Defusion of Distressing Thoughts: Acceptance and Commitment Therapy Series

How many thoughts would you guess pass through your mind in a single day? Let’s imagine you’re out to eat with a friend.  Even with your best intentions to stay present and listen, there’s a running commentary going on in your mind.  What are some of the thoughts you might have?  I wonder what she’s thinking of me.  Should I have said that?  I sound like an idiot. I’m still so angry from that meeting with my boss this morning.   He’s so overbearing and impossible to work with.  What am I forgetting from my grocery list?  I’m so forgetful, I must be losing my mind.

Needless to say, these thoughts pull you out of the moment and make it more challenging to listen. You might find yourself censoring what you say out of insecurity, comparing yourself to your friend, or even cutting your lunch date short to get back to the office quickly because you’re feeling stressed.

What’s happening?

When you find yourself stuck in your thoughts, you’re likely dealing with cognitive fusion, another destructive mental strategy that acceptance and commitment therapy (ACT) addresses.  When we’re in cognitive fusion, we believe that the workings of our internal mind (thoughts, memories, images, reasoning, comparisons, etc.) are true and real, such that we allow them to influence our behaviors.  Our thought patterns have power and control over our lives and seem to make our decisions for us.

Often these thoughts include cognitive distortions, like catastrophizing or all-or-nothing thinking.  They can include negative self-talk or beliefs about yourself that you hold to tightly based on past experiences.  When we believe these things, they become self-fulfilling prophecies.  For example, our fears of being awkward contribute to social anxiety or discomfort.  We then avoid social situations to try to manage the uncomfortable feelings that coincide with them, adding to the dynamics of experiential avoidance that lead us to disengage rather than live out what is important to us.

There are several different types of cognitive fusion that we may face.  They include:

• Rules: “shoulds” for self or others, ways the world or people “ought” to work or be.  Example: People should always be kind and respectful.

• “I” stories: identity-based statements about ourselves that become self-definitions and self-fulfilling prophecies.  Example: I’m always late.

• Judgments/evaluations: beliefs about what is fair vs. unfair, good vs. bad, or right vs. wrong.  Example: It’s unfair that I keep getting passed over for the promotion.

• Meaning-making/reasons: justifying what I do or looking for the answer to the “why?” question to explain what happens.  Example: I’m single because I’m so socially awkward and unattractive.

• Worries about the past/future: overfocus on the past or anxiety about the future that pulls us out of the present moment. Example: How am I ever going to pass that exam next Friday?

• “You/They” stories/comparison: beliefs about others that become self-fulfilling prophecies, particularly as they relate to us. Example: She’s better than I am at everything.

Cognitive fusion is a problem because our thoughts and feelings then run our lives for us and toss us around at every whim of our minds.  Yes, thoughts can feel very powerful.  Memories that pop up as flashbacks, ingrained patterns of meaning that carry shame, and automatic responses that elicit strong emotions can feel crippling at times.

Yet it is important to recognize that, though these thoughts can feel powerful and real, they may not have as much power as we think.

What is defusion?

Consider the image of defusing a bomb, as in an action movie.  In order for the hero to save the day, they must somehow disconnect the power this ticking time bomb has in order to keep it from destroying its target.

Similarly, our thoughts act as ticking time bombs that can unleash an explosion of painful thoughts and emotions, followed by destructive behaviors that lead us away from our values.  We can defuse the thoughts by removing the charge that sets them off: the automatic behavioral reaction that comes after the thoughts.  We do this by observing our thoughts from a place of distance rather than getting caught up in the storm they create in our minds.

The previous two concepts we’ve discussed in this Acceptance and Commitment Therapy series are essential building blocks to support this defusion.  Defusion helps us to practice acceptance to willingly encounter painful thoughts and feelings, rather than running away or avoiding experiences we find uncomfortable.  It is also essential for us to remain in the present moment in order to be aware of these thoughts from the role of an observer.

Principles

Thoughts are just thoughts.

Thoughts do not have the power to control your life.  You can have a thought come into your mind, but choose to act in a way that is different from your default response to the thought.  They do not have to control what you do.

Thoughts don’t last forever.

We find some surprising results when we pay attention to how many varied thoughts we have in a day.  To test this, sit quietly in a room with a pad of paper and write down every thought that pops into your head for 5 minutes.  When you’ve completed that list, count how many thoughts you had and multiply that number by 192 to create an estimate of how many thoughts you have in a day.  Recognizing that your thought patterns are fleeting and eventually come to an end can reduce their power.

