How to manage obsessive thoughts: 7 practical tips

Several guidelines and recommendations on how to manage obsessive thoughts on a daily basis.

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

They involve an enormous investment of cognitive effort and can generate a physiological response similar to that which would be observed if the feared event were actually happening.

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

In this article we will offer several tips on how to manage obsessive thoughtsall of them based on current scientific knowledge.

What is an obsessive thought?

An obsessive thought is a mental content that presents itself in the form of words or images, the nature of which is threatening and words or images, whose nature is threatening and that accesses the mind in an automatic and unwanted way.. It can take the form of worry about a future event or re-experiencing an event located in the past, which is accompanied by very difficult emotions whose intensity can exhaust the affective resources.

The threatening content often involves a physiological response of fear, with the difference that the stimulus that provokes it is not actually present, but wanders somewhere between the future and the past. The sympathetic nervous system (one of the branches forming the autonomic nervous system) interprets the situation in a manner analogous to that of direct experience, setting in 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 in an adequate way, which we proceed to describe in the following lines.

1. Preoccupation with a problem that is really solvable

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

It is not uncommon that people, when they are overwhelmed by an accumulation of stressful situations or by a particularly difficult event, tend to postpone the problem or consider that its avoidance will eventually bring about 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. in the medium and long term.

To avoid this circumstance, there are specific procedures devised for problem solving, 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 (writing it down in a simple and operational way), generation of alternatives (numerous, varied and delaying judgment), exploration of the feasibility 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 (DTC), has been the object of numerous investigations with the purpose of proving its efficacy in very diverse contexts and problems, demonstrating its potential as a therapeutic tool.

2. Time out and distraction

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

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

3. Thought stopping

Thought-stopping techniques do not have sufficient evidence, so this advice is aimed at questioning their usefulness. We now know that when a person fights against a thought because he/she considers it inappropriate, a paradoxical effect occursIt increases not only quantitatively, but also qualitatively (intensity and frequency). And the fact is that trying not to think about something is enough for it to knock insistently at the doors of our brain.

When a thought comes to mind, the brain cannot identify whether we want to avoid it or remember it. It simply activates a pattern of synapses that evokes sensations and emotions directly related to it, making it more available 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 focuses on the active maintenance of an attentive consciousness. This form of mindfulness allows one to focus on the present moment, avoiding judgment on events 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 seen are related to functions such as the processing of emotional experience and the regulation of the flow of thoughts, thus facilitating a "witness mind" on the internal experience.

Today there are numerous techniques based on Mindfulness, many of which can be put into practice in a variety 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, as the orientation of attention towards certain bodily processes (such as breathing) can accentuate the symptoms when these are interpreted in a catastrophic way.

This last detail extends to diaphragmatic breathing and progressive Muscle relaxation.which involves the coordinated tension and distension of large muscle groups in a logical sequence (always accompanied by inspiration and exhalation). There is ample evidence for their favorable action on the physiological and cognitive components of anxiety, but they may also require prior consultation with a mental health specialist.

5. Breaking dynamics

The presence of obsessive thoughts tends to divert attention to one's own mental processes, causing us to avoid our own thoughts.This can lead to excessive avoidance of those things that surround us. This self-absorption tends to be solved, occasionally, by modifying the activity in which we are immersed.

It is possible that something as simple as changing rooms, or embarking on a walk through an unfamiliar area, reorients the attentional processes towards the outside.

6. Exposure

Many negative and repetitive thoughts are associated with fear of events that could take place in the future, but rarely occur. This phenomenon is common in Generalized Anxiety Disorder (GAD), where worry becomes more prominent as a coping strategy.This phenomenon is common in Generalized Anxiety Disorder, where worry becomes more notorious because it is considered an effective coping strategy (a sort of mechanism to reduce the risk of manifesting one's fears). 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 from which many automatic negative thoughts spread, lies in exposure techniques. These can be very varied, ranging from those that involve direct contact with the feared thing (in vivo) to those that make use of the imagination to make possible a series of successive approximations to the phobic stimulus, and there are even procedures using virtual reality techniques.

While it is true that when we avoid what we fear we feel an immediate relief, this effect harbors the trap of perpetuating the emotion and even accentuate it on successive occasions when we may encounter the feared situation or stimulus again. Facing the monster we have created with our hands, from perpetual flight, may provoke some anxiety; but each firm step stands as an achievement that endows us with better self-efficacy and nourishes our chances of success.

7. De-dramatization

Obsessive thoughts are often attributed enormous credibility. There are people who even feel tremendously unhappy about the isolated fact of having experienced them, which, together with the loss of control that they generate, only aggravates their feelings of anguish and helplessness. The truth is that mental contents of this nature do not pose any danger to the person experiencing them, and that there are effective ways of dealing with them.and that there are effective ways of dealing with 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 is really a desire); are common cognitive distortions in many people, as they stand as heuristics through which we interpret reality when it exceeds the cognitive resources available to our species.

There are four criteria on the basis of which we can assess whether a thought is irrational, namely: it lacks objective foundations (we do not have evidence to prove its veracity), it generates overflowing emotions, it is useless in adaptive terms, and it is constructed in 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 professional help

Some obsessive thoughts occur in the context of major mental disorders, such as obsessive-compulsive disorder (OCD).such as Obsessive-Compulsive Disorder. In these cases the person is overwhelmed by thoughts over which he/she has no control, which are relieved by the implementation of a compulsion (counting, hand washing, etc.). The connection between obsession and compulsion tends to be clearly illogical and, although the person recognizes it as such, has great difficulty in breaking it.

Thoughts of this nature may also exist in cases of major depression (especially focused on past events or a very pessimistic (especially focused on past events or a very pronounced pessimism about the future), as well as in post-traumatic stress disorder or generalized anxiety disorder. These assumptions should be assessed 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.

Bibliographical references:

• American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and statistical manual of mental disorders. Madrid: Panamericana.
• Pérez, M.; Fernández, J.R.; Fernández, C. and Amigo, I. (2010). Guide to effective psychological treatments I and II:. Madrid: Pirámide.