How to manage obsessive thoughts: 7 practical tips

Obsessive thoughts, also known as negative automatic thoughts (PAN), are common in anxiety disorders and major depression, although they also occur in people without emotional problems.

They involve a huge investment of cognitive effort and can generate a physiological response similar to what would be observed in the event that the feared event was actually happening.

Most of the people who report experiencing them attribute to them the ability to persist despite the deliberate effort to eliminate them, which generates hopelessness and further increases worry.

In this article we will offer several tips on how to manage obsessive thoughts, all based on current scientific knowledge.

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What is an obsessive thought?

An obsessive thought is a mental content that is presented in the form of words or images, the nature of which is threatening and which enters the mind automatically and undesired. It can take the form of worrying about a future event or re-experiencing an event located in the past, which is accompanied by very difficult emotions whose intensity can deplete resources affective.

The threatening content often implies a physiological fear response, with the difference that the stimulus that provokes it is not really present, but wanders in some corner between the future and last. The sympathetic nervous system (one of the branches that make up the autonomic nervous system) interprets the situation in a way analogous to direct experience, putting into motion all the resources to fight or flee (anxiety).

How to manage obsessive thoughts

There are data that demonstrate the existence of strategies to manage obsessive thoughts adequately, which we proceed to describe in the following lines.

1. Worry about a problem that really is solvable

Problems, in general, are divided into two large groups: those that can be solved and those that cannot.. Each of them requires a different approach, otherwise our efforts may be fruitless or counterproductive. The first step that we should carry out is to analyze the possible cause of our thoughts. obsessive, because they may be associated with an objective situation that can be modified in its own right. essence.

It is not infrequent that people, when they are overwhelmed by a series of stressful situations or by a specific event particularly difficult, tend to postpone the problem or consider that avoiding it will end up bringing with it the desired solution. Scientific evidence tells us that, In the face of modifiable circumstances, assuming a passive attitude is related to worse consequences on emotional health in the medium and long term.

To avoid this circumstance, there are specific procedures designed for solving problems, such as the one proposed by Nezu and D'Zurilla. It consists of five well-defined steps, in the form of a sequence: description of the problem (write it in a simple and operational way), generation of alternatives (numerous, varied and delaying judgment), exploration of the viability of the different alternatives (considering the positive or negative consequences that may occur in the medium or long term) and implementation of the best of all possible solutions.

This model, known as Decision Making Training (ETD), has been the subject of numerous investigations with the aim of purpose of verifying its effectiveness in very diverse contexts and problems, demonstrating its potential as a tool therapy.

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2. Time out and distraction

A procedure that is useful to many people is known as "time out." Since obsessive thoughts can persist for many hours each day, the sufferer may end up with them most of the time. The procedure we are talking about has the purpose of establish in advance a specific time of the day in which this type of thought will be authorized, limiting it in the rest.

This procedure has the advantage that the person does not try to eliminate their negative thoughts, but reserves for them a space in which to exist, and dedicates the rest of the time to activities productive. It does not suppose, therefore, a form of experiential avoidance; but simply a different management of his resources. Evidence indicates that encapsulating worry reduces the intensity of thoughts by an underlying process of satiation and by increasing the subjective feeling of control.

3. thought stopping

Thought-stopping techniques do not enjoy sufficient evidence, so this advice is aimed at questioning their usefulness. Currently we know that when the person fights against a thought because they consider it inappropriate, a paradoxical effect occurs: this increases not only quantitatively, but also qualitatively (intensity and frequency). And it is that trying not to think about something is enough for it to knock insistently on the doors of our brain.

When a thought comes to mind, the brain cannot identify if what we want is to avoid it or to remember it. It simply activates a pattern of synapses that evokes sensations and emotions directly related to it, increasing its availability to consciousness.

Some procedures, such as Acceptance and commitment therapy, highlight the capacity of this experiential avoidance to contribute to the development and maintenance of emotional problems.

4. mindfulness

Mindfulness is not a relaxation exercise, but a meditative practice. It comes from Buddhist monastic traditions, although it has been stripped of its religious overtones to be used as a therapeutic procedure that directs its focus to the active maintenance of an awareness attentive. This form of attention allows us to focus on the present moment, avoiding judgment about the facts and the tendency to wander between the past and the future.

