The human mind is a complex and dynamic entity, capable of processing an immense amount of information every day. However, this mental machinery is not always in our control.
Often, we find ourselves grappling with intrusive and upsetting thoughts that disrupt our peace of mind. Suppressing these unwelcome mental intruders is a common challenge, and understanding the mechanisms behind them can empower us to regain control over our thoughts and emotions.
This article delves into the intriguing idea that suppressing upsetting thoughts may, in fact, promote mental health during adversity and that this capacity can be trainable.
The Nature of Upsetting Thoughts
Upsetting thoughts, also known as intrusive thoughts, are involuntary, distressing, and unwanted mental content that can range from fleeting worries to disturbing images or memories. They often fall into several categories, including:
- Obsessive-Compulsive Thoughts: These thoughts are characterized by repetitive and distressing themes, such as contamination fears, aggressive impulses, or thoughts of harm to oneself or others.
- Traumatic Memories: People who have experienced traumatic events may frequently experience intrusive memories or flashbacks of those events.
- Anxiety-Inducing Thoughts: These can encompass worries about the future, impending doom, or various irrational fears.
- Negative Self-Reflection: Thoughts related to low self-esteem, guilt, or shame can also intrude upon one’s mind.
Why We Experience Upsetting Thoughts
Understanding the origins of upsetting thoughts is crucial in managing them. Several factors contribute to their occurrence:
- Evolutionary Perspective: Some theories suggest that intrusive thoughts may have evolutionary roots, helping us anticipate and prepare for potential dangers.
- Brain Functionality: The brain’s default mode network (DMN) plays a role in mind-wandering, contributing to the occurrence of intrusive thoughts when we are not focused on a task.
- Past Experiences: Traumatic events, unresolved issues, or past experiences can trigger upsetting thoughts.
- Mental Health Conditions: Conditions like anxiety disorders, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD) can increase the frequency and intensity of intrusive thoughts.
The Negative Impact of Upsetting Thoughts
Upsetting thoughts can have profound effects on mental and emotional well-being, including:
- Increased Stress: Frequent intrusive thoughts can trigger the body’s stress response, leading to physical and emotional strain.
- Impaired Functionality: Intrusive thoughts can disrupt concentration, memory, and decision-making abilities, impacting daily functioning.
- Emotional Distress: Ongoing distress from upsetting thoughts can lead to anxiety, depression, and other mood disorders.
Historical Perspectives on Thought Suppression
The historical perspective on thought suppression is deeply rooted in Sigmund Freud’s psychoanalytic theory, which proposed that suppressed thoughts linger in the unconscious mind, eventually resurfacing through symptoms and dreams. This theory set the stage for a belief that suppressing thoughts was inherently maladaptive (1, 2). However, over time, contemporary theories have emerged, suggesting that thought suppression may not be as harmful as once thought.
Modern Theories and Neurobiological Evidence
However, these clinical views are at odds with neurobiological evidence, which suggests that thought suppression can be beneficial for mental health (5–11).
For instance, studies have shown that engaging the right lateral prefrontal cortex to suppress intrusive thoughts is associated with greater resilience to developing post traumatic stress disorder (PTSD) after traumatic experiences (11). Additionally, thought suppression has been linked to decreased anxiety about feared events (12), fewer distressing intrusions after exposure to traumatic stimuli (13), and a tendency to forget suppressed content on memory tests (14, 15). These findings challenge the traditional perspective that suppressing thoughts is inherently harmful.
The Lack of Causal Evidence
Despite the potential benefits of thought suppression, direct causal evidence of its effects on mental health has been lacking. Ethical concerns have deterred experimental studies from investigating the impact of thought suppression on vulnerable populations (18). Therefore, there is a need for rigorous research to determine whether thought suppression can genuinely improve mental health by reducing distressing thoughts and their emotional impact.
The Research Hypothesis
Individuals with these conditions often struggle with thought suppression in both laboratory measures and daily life (11, 27–31). This difficulty is often attributed to deficits in inhibitory control over memory and emotion, potentially stemming from various neurobiological factors (32–40).
The authors sought to determine whether thought suppression deficits could also reflect modifiable factors, such as inexperience with suppression, ineffective strategies, or metacognitive beliefs discouraging its use. To test this hypothesis, they conducted a study in which participants were trained to suppress their distressing thoughts about feared future events. Given the rise in anxiety, depression, and posttraumatic stress during the COVID-19 pandemic, the study aimed to address a symptom common to these conditions (41–43).
Study Methodology
The study involved 120 adults from 16 countries and utilized individualized videoconferencing for treatment delivery. Before training, participants listed feared future events related to their current concerns, each associated with a cue word that served as a reminder. Participants briefly described each fear and provided a single word representing a central detail of what they typically imagined about the event.
During the training phase, participants engaged in the Imagine/No-Imagine (INI) task, which required a specific form of thought suppression known as retrieval stopping (5, 14, 15). Over three days, participants practiced suppressing thoughts related to their feared events, with each event cued 36 times. After this training and following a three-month delay, the researchers assessed how thought suppression had affected these events, particularly in terms of memory and affect.
Central Focus on Mental Health
The primary focus of the study was to determine how training participants to suppress distressing thoughts would causally impact their mental health. To measure these effects, the researchers assessed changes in clinical indices related to depression, anxiety, worry, affect, and well-being. These assessments were conducted before and after thought suppression training and again after a three-month period.
To differentiate the unique effects of suppressing distressing thoughts from other factors, the study compared changes in these indices between two groups: one that suppressed feared events (the Suppress-Negative group) and another that suppressed neutral events (the Suppress-Neutral group).
The latter served as a control group to account for general changes resulting from various factors, including the generation of positive, negative, and neutral events at the study’s outset, the general experience of thought suppression training, potential placebo effects, and social interaction with experimenters.
