10/19/2024
Distressing, Unwanted, Obsessive, or Ruminating Thoughts: THINGS YOU NEED TO KNOW
If you have ever taken meds for anxiety, I have important information at the end of this article.
Distressing, unwanted, unhelpful, ruminating thoughts. They happen to all of us from time to time and are a normal part of being a healthy, fully functioning individual. Even those really gross ones- they happen to us all. The fact that distressing thoughts exist may be unwanted or uncomfortable when they pop up, but in most cases, they are not problematic. But what happens when they DO become problematic, intrusive, and disruptive to our daily lives and general sense of peace?
My purpose here is not to give a step-by-step of how to deal with this issue, but to fly up to about 500 feet and look at the big picture goals.
Let's look at what is happening inside the brain. Think of **EVERYTHING** that you have a concept of as having its own box inside your brain. Boxes are connected to other boxes. Some of those links may be very weak and some may be very strong. There is a saying that "Neurons that fire together wire together." What does this mean? It means that the more a link is reinforced inside the brain, the stronger that link becomes. Emotions have the role of telling the brain which of those is important. The problem is NOT "having a distressing thought", but the person's emotional relationship to the thought. When a distressing thought arises and you respond with very strong emotion, your response tells the brain that "this is REALLY important and we NEED to hold onto this for survival." A strong emotional response actually strengthens the link, strengthens the thought or image, and in this example, strengthens the distress.
There is another saying that "What you resist, persists." So when it comes to distressing or obsessive thoughts, AVOIDANCE DOES NOT WORK. It actually has the opposite effect of increasing anxiety, strengthening that unwanted link, and makes the brain EVEN MORE prone to serving up that unwanted or distressing thought or image. It is impossible to "just not think that."
The GOAL is to desensitize to the thought. To reduce the amount of emotional reactivity. To be able to simply observe the thought such as "Oh! Hi thought. There you are. I see you." and to come to the place where emotional distress is diminished. When this happens, the lack of reactivity gives your brain the space that it needs to weaken that link, to recognize it as less important, and to focus on other things. Eventually that unwanted thought has the freedom to either go away or to just simply fade into the background and be less intrusive.
I wish that doctors would provide more psycho-education about this when they prescribe medications for anxiety. Not everyone needs prescriptions. But if you do, they work as ONE approach to treat anxiety and obsessive, ruminating thoughts (you still need to work with a therapist to help with all of the other pieces necessary to successfully combat this situation). Meds are a mixed bag filled with pros and cons. As a con, they tend to dull the senses and make ALL emotions less reactive- even the positive and desirable ones. We don't get to choose which emotions they dull. But on the other hand, by decreasing the emotional reactivity to those highly distressing and intrusive thoughts, it gives the brain a break and the space it needs to begin to weaken the links. Then, when the time comes that you and your doctor decide to end prescription interventions, the brain has had a chance to "re-wire" so to speak. That is the goal of prescriptions for anxiety. You do still need therapy to help you learn what you need to heal and maintain as the other prongs of approach.
If more people understood the big picture and understood the goals, they would have more agency in recognizing success or in even knowing how to define success. They would be more involved in their own recovery rather than automatically assuming that meds are necessarily a "life sentence."