How we relate to our thoughts is more important than the content of the thoughts.

ACT approaches thoughts differently from a traditional cognitive-behavioral approach, which places emphasis on understanding and changing the content of your automatic thoughts and core beliefs.  While reframing thoughts can be beneficial for some people, ACT theory emphasizes that our thoughts are powerful because we assign that power to them.  Rather than attempting to change a thought that may not be changed very easily, it is more effective to defuse the power of those thoughts.

This approach is helpful if you have tried to change the way you think about yourself or others for a long time, but aren’t finding those changes sticking.  Rather than continuing to try to force a change, allow the thought to be present, but reduce its power by taking an observer role and acting in accordance with your values instead.

Thoughts, emotions, meaning-making, memories, images, and other internal experiences are just products of the mind.

These internal workings don’t have any greater meaning than that.  They don’t have the power to force us to behave in any particular way, despite the fact that we may believe they do. 

At the same time, we can choose situations in which we want our thoughts to have an influence over our behaviors.  We can choose to engage the thoughts that move us more toward what is important to us.  In this way, we’re not eliminating the power of our thoughts entirely, but making an intentional decision of how much power we want to give to those thoughts.

Practices

Keep a record of your thoughts.

Listen to and track your thoughts, noticing whether they carry a positive, negative, or neutral charge.  Identify if there are any strong emotions that go alongside them.  Notice what behaviors flow naturally out of your thoughts and emotions.  Are those behaviors you want to be engaging in?  Or are they impulsive, reactive, automatic responses?  You can find a helpful tracking tool for this step here.

Affirm your role as an observer of your internal world.

After recording your thoughts, you are in a better position to recognize and notice thought patterns as they come up.  When you have a distressing, painful, or challenging thought, see what happens when you intentionally remind yourself of the phrase, “thoughts are just thoughts.”  How does it impact the power of that thought?

Similarly, you could label your internal experience as if you were an outside observer with words like, “I’m having the thought…” or “I’m having the emotion…”. Another strategy is to imagine your thoughts being played on a radio or told as a story outside of yourself.

Visualize the thoughts passing by.

Often we fixate on our thoughts, which gives them the illusion of power.  We obsess over them or attempt to stop them from coming up, which just entrenches them more deeply in our minds.  Instead, use this commonly practiced mindfulness technique: instead of trying to control, change, alter, or rid yourself of your thoughts, just notice them passing by.  Using a visual cue, like imagining thoughts like cars passing on the street or clouds floating by in the sky, can help you to allow them to pass through your awareness without giving them undue attention.  You’ll notice that your thoughts don’t need to command your focus all the time, but that they can come and go.

Write the thought down and look at it regularly.

If you notice a pattern to your distressing thoughts, such as a repeated phrase or belief that feels like it controls you, take that thought and write it down on something you can carry with you, such as a notecard or post-it note.  Throughout your day, pull out the note with your thought on it and read through it.  Notice how it feels when you look at it.  See yourself as an outside observer of that thought.

Notice how the relationship you have to the thought changes.  The words on the paper do not change, but the way you interact with them will differ at various points throughout the day.  This is a good indicator of the importance not of the content of the thought, but of how you relate to it.

Imagine a common situation influenced by this thought, but with a different outcome.

Choose this thought you’ve written on the card, another common thought pattern you’ve identified, or an image or memory that tends to impact your behaviors.  Now imagine yourself having that thought, but making a different decision about how to respond to it.  What behavior might line up better with what is important to you?  What would change?  How would an outside observer see you?  Would it be possible to act in a different way while still having the thought?

Take a risk and put your different outcome into practice.

Now put into practice this shift in behavior in response to your thought.  Release the thought using a statement like, “thoughts are just thoughts,” and take a risk to act in a way that aligns with what is important to you.  For example, if you’re in a social situation with the thought, “I’m too awkward to talk to people like them,” take a risk by engaging in conversation with one of those feared individuals.

Recognize that this will not eliminate the thoughts.  In fact, taking the risk may even intensify your discomfort.  But this practice of stepping out and making a change in your behavior while still experiencing the uncomfortable thoughts can teach you that your thoughts don’t have the power you think they do. You still have control over your own actions such that you can respond to challenging circumstances in alignment with your values.

Seven Signs You Might Have Clinical Anxiety

Your heart is racing, your hands are shaky, and your palms are sweating.  Your pupils dilate, and you feel panic rising in your chest.  You start to feel nausea growing in the pit of your stomach, and you feel slightly dizzy and off balance.

