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Intrusive thoughts and defusion

Why you can’t stop thinking, and what you can do instead

Guide

Fused“I’m a mess.”Thought = reality.I obey it.Defused“I’m having the thoughtthat I’m a mess.”I notice it.I choose what to do.step back

Everyone has thoughts that arrive without warning: worries, unpleasant images, self-criticism. It isn’t a sign that you are going mad or that you are a bad person: it is how the mind normally works.

Why trying not to think about it doesn’t work

The more you try to push a thought away, the more it comes back, and the more powerless you feel. Reassuring yourself, checking or reasoning brings relief for a while, and then the thought returns. The problem isn’t having these thoughts, but the struggle against them and the power we give them.

A little theory · In a famous experiment, people who were asked not to think about a white bear thought about it more often afterwards than those who had been allowed to think about it freely (Wegner et al., 1987). Pushing a thought away makes it more present.

“Whatever you do, don’t thinkabout a white bear”and then…I check if I’m thinking itand then…The bear comes backeven more often

A little theory · Intrusive thoughts are universal: in a classic study, the great majority of people without any disorder described intrusive thoughts very similar to those of people with OCD. The difference wasn’t in the content, but in the importance given to them and in the struggle against them (Rachman and de Silva, 1978).

Defusion: seeing a thought as a thought

Being “fused” with a thought means taking it for reality (“I’m a mess”) and obeying it. Defusion means taking a little distance: noticing that you are having a thought (“I’m having the thought that I’m a mess”). The thought doesn’t have to disappear, but it weighs less on what you do.

Several ways to step back

There are many small techniques; the idea is always the same: looking at the thought instead of looking at the world through it. Try several and keep the ones that work for you.

The thoughtis stilla thought“I’m having the thoughtthat…”Give ita title“Thank you,mind”Put iton a leafSing itor say it slowly

A little theory · In one study, repeating a charged word out loud for 30 seconds (for example, a negative word about oneself) reduced both distress and the believability of the thought, more than distraction or doing nothing (Masuda et al., 2004).

What defusion is not

It isn’t making fun of yourself or convincing yourself that the thought is false. Some thoughts are unpleasant and partly true; the question becomes: “Does this thought help me live the life I want?”

When to talk to a professional

If intrusive thoughts take up a lot of space (several hours a day), lead to rituals (checking, washing, counting) or are about harming yourself, talk to a professional: these are common difficulties that respond well to treatment.

Watch: short videos

The videos open on YouTube. They complement this guide and are no substitute for support.

Worksheets to practise

Sources

Hayes, S. C., Strosahl, K. D. & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change (2nd ed.). Guilford.
Masuda, A., Hayes, S. C., Sackett, C. F. & Twohig, M. P. (2004). Cognitive defusion and self-relevant negative thoughts: Examining the impact of a ninety year old technique. Behaviour Research and Therapy, 42(4), 477-485.
Clark, D. A. & Beck, A. T. (2010). Cognitive Therapy of Anxiety Disorders: Science and Practice. Guilford.
Wegner, D. M., Schneider, D. J., Carter, S. R. & White, T. L. (1987). Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53(1), 5-13.
Rachman, S. & de Silva, P. (1978). Abnormal and normal obsessions. Behaviour Research and Therapy, 16(4), 233-248.

These worksheets do not replace therapy. If you are in distress or having suicidal thoughts, call your local emergency number (112 in Europe; 3114 in France, free, 24/7).

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Gonzalo Garzo, clinical psychologist

Gonzalo Garzo, clinical psychologist

A psychologist since 2018, I work with people online (in English, French or Spanish) and at my practice in La Rochelle, using third-wave CBT and EMDR. These worksheets help you move forward; if you need support, the first contact (20 min) is free.