There are many studies that, using functional and structural neuroimaging techniques, detect subtle changes in the structure and function of the brain as a result of the continued practice of Mindfulness. The areas on which an effect is appreciated are related to functions such as the processing of experience emotion and the regulation of the flow of thoughts, thereby facilitating a "witness mind" about the experience internal.

Today there are numerous techniques based on Mindfulness, many of which can be put into practice in a multitude of real-life situations (from eating to walking). In the case of suffering from anxiety, it may be necessary to consult a specialist before practicing it, since the orientation of the Attention to certain bodily processes (such as breathing) can accentuate symptoms when they are interpreted in a wrong way. catastrophic.

This last detail is extended to diaphragmatic breathing and progressive muscle relaxation, which involves the coordinated tension and relaxation of large muscle groups in a logical sequence (always accompanied by inspiration and expiration). There is numerous evidence regarding its favorable action on the physiological components and cognitive effects of anxiety, but may also require prior consultation with a health specialist mental.

5. rupture of dynamics

The presence of obsessive thoughts tends to divert attention towards one's own mental processes., causing us to evade excessively from those things that surround us. This self-absorption tends to be resolved, occasionally, by modifying the activity in which we are immersed.

It is possible that something as simple as changing the room, or embarking on a walk through an unaccustomed area, redirect attentional processes towards the outside.

6. Exposure

Many negative and repetitive thoughts are associated with the fear of events that could take place in the future, but that rarely do. This phenomenon is common in Generalized Anxiety Disorder, where worry acquires greater notoriety for being considered an effective coping strategy (a kind of mechanism to reduce the risk of their fears manifesting). It is also common in some phobias, such as agoraphobia and social phobia.

There is evidence that the best approach to fears, which are often the root of from which many automatic negative thoughts spread, resides in the techniques of exposure. These can be very varied, from that which involves direct contact with the feared (in vivo) to that which makes use of the imagination. to make possible a series of successive approximations to the phobic stimulus, and there are even procedures using reality techniques virtual.

While is true that when we avoid what we fear we feel immediate relief, this effect harbors the trap of perpetuating the emotion and even accentuate it on successive occasions in which we can meet again with the feared situation or stimulus. Standing up to the monster that we have created with our hands, from perpetual flight, can cause some anxiety; but each firm step stands as an achievement that gives us better self-efficacy and feeds our chances of success.

7. de-dramatization

Obsessive thoughts are often credited with enormous credibility. There are people who even feel tremendously unfortunate for the isolated fact of having experienced them, what that together with the loss of control that these generate in them, only aggravates their feelings of anguish and helplessness The truth is mental contents of this nature do not pose any danger to the person who experiences them, and that there are also effective ways to address them.

Catastrophizing (belief that the occurrence of an event would be impossible to tolerate), polarization (expression of thoughts in absolute and dichotomous terms) or "shoulds" (imposition of necessity on what really is a desire); constitute habitual cognitive distortions in many people, since they are erected as heuristics through which we interpret reality when it exceeds the cognitive resources of which our species has.

There are four criteria from which we can assess whether a thought is irrational, namely: it lacks foundations objectives (we do not have evidence that proves its veracity), generates overflowing emotions, is useless in adaptive terms and is constructed with lapidary or absolutist terms. In all these cases there are specific cognitive restructuring techniques that have proven to be effective in the hands of a good therapist.

When to seek help from a professional

Some obsessive thoughts occur in the context of major mental disorders, As the Obsessive-Compulsive Disorder. In these cases, the person is overwhelmed by thoughts over which they lack control, which are alleviated by putting a compulsion into practice (counting, washing hands, etc.). The connection between obsession and compulsion tends to be clearly illogical and, despite the fact that the person recognizes it as such, has enormous difficulty in breaking it.

There may also be thoughts of this nature in cases of major depression (mainly focused on past events or a very pronounced pessimism about the future), as well as post-traumatic stress disorder or generalized anxiety disorder. These assumptions must be evaluated by a mental health professional, so you should not hesitate to consult one if you suspect that you might be suffering from any of them.

Bibliographic references:

• American Psychiatric Association –APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Pan American.
• Perez, M.; Fernandez, J.R.; Fernandez, C. and Friend, I. (2010). Guide to effective psychological treatments I and II:. Madrid: Pyramid.