Saturday, August 29, 2009

Suppressing Does not Work - Part Two of Two - Searching for Something that Does Work

Hello Friends:

There's a post on Psyblog called "Why Thought Suppression is Counter Productive" that follows along similar lines to those I'm addressing in Parts I and II here. So either I'm a really trendy blogger, have come late to the party, or (the worst) I'm a conformist. Egads.

Anyway, they cite some of the same studies (including the famous one with the white polar bear that I changed to chocolate; Wegner et al. 1987). And come to the same obvious conclusions - suppression does not work. Suppressing thoughts is (a) impossible, and (b) makes you think more about what you are suppressing, and (c) makes you feel like a failure for not doing the impossible.

The amount of research suggesting that thought and emotion suppression = bad is pretty overwhelming, and this is just from doing simple searches for the stuff on Google. Like this article in the October 2008 Journal of Aggression, Maltreatment, and Trauma (there is a journal for everything out there) entitled A Preliminary Examination of Thought Suppression, Emotional Regulation, and Coping in a Trama-Exposed Sample. They find that "Thought suppression, emotion suppression, and avoidant coping strategies were positively related to psychopathology." And this one from the Association for Behavioral and Cognitive Therapies published in 2005 entitled Rebound Effects Following Deliberate Thought Suppression: Does PTSD Make a Difference? In this study they found that all groups, regardless of PTSD diagnosis or not, "showed a rebound in trauma-related thoughts following deliberate thought suppression. This rebound was associated with increases in negative affect, anxiety, and distress ...."

On top of the difficulty with trying to avoid thinking about something (again, not at all surprisingly) it is even more difficult to stop thinking about something if it is emotionally charged in some way. Like say those people from the second study above who were trying to suppress thoughts about their car accidents, and subsequently suffered yet more anxiety and distress. This in the end makes it even harder to suppress the thoughts, since they can be associated with additional anxiety from just trying to suppress them. And then iterate until you are seriously messed up. This has direct application for us anxious/depressed folks from the get go, since we have very strong emotional associations with things other people might not. For us, there are huge challenges in trying not to ruminate over thoughts and memories tied to emotions of shame, failure, humiliation, sadness, anger, despair, and fear. Say that three times fast. (Side note - Kinda like Carlin's old skit of the Seven Words You Can't Say on TV. Dated and dirty, but then again most things are.)

So what to do? Well, the result of all this research, and plenty of other stuff as well, is the new focus on the 'third generation' therapies which include the concepts of acceptance and mindfulness. ACT, for example (described nicely in this article from the 2008 edition of Social Work) is a therapy based on accepting what is happening instead of running from it. MBCT (described poorly on the MBCT site, since I'm assuming they'd prefer you bought their book) targets using acceptance and mindfulness to try stop the downward mood spirals that they believe lead to recurrent depression.

These 'accepting' based therapies are not saying "I'm disordered, I accept it, and am stuck with it". Accepting here is more like non-judgmentally admitting and acknowledging. It is the starting point that supposedly lets you stop brooding. There is no longer any 'point' to feeling bad about being depressed, or feeling embarrassed because you have OCDs. In the therapies you hypothetically learn to accept yourself the way you are now, and realistically determine: what really can't change, what can change in the future, and what can actually be changed right now.

This is essentially why I've been checking out Mindfulness, Zen Mediation, and stuff as a new way to try to help myself. I think there is some great stuff in these therapies. And I also think there are some serious problems, but I'll talk about those in detail when I do my book reviews on the subject, especially the MBCT book. Which I actually did buy.

And now, should I go meditate, or watch some Carlin on UTube?

Image is Trinity from Katie Tegtmeyer on Flikr via Creative Commons


europas_ice said...

Fascinating. The experts agree with what I learned by trial and error. I'll be interested to read your book reviews on what to do about the problem.

The Blue Morpho said...

Hello europas_ice!! Nice to see you there - thanks for reading and commenting. I think our intuition (as you said, what we know by trial and error) is often right. But we don't have a lot of confidence in ourselves, so tend to dismiss it. Book reviews about mindfulness are on the way, after I review my old and most hated book. That way I can have a basis to compare the difference between CBT and MBCT.

The Tenacious Writer said...

The web site describes MBCT as "enormously empowering" for a wide range of physical and mental illnesses. I wonder if that's true?

Thanks for introducing me to this idea. Apparently, I am *quite* late to the party!

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