. You feel driven to ask for reassurances of safety, and you try to avoid the situations that trigger the feeling. And, of course, anxious thinking can’t get that guarantee.

Thoughts Feel Sticky Anxious thinking makes your scary thoughts hard to avoid. They seem stuck in your mind. No matter how much you tell yourself to think of something else, catastrophic thoughts come right back to intrude into your consciousness. Distractions are only partially helpful in getting your mind onto another subject, and they sometimes are no help at all. This is the neurological basis for the ironic process of the mind, which was first introduced in chapter 1. Effort used to not think of a thought actually makes it more intrusive.

Intolerance of Uncertainty Life has plenty of uncertainties, and no one can predict the future. Most of the time, you are able to accept that nothing in life is risk-free and go on with your activities with little worry. But anxious thinking makes any uncertainty feel threatening. In addition, anxious thinking makes thoughts feel threatening. Certain thoughts are experienced as dangerous. It is very hard to hold onto the truism that thoughts and feelings are not facts. Helpful Fact: Neither thoughts nor feelings are facts. These are just a few of the ways that anxious thinking makes you vulnerable to unwanted intrusions. Your brain makes you sensitized and reactive to certain thoughts by altering the way your thoughts feel, and this begins the process....

You may recall having different unwanted intrusive thoughts at different times in your life. They occur when your mind has become particularly “sticky,” and you start paying way too much attention to your thoughts. “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.

Whether you like it or not, you have a sticky mind, and you need to learn the factors that affect it. Sticky mind has a biological basis. It comes from a sticky brain. 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. Minds are stickier if you are hungover, and for many, even a small amount of drinking can increase stickiness.

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.

Sticky mind goes along with feeling anxious. One obvious aspect of the altered state of awareness we call anxious thinking is that threatening thoughts become extremely sticky. It is as if you are expecting danger and looking for it, so thoughts that feel dangerous—such as unwanted intrusive thoughts—stay glued to your mind. It’s like flypaper. Sometimes the theme of the content remains the same; sometimes it is different. Stickiness is a bit like those amusement park machines called “the claw,” in which the arm comes out, wanders around, drops, and randomly picks up whatever is sticking up in the big jumble of junk in the cage. Whatever it picks up is not even worth the quarter you put in the machine.

Paradoxical Effort 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 w...

It does not work to try to force your body to relax, to feel a particular emotion, or to force your mind to not have specific thoughts. And yet that is what most of us try (at least at first) when we are offended or scared by an unwanted intrusive thought. And then, when effort works backward, we think we should redouble our efforts. This is like trying to climb out of a hole by digging with a shovel, stopping a car by pressing the accelerator, or extinguishing a fire by fanning the flames. Paradoxical effort is illustrated by the adage “less is more.” But let’s be clear: there are many times that effort works well in our lives. In fact, most of us believe (and for good reason) that hard work increases the chances of success. Not that hard work guarantees success, but people who work harder are generally more successful and fulfill their goals, on average, more often than people who work less hard. While this is true, there are, however, many important times in everyone’s lives where less is more. And putting less direct effort into accomplishing a goal actually makes success more likely! This is paradoxical effort at work.

Yet another illustration: What’s the best way to handle quicksand? The more you struggle to climb out, the more you sink. It is not immediately obvious, but the way to get out is to lie back and stop struggling! This increases your buoyancy, and you naturally float to the top where you are safe. There are other areas where effort directly interferes with your goals. Learning is one of these activities. Maximum learning requires an open, passive, curious attitude of attention. Judging yourself harshly while you are learning is not only unpleasant, it works against you. Have you had the experience of feeling pressure to learn something (a basketball play, French vocabulary, the plot of Hamlet, an app on your phone), and you keep getting it wrong? This is because you are putting pressure on yourself to learn, and this pressure interferes with the open, passive, attentive attitude that is best for learning. Once again, paradoxical effort means less is more in these circumstances. Helpful Fact: Less is more when coping with unwanted intrusive thoughts.