The study also incorporated a complementary manipulation by comparing the mental health effects of suppressing fearful thoughts with those induced by imagining positive and neutral future events. This allowed the researchers to evaluate how thought suppression stacked up against the well-established technique of positive thinking for enhancing mood (44–46).
Suppressing Upsetting Thoughts
While it is challenging to completely eliminate upsetting thoughts, various strategies can help individuals manage and suppress them:
- Mindfulness and Awareness: Acknowledging the presence of upsetting thoughts without judgment can reduce their emotional impact.
- Cognitive Behavioral Therapy (CBT): CBT techniques, such as cognitive restructuring and exposure therapy, help individuals challenge and modify negative thought patterns.
- Relaxation Techniques: Deep breathing, meditation, and progressive muscle relaxation can help calm the mind and reduce the frequency of upsetting thoughts.
- Medication: In severe cases, medication prescribed by a mental health professional can alleviate symptoms associated with conditions like anxiety and OCD.
- Distracting Activities: Engaging in hobbies or activities that require focus can divert attention away from upsetting thoughts.
- Seeking Professional Help: Consulting a mental health therapist or counselor can provide valuable guidance and support in managing intrusive thoughts.
Discussion
In this study, we have delved into the intricate dynamics of thought suppression and its potential impact on mental health. The findings presented herein challenge long-held beliefs regarding the role of thought suppression in mental health disorders. We have explored the nuances of thought suppression, its effects on awareness of distressing content, voluntary access to details of feared scenarios, and subjective distress. Moreover, we have examined its potential to prevent repetitive thinking patterns that contribute to anxiety, depression, and posttraumatic stress.
The mnemonic and affective patterns we observed following the training of participants to suppress distressing thoughts suggest a protective and enhancing role of thought suppression in mental health. When executed effectively, thought suppression achieves three critical outcomes: it diminishes immediate awareness of distressing content, restricts voluntary access to details of feared scenarios, and reduces the subjective distress associated with these scenarios.
These regulatory impacts, when successful, act as barriers to the escalation of worrying, rumination, and other forms of repetitive thinking that amplify the burden of anxiety, depression, and posttraumatic stress. Simultaneously, the increased perception of control over one’s thoughts, as demonstrated in Table S12, has a positive effect on overall well-being. It is worth noting that participants continued to voluntarily apply suppression techniques to both their initial fears and new fears for up to three months after training, yielding enduring mental health benefits for those who had experienced symptoms.
This research challenges the prevailing view that thought suppression plays a detrimental role in the development of mental health disorders. Contrary to concerns, we did not observe any evidence that training individuals to suppress distressing thoughts increased the risk of paradoxical rebound effects on mnemonic, affective, or mental health indices. This risk remained unchanged regardless of the delay, the affective intensity of feared events, or the participants’ level of trait anxiety, depression, or posttraumatic stress at the beginning of the training. This finding contradicts historical Freudian views that suppressed contents persist in influencing us unconsciously and theoretical claims about the ironic effects of thought suppression.
The negative perception of thought suppression within the clinical psychology community has largely stemmed from data derived from the White Bear thought suppression task, which involves remembering and monitoring a specific forbidden thought while simultaneously attempting to suppress it. However, our data suggest that retrieval suppression, which aims to interrupt the progression from cues to unwelcome thoughts, does not carry the risk of rebound effects.
We propose that retrieval suppression succeeds by engaging inhibitory control mechanisms in tandem with the circuitry underlying fear extinction. This dual process inhibits both mnemonic and affective responses, aligning with natural thought suppression processes. By training individuals to confront reminders that reactivate their fearful thoughts and subsequently suppress awareness of the associated memory, our protocol combines active forgetting of distressing imagery with the controlled recruitment of extinction circuitry, believed to be critical in adjusting emotional responses to threat.
Regardless of the precise mechanisms underlying these benefits, our experiment unequivocally demonstrates that suppression training can substantially improve the mental health of individuals suffering from symptoms of anxiety and posttraumatic stress disorder. This suggests that the origins of persistent intrusive thinking in these disorders may be more behaviorally treatable than previously assumed.
The notable improvement in symptom control observed after a brief, three-day training regimen calls into question the emphasis on anatomical deficiencies in these conditions. Instead, it suggests that many psychiatric disorders may have roots in treatable behavioral patterns rather than fixed neurobiological deficits. This insight can help identify patients who strongly benefit from suppression training, enabling more precise and tailored interventions while also improving the scientific understanding of these conditions.
In a broader context, the substantial and enduring mental health benefits, coupled with the safety, high endorsement, spontaneous use, and accessibility of suppression training, make it a promising and scalable intervention. It can stand alone as a therapeutic approach or complement traditional treatments such as exposure therapy or cognitive behavioral therapy, offering a neurobiologically grounded option to enhance mental well-being. The potential of suppression training to reshape the landscape of mental health interventions is a testament to its efficacy and adaptability.
Conclusion
This article has provided an overview of a groundbreaking study that challenges the prevailing belief that thought suppression worsens mental health. Instead, it suggests that training individuals to suppress distressing thoughts about feared future events could have a positive impact on mental well-being. The research methodology employed in this study involved individualized videoconferencing and rigorous assessments of mental health indices, providing valuable insights into the potential benefits of thought suppression as a therapeutic tool.
As the study’s results are analyzed and published, they may significantly influence the way anxiety, depression, and PTSD are treated, potentially leading to a paradigm shift in mental health interventions. By understanding the role of thought suppression and its trainability, we may unlock new avenues for helping individuals build resilience and manage distressing thoughts during challenging times.
reference link : https://www.science.org/doi/10.1126/sciadv.adh5292
