healfrmdepress

Have you ever heard of the term rumination? It is something that a cow does when it chews its foods over and over again. Even though we depressives are not cows, we tend to do the same thing with our thoughts. And these thoughts tend to be negative. So harmful is this habit that people who ruminate too much find it very difficult to recover from depression, no matter what else they do to get better. So says Stephen Illardi in his book The Depression Cure.

Have you ever caught yourself going over same thought over and over again. Perhaps it was the breakup of your marriage or another major loss. Perhaps it was a bad decision you made about your career or an investment that went south. Ruminating over and over again reinforces the same sad feelings and digs you deeper and deeper into a ditch that it is hard to get out of. If you find yourself excessively I have good news. There is a simple two=step process that you can use to break the habit.. and the second is learning how to redirect your focus to some other activity.

Step 1 is learning to notice when you are ruminating. Increasing your awareness of rumination begins by checking in with yourself every hour or to monitor your thoughts and see what you have been paying attention to. You can do this by setting a timer on your ? or one in the house to ring once an hour, and then make a note of what you are thinking about. You can also write down what you have been doing, noticing how much time is spent ruminating and then rating your negative mood on a 1-10 scale. For example, if you spent 50 minutes in lying in bed, your mood might be an 8, while having tea with a friend would score as a three out of ten.

This leads us to step two, which is based on a simple but powerful fact—that people tend to ruminate and feel the worst when they have nothing else to occupy their attention.  

The antidote to this is to redirect your attention and turn away from the inner world of thought and memories to the outer world of other people and activities. Simply put this means less thinking and more doing. And the best activities are those that involve other people, For there is something about the presence of another person that makes the person less likely to turn inward. Now we can see what the depressed person’s tendency to isolate and withdraw–is so counterproductive. Because not having people to connect to amplifies the rumination process, and in turn makes the depression worse. Activities with other people could involve walking with a friend, seeing a movie, going on a bike ride, etc.  Other ways of turning your attention outward include listening to music or books on tape, watching videos, or playing with children.

Distractions such as these can be very helpful.  Normally, we think of distraction in negative terms; an example is the title of the book about attention deficit disorder called Driven to Distraction. But when it comes to taking your mind off  mental obsessions that can lead you down the rabbit hole of hopelessness and despair, distraction is a very good coping strategy. The exception to this is if you are using distraction to avoid engaging in positive coping strategies such as going to the gym or working on a job resume. In these cases, the best thing to do is to push through the resistance and engage in those tasks that you know are going to promote your mental health recovery.

This is Part 2 of How to Respond Intrusive and Obsessive Thoughts. One kind of challenge that comes up for depressed people are those persistent self-critical thoughts that so many depressed people think. When these arise, you can use affirmations to replace the critic’s negative self-talk with a more realistic and compassionate view of yourself. Here’s a link to Part 1.

 

Here are some examples:

Inner Critic’s Self-Talk Replacement Affirmation

You’re not good enough. I’m okay the way I am.
I hate myself. I like myself.
You’re worthless. I’m awesome.
You can’t do anything right. There are many things I can do.
No one cares what I have to say. I have important things to share.

Ultimately, the best way to inoculate yourself against the inner critic is to practice self-acceptance and self-compassion..

A third thing to respond to intrusive thoughts is ask yourself, “Is this really true,” This is what is done in cognitive therapy where you challenge the irrational thought and place it with a more realistic one. For example, one of my clients had this thought pop into her head while walking in a local park: Other people are disgusted by me.” So she asked herself, “Is this really true? How do I know what the people around me are thinking. They are probably so absorbed on their own worlds that they aren’t even noticing me. “

And finally, you can respond to the intrusive thought by using the principle of distraction. And while distraction usually has a bad connotation, in this context it is a positive thing, in that it means participating in an activity that distracts you from the negative thought and brings you into the here and now, such as going on a nice walk around the block or watching your favorite YouTube video.

I remember many years ago during a bad depressive I was living with my parents in their retirement community. I made friends with a person my age who worked in the pro tennis shop, and any time he saw me obsessing about thoughts of gloom and doom, he would day, “Doug, I will meet you on the tennis court in five minutes.” Before I knew it, all I could think about was returning his wicked serve over the net.

If you would like an extreme version of using the distraction technique, I recently posted a video that tells the story of how one person used skydiving to get him out of his head and into the present moment. I guarantee you that when he jumped out of the plane and was in free fall, all he could think about was one thing—pulling that parachute chord!

Then, for those who believe in better living through chemistry, there is an antidepressant named Luvox, that’s L-U-V-O-X as in X-ray, which is used to treat people with OCD. Two of my support group members told me that taking this medication reduces both the frequency and the intensity if their negative thoughts.

Finally, before we who suffer from depression and OCD feel too sorry for yourself, think of the poor schizophrenic with who actual hears REAL voices. I once attended a virtual reality exhibit where I entered the virtual world of someone with schizophrenia. After two minutes of hearing persistent voices whispering in my ears, I thought I was going crazy. This is one case where the benefits of antipsychotic drugs might outweigh the risks.

Today’s comment is How to Stop Intrusive and Obsessive Thoughts. I got the idea to do this video after a number of people on my live you tube chats repeat asked, “Dr. Bloch, how can I stop these intrusive thoughts? This a big problem for those of us who suffer from depression. So let’s start by asking, What is an intrusive thought?” I like what Wikipedia says. “An intrusive thought is an unwelcome involuntary thought, image, or upsetting idea that may become an obsession, and can feel difficult to manage or eliminate.”

Another name for intrusive thoughts is automatic negative thoughts, better known by their acronym (ANTS). By the way is there an anteater in the house.

The problem with I intrusive thoughts is they are repetitive, and over time create neural pathways in the brain, kind of like grooves in an LP vinyl record, that make them stronger and stronger. And while we can’t prevent these thoughts from arising, we can control how we respond to them. And so now I am going to give you a few tips for doing this.

The first thing I am going to say is what not to do. Don’t dwell on the thoughts or try to fight against them. If you give them special attention or try to fight against them, they will become stronger. It’s like if you say to yourself, “Don’t think if pink elephants, what do you think will happen? You will think of a pink elephant.

Instead, it is better to practice the principle of non resistance and just observe the thoughts without grabbing onto them or pushing them away. You you can visualize your thoughts as clouds passing overhead or leaves drifting down a river. This process of observing your thoughts in a detached way is called mindfulness meditation practice. There is a ton of information out there about how to do this, I have a video called, “The Mindful Way Through Depression. It is easy to start a daily practice of mindfulness meditation practice, and if you have one you are far more likely to use it in the heat of the battle.

The second technique that I frequently use is to say, CANCEL! CANCEL! And then replace the negative thought with a more empowering one. This is based on the principle of thought substation which says two thoughts can to occupy the same place in your mind at the same time.

So if the intrusive thought is “I’ll never get better” you can replace it with the affirmation “This too shall pass” or “I can attract the resources I need to heal from this depression.”

Or, your intrusive thought could be one about the past such as, “I never should have moved to Oregon from San Diego,” to which you can respond, “I made the best decision I could with the information I had at the time.” Or, “I can always move back to San Diego” which one of my clients actually did. In general, if the intrusive thought involves berating yourself for something you did in the past, then you should seek to practice self-forgiveness.

Continued in Part 2