Entanglement 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. Or, you are trying to figure out some way to become less annoyed or less irritated by the intrusive nature of certain sounds, bodily feelings, or other intrusions. You become focused on the thought or sensation and your attempts to rationalize it, explain and understand its meaning, or just put it out of your mind. 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. If this seems difficult, then let’s start with an example that we all know very well, which is from Dave Carbonell (2016), who has authored several self-help books on panic and worry (and hosts the popular website AnxietyCoach.com). Imagine that you open the following e-mail addressed to you: Congratulations! This is your lucky day. Your third cousin twice removed, who was the head of the [insert foreign country] Diamond Industry, has died and left $14 billion dollars to you. In order to collect this inheritance, please click on this link and provide us with your bank routing number. We will immediately transfer into your account the sum of $14 billion dollars. Again, accept our sincere congratulations. Would you start excitedly imagining what it would be like to buy your own yacht, own your own private jet, or buy your own island? (We hope not, of course.) Because the words in this communication are not to be believed. The content is immaterial. This is a scam, and not an inheritance notice. When you push the “send to spam” button, you have already disentangled yourself from the content of the e-mail. You have no problem buying the idea that the words should not be believed, and the e-mail is communicating a very different message: “Send me your mone...

Entanglement increases as you become more involved with your internal dialogue. Responding to Worried Voice by trying to help keeps it going. False Comfort is the agent that increases entanglement. Worried Voice: What if this doesn’t work? What if I get so freaked out that I actually do what I’m afraid of? False Comfort: Don’t be silly, wipe that thought out of your… Wise Mind: False Comfort, please don’t respond to Worried Voice. Nothing good comes of it. Worried Voice: OMG! Are you really going to subject me to these thoughts! I might just freak out. Wise Mind: Not worth an answer. Worried Voice: Did you hear what I said? I might actually do it! Wise Mind: This is an intrusive thought. A thought is a thought. Worried Voice: This is dangerous! I might have a nervous break-down! Wise Mind: I accept and allow thoughts. Worried Voice: WHAT IF I CAN’T CONTROL MYSELF? Wise Mind: I know there might be another intrusive thought that follows. Worried Voice: I don’t think I can stand this much longer! Wise Mind: I’m letting time pass. Worried Voice: I’m just so nervous about this. What if I never calm down? Wise Mind: I’m floating and observing. Worried Voice: What if I actually do it? Wise Mind: No answer is needed. Worried Voice: I’m not sure I can control myself. Wise Mind: I’m allowing the thoughts. Worried Voice: This is going on for such a long time. What if it never stops? (softly) Wise Mind: I’m accepting the thoughts. Worried Voice: I’m not sure I can control myself. (bar...

Reassurance is usually the first way people try to get rid of unwanted intrusive thoughts. Most people try to reassure themselves internally, by seeking reassurance from their own inner voices, from websites, and books, and then when that does not help, they seek reassurance from others. Reassurance involves entanglement by encouraging you to argue with the thoughts, as if they were valuable or meaningful or worthy of attention. And usually reassurance ends up with escalating efforts because it only works temporarily, and your mind comes back for more and better arguments, producing paradoxical effort.

There are plenty of good reasons to eat right and get good exercise. In fact, it is clear that healthy eating and healthy exercise improve your mood and lower anxiety. But unfortunately, these activities alone won’t stop your unwanted intrusive thoughts. There is a relationship between stress and fatigue, on the one hand and unwanted intrusive thoughts on the other. Eating, exercising, and sleeping well, as well as avoiding drugs and reducing stress, may reduce the intensity and frequency of intrusions. Conversely, poor eating and sleeping, lack of exercise, drinking alcohol, and a highly stressful lifestyle tends to increase the intensity and frequency of unwanted intrusive thoughts. But—and here is the point we would like you to take away—healthy living will not cure unwanted intrusive thoughts, and unhealthy living will not cause them. While healthy living may temporarily reduce your sticky mind, it has no effect at all on the two other factors—paradoxical effort and entanglement—that function