Maybe you’ve had this experience when you were about to give a speech, run a race, or play a sport.   This is an example of what happens when our bodies go through the fight-or-flight response that characterizes anxiety. It’s our body’s response to any perceived threat: our adrenaline kicks in to give us that extra boost of energy to push through.

However, when you struggle with clinical anxiety, that fight-or-flight response never truly turns off.  You’re responding to all of life’s daily worries with an adrenaline surge, and your body and mind get worn out as a result.

Occasional anxiety can be helpful, because it keeps us motivated.  But when it becomes problematic and interferes with our lives, it becomes more harmful than good.

You may be asking: what is the difference between just feeling worried or anxious occasionally, and actually struggling with an anxiety disorder?  Here’s some common signs of clinical anxiety:

You notice physical symptoms, like feeling restless and worked up all the time, or your muscles feel tense and tight.

Physical symptoms of anxiety can often be one of the early indicators that you may struggle with this particular disorder.  Have you ever noticed you’re feeling nervous by holding up a hand and watching it shake?  Pay attention to how your body feels: if you notice shaking, trembling, twitching, exaggerated startle response, or feeling shaky, these might be indicators that you’re feeling some anxiety.  It can also show up in common stress responses, like headaches or stomach issues.

I’ve recently noticed anxiety shows up in me in the form of an internal shakiness: when I’m feeling fear or anxiety about an upcoming event, I shiver as though I were outside in the cold, even if I’m in a warm room.  While I may not be feeling the emotion of fear or anxiety, I am aware that I am anxious because of my body’s response.

Your negative thoughts and fears feel like they’re on a constant loop that you can’t turn off, and you feel worried about most areas of your life.

It is common to experience anxiety about a particular area of your life from time to time.  Clinical anxiety, however, is characterized by worrying so much about all different areas of your life such that you can’t shut the worry off, even when you may need to for an important reason.  This anxiety is excessive, interfering with daily life and the tasks at hand.  It is a general rule that the more areas over which you are feeling anxious, the more likely it is that you are struggling with an anxiety disorder.

The worst-case scenario is the first option that pops into your mind.

Everyday worries can usually be explained or rationalized away, and they typically don’t jump to the worse possible option.  On the other hand, clinical anxiety cannot be rationalized: even when you know your fears are unfounded, the experience of the emotion of anxiety won’t stop.  Even if your fears aren’t realistic or logical, they can feel overwhelming.  This is often one of the most frustrating parts of experiencing an anxiety disorder!

You’re at a loss to figure out what made you anxious in the first place.

“I know I’m nervous because I have a big test tomorrow.” Understandable, right? Feeling anxious about a definable problem like a big exam can be expected.  But when the exam is over and the worry doesn’t stop, or you wake up one morning and feel on edge without any particular reason, that might be an indicator of a more severe form of anxiety.

You have hard time focusing, or you forget what you were doing right after you begin.

Have you ever had the experience of sitting down to focus on a task, and immediately thinking of five other things you need to do?  The constant stream of anxious thoughts running through your head can be too much for your brain to hold.  Trying to keep track of multiple different threads of worries at once can distract you from the task at hand, which leads to forgetfulness and difficulty maintaining attention.  This can have an impact on your ability to be productive, which then feeds right back into anxiety you feel about being unproductive.

You’re short-tempered and easily irritated.

Having so many things on your mind can detract from your empathy and understanding of others.  You can feel overstimulated and overwhelmed by the stress response you’re experiencing.  For that reason, you may notice yourself becoming more annoyed or frustrated with people or circumstances around you that increase your worry.

Some symptoms of anxiety can mask themselves as depression: feeling tired all the time, lack of energy, and/or insomnia due to racing thoughts or fitful sleep.

You might think, “I worry a lot, but I don’t always get keyed up.  Mostly I shut down, and feel sad, exhausted, and unmotivated.”  Anxiety and depression play off of one another, so much so that what feels like depression might actually be anxiety.  They are two sides of the same coin: you may be depressed and your body needs to create anxiety in order to get you energized to complete the task at hand, or you may have anxiety followed by depression when your body decides it is too much and slows you down.

With anxiety, the constant stream of worry and anxious thoughts that you’re experiencing wears your body down.  As a result of your body functioning mostly on the adrenaline produced by the fight-or-flight response, you are more easily tired out.

This article was originally posted on April 6, 2017.