Dr. Daniel Wegner, a Harvard psychology professor, has done some fascinating research on how people try to control or suppress unwanted thoughts. This is important for all people, but especially for people with chronic pain. Try one of Dr. Wegner's experiments. You will need a piece of paper, a pen, and a clock so you can watch the time. For the next two minutes, you will be asked to try not to think of a white bear. If you do happen to think of a white bear, make a little line on your piece of paper each time you think of one (as shown in the picture below). Turn away from the screen so you can't see my photo of the white bear. Then try the experiment…
All done? Next, count up the number of times you thought of the white bear. If you are like most people, you probably had trouble NOT thinking of a white bear. In fact, you may have found that white bear thoughts were bombarding you. You may have even found that when you checked to see if you were thinking of the white bear, that made you think of one.
So, what does this have to do with chronic pain? Living with severe pain can trigger all kinds of intrusive, negative, scary, pessimistic thoughts and images that make chronic pain management even more difficult. You may get caught in a cycle of rumination and depression. You may find yourself trying not to think of such thoughts.You might try to push these thoughts out like you tried to get rid of the white bear thoughts. As you just saw, it is difficult to “just not think about” something.
Dr. Wegner and his colleagues have spent a lot of time trying to understand the best way to live with intrusive thoughts. In a recent review, he talks about methods of effective thought suppression and notes that:
“Many of these strategies entail thinking about and accepting unwanted thoughts rather than suppressing them–and so, setting free the bears.”
I have listed several of the techniques below:
- Focused Distraction – simply paying attention to something else
- Stress Avoidance – stress makes it harder to control thoughts and emotions; of course avoiding stress is easier said than done. But, when you are under stress, try to be aware that you may be more likely to let unwanted thoughts intrude. Then, use relaxation to settle both your stress levels and your thoughts.
- Thought Postponement – notice the troubling thought and promise yourself to think about it later. Some people schedule a 10 minute session each day to think over the unwanted thoughts, and then let them go.
- Exposure and Paradoxical approaches – a paradoxical approach involves intentionally thinking about the unwanted topic. The idea is that if you choose to do something, you must be in control. If you are in control, you need not fear your thoughts. You get to choose what is in your head.
- Hypnosis – you may need a therapist for this, although there are some books about self-hypnosis
- Mindfulness and Acceptance – note that the thought is there, but don't engage it or try to push it away; let it be and go on to something else
- Meditation and Focused breathing – This pair of strategies will serve to give you a focused distraction, calm you down, and make it easier for you to let the thoughts go and turn to something more positive
- Journal writing – Emotional disclosure through writing has a few advantages. Expressing your emotions may help you to release them, think about solutions to issues, and reduce your stress.
If you find yourself struggling with intrusive, negative, upsetting thoughts or images, I hope you will try out some of Dr. Wegner's techniques. At the very least, you may start by “acknowledging the bear” and then moving onto something more positive, more hopeful, and more productive.
About the Author. Dr. Linda Ruehlman is a social/health psychologist and researcher, co-founder of Goalistics, and Director of the Chronic Pain Management Program, an interactive site that helps people with chronic pain to manage their pain and live richer, more effective lives.
DISCLAIMER: This blog is provided as an educational and informational resource only. It is not intended nor implied to be a substitute for professional psychological or medical advice.