Why Can’t I Stop Having Intrusive Thoughts?
Answering the question “Why can’t I stop having intrusive thoughts?” is one of the most important foundations of any successful OCD treatment.
In this post, we’re going to dive into the research and how this applies to OCD treatment.
But, before we do that, we’re going to start with an experiment that I’ll need your help in completing. We’re going to start with this experiment because it’s a great way of obtaining first-hand knowledge – right here, right now – that will reinforce the more abstract research we’ll touch on later.
So, what’s experiment?
The Experiment
I want you to settle into your chair (or couch or bed or wherever you are). Through your nose, take a deep breath, in and out.
Now, in a moment, you’re going to read a word. It’s not a complicated word. You’ll know what this word is right away.
When you read this word, I’m asking that you simultaneously complete a task: Your task is to NOT have any images of this word when you read it. To repeat: When reading the word, your job is to have NO images of the word in your mind.
Full disclosure: I’ve never had a single client report they succeeded in this task (we’ll talk more about why this is the case later).
OK, ready?
PINEAPPLE
What Does This Experiment Teach Us?
Did you see a pineapple? What did it look like? Was it a pineapple with the green, leafy stuff on top? Or was it pre-cut pineapple in a plastic container? Or a can of pineapple?
I’ve heard most of the possible varieties of pineapple images. But not one client has told me “I didn’t see a pineapple, William.”
When my clients tell me “I saw a pineapple”, I’ll follow up by asking them, “Did you feel like you understood the experiment instructions to not have an image of the pineapple?”
And they’ll say something like, “Yes, I understood the instructions. But when I read the word, the image just instantly came to mind. It just happened automatically.”
I suspect something very similar happened to you. You’re not alone. As I mentioned above, this happens to basically everyone.
What this experiment shows us is related to a phenomenon that’s been extensively studied in research settings. Although there are some nuances, the long-story-short of these research findings is this: If you attempt to not think of something, you’re going to find yourself thinking of that something more and more.
We call this process the “ironic effect of thought suppression”.
What Does The Research On The Ironic Effect Of Thought Suppression Tell Us?
The most famous research exploring the ironic effect of thought suppression asked participants to not think of a white bear. The researchers found that the participants ended up having lots of thoughts about white bears.
Later research found that, in specific circumstances, individuals can sometimes suppress a thought in the short term. But, as soon as they relax their thought suppression attempts, the suppressed thoughts then come back with even greater frequency (this is called a “rebound effect”).
This research has been studied and confirmed for more than 30 years!
Now, let’s apply this knowledge to those of us with OCD.
What Does This Research Mean For Those Of Us With OCD?
Those of us with OCD aren’t trying to suppress thoughts of white bears, which seems like a neutral thought to have. We’re trying to suppress thoughts we find abhorrent, disgusting, terrifying, awful.
Since our intrusive thoughts are abhorrent, disgusting, terrifying, and awful, we try really, really hard to not have them. So, our attempts at suppressing these thoughts can be extreme. However, due to the ironic effect of thought suppression described above, the harder we try to suppress the intrusive thoughts, the more of the intrusive thoughts we have.
When we add all of this up, we can see why those of us with OCD end up having our intrusive thoughts all the time. We’ve fallen into OCD quicksand: The harder we struggle to suppress our intrusive thoughts, the deeper we sink.
So, what do we do? That’s a question that requires some time to answer. But the quick version of the answer is this: We practice not engaging in thought suppression. We allow the intrusive thoughts to be present in our minds. This does not mean that we participate in the thought (e.g., arguing with the thought, worrying about the thought, trying to problem solve the thought). It means we notice that the thought is there and let it be there without engaging with it.
Of course, allowing intrusive thoughts to be present in our minds is not fun. And often we will slip up and begin participating in the thought instead of simply being aware of it. Many of my clients have described the process of letting the thoughts be there as one of the most challenging experiences of their lives. That matches my lived experience with OCD.
The good news is that there’s a structured process that helps us get better at allowing the thoughts to be present. This process is called Exposure and Response Prevention Treatment (ERP).
Completing ERP is tough, but it becomes easier and easier over time. And the true value of ERP is that, instead of kicking the problem down the road, it addresses the problem at its root. Addressing the problem at its root allows us to truly heal, resulting in far less intrusive thoughts, far less anxiety, and finally feeling safe to enjoy our lives.