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Writer's pictureDavid Brookes

Coping with intrusive thoughts


 

These are thoughts or images that are unwanted and often distressing that come into your mind uninvited. Possible therapeutic approaches include being aware of triggers, noticing the impact of the thoughts on you, grounding techniques, mindfulness and setting aside time for the thoughts to help contain and maybe reframe them.

 

The distressing aspect of thoughts may come from the impact they have upon you, ie they are not dangerous in themselves but may cause stress when they come along. Building an awareness of how these thoughts affect you and when they arise can help to spot them early and to take action to counter them. This can include using grounding techniques such as breathing, a body scan or a five senses exercise to help you stay in your environment and appreciate that you are safe and OK. You may also be able to practice observing the thoughts without engaging with them – eg I am going to die at some point moves to “I am having the thought that I will die at some point” and then “I am watching myself having the thought that I will die at some point” – rather than going to the question what happens when I die and all the other fears and questions that may prompt. Like lifting weights to build your biceps practising mindfulness helps to improve your ability to step away from rather than engage with distressing thoughts.

 

If you find it difficult to put distance between you and the thoughts another option is to set aside time later for those thoughts. This respects the thoughts, does not minimise them but does enable you to return to them at a later point. When returning to them you may find it helpful to have a set time and place with a dedicated book to write down the thoughts that are disturbing you. It may also be worth putting the thoughts on one side of a page and on the other side write down how you might reframe them in a way that is more attuned to how you want to live your life. Writing down thoughts helps put some distance between you and the thoughts, allowing you to build more of a sense that you are more than just your thoughts and can actively observe and choose whether you wish to engage with them.

 

At the time you have set aside to be with the thoughts that disturb you it may also be worth thinking about some of the lessons from Exposure Response Prevention (ERP) therapy. These would include deciding what your goal is – for example it might be to be able to have these thoughts without being overwhelmed by them. There is also a technique called the “Ladder of Fear” which involves noting down different levels of exposure to the thoughts that trouble you with a view to working up to progressively more difficult aspects without becoming overwhelmed.

 

The plasticity of the brain is a great thing and can enable you to make real changes in how you are aware of and respond to intrusive thoughts so that you can step back from them and be able to weigh whether they are useful or not to what you seek.

 

David Brookes

17th July 2024

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