Ask Dr. Barb: How to control obsessive thoughts

Dear Dr. Barb,

I was talking with a friend about our Catholic upbringing and how nuns told us that thinking of stealing (or cheating or fornicating, etc.) means a person has already sinned. Whether one believes this or not, we agreed that constantly thinking of a certain misdeed might lead to doing it. So, we wonder if you know ways people can control their thoughts. For example, if you think your best friend’s wife is very attractive, it might be difficult to stop fantasizing about being involved with her. Should a person consider such thoughts harmless if not acted upon? If such thoughts are mentally unhealthy, how do you avoid them?

Dear Reader,

A thought is just a thought and there is nothing harmful about a thought as long as it is not acted upon. Also, we are only human and it is unrealistic to think that socially unacceptable images should never enter our minds. We are all capable having unwanted thoughts.

Sometimes a very strict upbringing — religious or not — can cause one to feel very anxious about unwanted thoughts. It becomes scary to think that just thinking about doing something unacceptable will result in carrying it out. In these situations, the thoughts may become obsessive.

They enter one’s mind and instead of being easily dismissed, they get stuck there and become unwanted, obtrusive and repetitive.

In your example, the individual who becomes obsessed thinking about his friend’s wife may become so uncomfortable that he may act on his fantasies as a way to relieve the inner tension caused by his obsessions. If she reciprocates, his involvement with her would become compulsive, something he feels unable to control, but can learn to.

On the other hand, another individual might never act on his unacceptable thoughts, but feel extremely uncomfortable, anxious and ashamed about being unable to control them. In either example, the thought of unacceptable behavior is only unhealthy when the person is unable to stop obsessively thinking about it or is unable to override the compulsion to act on it.

However, the anxiety caused by such thoughts is manageable. There are numerous approaches in learning to cope. First, challenge the belief that you can avoid unwanted thoughts and that you are an unworthy person for having them. In fact, just challenging this faulty belief can lower one’s level of anxiety and reduce feelings of shame and guilt about having them. Remember, no one is perfect. Beliefs instilled by parents and religious teachers, though perhaps well-intended, at times may have been too perfectionistic and irrational.

Second, obsessive thinking is habit-forming. Be mindful of its pattern of occurrence, namely what kinds of situations lead up to how and when they appear. For example, some individuals begin to obsess when they try to wind down from work and have a hard time relaxing. There may be some underlying fear or insecurity causing inner tension that makes it difficult to relax. Try to identify these fears and insecurities.

Third, once the recurring pattern of stress  is identified, learn new relaxation methods. Slow, deep breathing with progressive muscle relaxation is an excellent way to slow down rapid heart rate and relieve muscle tension. Yoga is another mental and physi- cal stress buster that incorporates breathing exercises with muscle control.

Meditation is a recommended exercise in learning to calm the mind and let unwanted thoughts come and go. Of course, listening to your favorite music can improve your anxious mood, and physical exercise can enable a sense of control overall.

Last, using mental imagery or visualization can stop obsessive thinking. Try visualizing a big red stop sign, as a reminder to interrupt worry and rumination. Or, picture throwing obsessive thoughts into a trash can. Some people have had success wearing a rubber band on their wrist and snapping it when such thoughts emerge.

Should the obsessive thinking become so severe that one is unable to concentrate and perform responsibilities, professional help may be necessary. Working with a psychologist who specializes in cognitive behavioral therapy can be enormously beneficial for evaluation of obsessive thought patterns and for modification of irrational beliefs leading to maladaptive behavior. Also of benefit will be the psychologist guiding relaxation and visualization exercises until the individual can practice these exercises effectively alone.

As an adjunct to therapy, working with a psychiatrist to assess the need for medication may be necessary. It is not recommended to just work with one or the other. Medication can enhance the effects of therapy, and therapy may eventually decrease the need for prolonged medication. In severe cases of obsessive-compulsive thinking, professional treatment can help an individual feel relief from repetitive unwanted thoughts, feelings and behaviors.

Those never having been in that position can find it difficult to understand how helpless a person can feel when unable to control the unending discomfort of obsessive thinking. Accepting treatment for this problem is a lot healthier in the long run than turning to unsafe alternatives such as uncontrolled substances or other addictive behaviors in order to calm the mind.

Barbara L. Rosenberg, Ph.D, is a licensed psychologist whose Summit practice serves individuals of all ages, as well as couples and families. She previously chaired educational and social programs for the Essex- Union County Association of Psychologists. Contact her through BarbaraRosenberg.com or call her office.