How to Control (and Learn from) Compulsive Thoughts

July 28, 2009 at 10:32 am | Posted in Cognitive Problems | Leave a comment

I recently discovered — created, really — a technique for dealing with compulsive thoughts. In my experience most people with a mood disorder experience distressing, intrusive thoughts and images pretty regularly. An obvious example, and one that most people have experienced, is the impulse to jump when standing on a precipice. You don’t actually want to jump — you’re not suicidal or even depressed — but you can’t help but entertain this odd and self-destructive urge.

For bipolar or depressed people, the urges can be far stronger and more disturbing. You may have a persistent thought like, “I wish I were dead,” or, like the bipolar character in a story by Donald Antrim, you may be tormented by images of smashing your hands through a window, complete with crashing and tinkling, glass rammed into soft flesh, and blood streaming down your forearms.

Here’s the trick: any time you have one of your most persistent self-destructive thoughts, stop and ask yourself, “What am I feeling right now?” Pinpoint whether you feel anxious, humiliated, frightened, angry, or whatever. Once you’ve done this often enough, you’ll realize which emotions tend to trigger intrusive thoughts. Before I started this exercise, I believed that these thoughts reflected how I truly felt — that I really wanted to die or hurt myself. Naturally, that was upsetting. I often felt ashamed of my thoughts and afraid of them. Once I pinpointed the feelings behind each them, though, I realized that they are merely a reflex that follows from particular feelings.

It can also help to take the next step and ask yourself why you feel anxious, for example. You may have made an embarrassing error, or you may be interpreting something your partner said to mean that he doesn’t love you. Once you’ve isolated the cause, ask yourself if you can do anything concrete to take control of the situation. For instance, can you analyze why you made the mistake and come up with a plan to avoid it in the future? If you can take action, do.

If you can’t, take one final step. This one comes from David Burns’ classic of cognitive therapy, The Feeling Good Handbook. Ask yourself, How long do I intend to do penance for this event, to feel guilty or angry or frustrated? Five minutes? All day? A month? A year? If you can forgive yourself and move on tomorrow, why not just do it now? No matter how horrible the event, this can help you to realize that you needn’t suffer for it eternally.

I’ve been following this process for about a month now, and it’s really helped me to gain perspective on compulsive thoughts. In fact, it seems to be slowly rooting them out and replacing them with constructive action. I don’t do this exercise in writing, since I find that I often have bad thoughts when I’m nowhere near paper — in the bathroom, for example, or while I’m driving. It helps to write down the steps, though, and carry them with you in case you forget them in the distress of the moment.

If you try this technique, please leave a comment describing whether or not it worked. If you have your own successful system for dealing with compulsive thoughts, please share it.

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