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Thought-Stopping: A Technique That Can Make OCD Worse

by edinburghtherapyservice
11 minutes read

Thought stopping

If you have obsessive-compulsive disorder (OCD), the desire to alleviate intrusive thoughts can lead you to explore various methods. It’s entirely natural to seek relief, given the challenging and distressing nature of these obsessions. Among the strategies you may have experimented with is the technique known as thought-stopping. 

Thought-stopping is a cognitive-behavioural therapy (CBT) technique introduced in 1928 that gained popularity in the 1950s (Melton, 2017). However, its effectiveness has been questioned, suggesting that even if you have some success, unwanted thoughts or emotions tend to disappear only temporarily (Aldao, Nolen-Hoeksema & Schweizer, 2010).

Furthermore, in OCD, this technique not only is unhelpful at suppressing intrusive thoughts in the long term, but it is also a compulsion that makes the disorder worse. 

What is thought-stopping?

Thought-stopping is a technique used to interrupt and eliminate unwanted thoughts. Executing this technique is rather straightforward: introduce a subtle discomfort each time an unwelcome thought surfaces, usually accomplished with a gentle snap of a rubber band on the wrist. Moving beyond this initial step includes transitioning to less intrusive methods, like vocalising a firm “STOP!” and, over time, evolving to the internalised repetition of the word “STOP” as a personal intervention.

Thought-stopping can make OCD worse

While it has been used in the past, the available evidence indicates that following this method is likely to exacerbate symptoms (Christensen et al., 1987). In particular, when someone attempts to repress a thought, the accessibility of that specific thought ironically rises. In other words, when you try not to think about something, the mere act of trying to suppress that idea keeps the idea alive. It’s nearly impossible to refrain from thinking about something once your attention is directed towards it.  This results in a rebound effect, causing the undesired thoughts to manifest more frequently and with increased intensity (Purdon, 2004). 

Furthermore, while trying to suppress thoughts, you might be unintentionally signalling to your mind that these thoughts hold significance or indicate genuine danger. If there were no danger, you wouldn’t need to suppress the thought. Simply attempting to suppress it communicates a signal of risk.

A substantial number of those with OCD engage in compulsive thought suppression, essentially turning thought-stopping into a ritual. Consequently, this so-called technique guides people with OCD to perform rituals, contrary to established effective treatment approaches for OCD. 

Not to mention that pushing away distressing thoughts also demands energy; it’s an engaged effort. Staying alert to keep these thoughts in check requires vigilance, and this can drain your energy and wear you out, particularly when practised consistently over extended periods. When your energy is depleted you are stressed, and you become more susceptible to intrusive thoughts.

Moreover, first-line treatments for OCD like exposure and response prevention (ERP) are effective because they do the opposite of thought-stopping. In ERP, the person deliberately confronts their obsessions, intentionally immersing themselves in these thoughts. By embracing and not attempting to halt these experiences, they have the chance to discover that these thoughts are not inherently dangerous and they can cope with them. As a result, OCD specialists are unlikely to endorse or recommend thought suppression.

What's a different approach I can take?

The most effective approach to intrusive thoughts is to let them be, without engaging with them, endure the discomfort they bring, and continue with your life as they naturally diminish. It is about giving up control and leaning into the anxiety and uncertainty, as opposed to what OCD craves, that is the seek of absolute certainty regarding your thoughts, doubts, and fears, asserting that anything less is intolerable. Seeking certainty is the foundation for numerous compulsions that only serve to worsen OCD.

By permitting thoughts to exist, embracing uncertainty about your fears, and carrying on with your life despite temporary discomfort, you are practising response prevention, which is a key element in therapy for OCD. Over time, facing your obsessions in this way will gradually diminish OCD’s influence.

Aligned with this purpose, mindfulness can help you tame your intrusive thoughts. Through meditation you practise observing your thoughts and feelings without judgement, allowing the uncertainty and fear that comes with them. Learn here more about how mindfulness practices can help you with your OCD

Another helpful strategy for embracing uncertainty is the ‘maybe, maybe not’ approach. When your OCD prompts doubt, you can respond with something like, “Perhaps I’m a paedophile, perhaps not, and I may never know”, and stay with the discomfort created by the doubt. 

Therapy for OCD

Apart from the above strategies, one of the best ways to cope with your intrusive thoughts is to seek therapy with an OCD specialist. Exposure and response prevention (ERP) for OCD can assist in breaking the reliance on suppressing thoughts. An OCD therapist can collaborate with you, providing guidance on how to detach from intrusive thoughts, feelings, urges, or images, allowing you to lead a life not dictated by compulsions and fear. 

References

Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical psychology review, 30(2), 217–237. 

Christensen, H., Hadzi-Pavlovic, D., Andrews, G., & Mattick, R. (1987). Behaviour therapy and tricyclic medication in the treatment of obsessive-compulsive disorder: A quantitative review. Journal of Consulting and Clinical Psychology, 55, 701-711.

Melton L. (2017). Brief Introduction to Cognitive Behavioral Therapy for the Advanced Practitioner in Oncology. Journal of the advanced practitioner in oncology, 8(2), 188–193. 

Purdon, C. (2004). Empirical investigations of thought suppression in OCD. Journal of Behavior Therapy and Experimental Psychiatry, 35, 121-136.

Further reading

Do you offer OCD therapy near me?

Edinburgh Therapy Service offers both in-person OCD counselling in Edinburgh (United Kingdom), and online therapy accessible worldwide. We specialise in therapy for OCD, offering CBT with ERP as the main treatment option. 

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The Edinburgh Therapy Service is a psychotherapy and counseling practice based in Edinburgh, Scotland (United Kingdom). We offer therapy both in-person in Edinburgh and online, available in English and Spanish.

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Contact us for more information or to book your first appointment: [email protected]