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 an enormous investment of cognitive effort and can generate a physiological response similar to that which would be observed in the case of the fact that the feared event is actually happening.

Most people who report experiencing them attribute to them the ability to persist despite deliberate efforts to eliminate them, which creates despair and further increases concern.

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

What is an obsessive thought?

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

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

Managing 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. Concern about a problem that is actually solvable

Problems are generally 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 unsuccessful 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 for people, when they are overwhelmed by a number of stressful situations or by a particularly difficult event, to tend to postpone the problem or consider that avoiding it will bring 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, there are specific procedures designed to solve 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 (writing it down in a simple and operative way), generation of alternatives (numerous, varied and delaying the trial), exploration of the viability of the different alternatives (considering the positive or negative consequences that may concur in the medium or long term) and implementation of the best of all possible solutions.

This model, known as Decision-Making Training (DT), has been the subject of numerous investigations with the purpose of proving its effectiveness in the face of very diverse contexts and problems, demonstrating its potential as a therapeutic tool.

2. Time out and distraction

One procedure that is useful to many people is known as “time out”. Since obsessive thoughts can be kept up 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 specific moment of the day when 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 a space for them 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 their resources. Evidence indicates that encapsulating concern reduces the intensity of thoughts by an underlying process of satiation and by increasing the subjective sense of control.

3. Stop thinking

The techniques for stopping thought do not enjoy sufficient evidence, so this advice is aimed at questioning their usefulness. We now know that when a person fights against a thought because he or she considers it inappropriate, a paradoxical effect occurs : this increases not only quantitatively, but also qualitatively (intensity and frequency). Trying not to think about something is enough to make it 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 ability 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 the Buddhist monastic traditions, although it has been stripped of its religious nuances to be used as a therapeutic procedure that focuses on the active maintenance of a mindfulness. This form of attention allows one to focus on the present moment, avoiding judgment on 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 continued Mindfulness practice. The areas where 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” over internal experience.

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

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

5. Breakdown of dynamics

The presence of obsessive thoughts tends to divert attention towards one’s own mental processes , causing us to avoid too much of 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 rooms, or embarking on a walk in an unaccustomed area, redirects the attentional processes to the outside.

6. Exposure

Many negative and repetitive thoughts are associated with fear of events that might take place in the future, but rarely occur. This phenomenon is common in Generalized Anxiety Disorder , where the concern becomes more noticeable because it is considered an effective coping strategy (a sort 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 cause of many automatic negative thoughts, lies in exposure techniques. These can be very varied, from those that involve direct contact with the feared (in vivo) to those that make use of the imagination to make possible a series of successive approaches to the phobic stimulus, and there are even procedures using virtual reality techniques.

Although it is true that when we avoid what we fear we feel an immediate relief, this effect harbours the trap of perpetuating the emotion and even accentuating it on the successive occasions when we may encounter the feared situation or stimulus again. Facing the monster that we have created with our hands, from perpetual flight, may 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 given enormous credibility. There are people who even feel tremendously unhappy because of 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 who lives them , and that there are also effective ways of dealing with them.

Catastrophization (the belief that the occurrence of an event would be impossible to tolerate), polarization (the expression of thoughts in absolute and dichotomous terms) or “should” (the imposition of necessity on what is really a desire); constitute common cognitive distortions in many people, since they stand as heuristics through which we interpret reality when it exceeds the cognitive resources available to our species.

There are four criteria from which we can assess whether a thought is irrational, namely: it lacks objective foundations (we have no evidence to prove its veracity), it generates overwhelming emotions, it is useless in adaptive terms and it is constructed with lapidary or absolutist terms . In all these cases there are specific techniques of cognitive restructuring that have been shown 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. In these cases the person is overwhelmed by thoughts over which he or she lacks control, which are relieved by the implementation of a compulsion (counting, washing hands, etc.). The connection between obsession and compulsion tends to be clearly illogical and, despite the person’s recognition of it as such, he or she has enormous difficulty in breaking it.

Thoughts of this nature can also exist in cases of major depression (mainly focused on past events or a very pronounced pessimism about the future), as well as in post-traumatic stress disorder or generalised anxiety disorder. These assumptions should be evaluated by a mental health professional, so don’t hesitate to consult one if you suspect 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: Panamericana.
  • Pérez, M.; Fernández, J.R.; Fernández, C. and Amigo, I. (2010). Guide to effective psychological treatments I and II:. Madrid: Pirámide.