Two ways to tackle problem thoughts

The dominant psychological treatment for depression, anxiety, and a range of other mental health problems over many years has been Cognitive Behaviour Therapy- CBT. A key focus of this approach is recognising and testing the accuracy of inaccurate thoughts that contribute to mental health problems. For instance, thoughts like 'I will never feel better', 'I am a terrible person', and 'I will never find a loving partner' are commonly associated with depressed mood.

In CBT, we look to evaluate these thoughts to see how accurate they are. For example, we can look at evidence for and against a particular thought. We might also look at the pro's and con's of holding a particular thought. Another approach can be to put yourself in the shoes of a trusted friend to imagine what he/she would say about a negative thought. After we have evaluated a thought for accuracy, the next step is to replace inaccurate thoughts, with more accurate ones. They point of all this is to improve psychological functioning through improved identification and challenging of the thoughts that cause us trouble.

In recent years, there has been a growth in approaches that take a different stance with problem thoughts. Instead of directly challenging thoughts, an approach can be used where we try to 'unhook' from problem thoughts. Often, people forget that thoughts are just that- thoughts. We can easily buy into a thought to the extent that thoughts replace actual experience. This is also known as ‘cognitive fusion’ (thoughts become reality, rather than being aware that thoughts and the real world are separate things). When we step back and see thoughts as nothing more than products of our brain ticking away, people can feel a sense of relief. Another benefit can be that unpleasant thoughts lose some of their intensity. This approach can also help foster the belief that you can get on with life, even when unpleasant thoughts are hanging around. There are many ways to achieve ‘defusion’, for example, adding “I am having the thought that” to the beginning of a negative thought. You can repeat the distressing thought using a funny or ridiculous voice (e.g., Yoda- to keep you Sci Fi fans happy). There are also visual ways to defuse, such as imagining thoughts as clouds passing by in the sky.

So, these are two very different approaches to dealing with distressing thoughts. One says 'Attack the inaccurate thought head-on, evaluate it, then re-work it', the other says 'Leave it alone, step back, and see it for what it is'.

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