Tag Archives: CBT

Overcoming Thought OCD with a Smile: Strategies for Managing Intrusive Thoughts

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Living with Thought OCD, or Pure Obsessional OCD, can sometimes feel like having a pesky roommate in your brain who won’t stop playing the same annoying song on repeat. You know the one—those intrusive, unwanted thoughts that pop into your head uninvited, causing anxiety and distress.

Thought OCD, also known as Pure Obsessional OCD or Pure O, is a subtype of OCD characterized by intrusive, unwanted thoughts or images that lead to distress and anxiety. These thoughts often revolve around themes such as harm, violence, or inappropriate sexual behavior.

But fear not! With a sprinkle of humor and a dash of lightness, you can learn to manage these intrusive thoughts and reclaim your mental space.

  1. Name That Thought: Sometimes, giving your intrusive thoughts a silly or ridiculous name can help take away their power. For example, if you’re constantly worried about locking the door, you could call that thought “Locky the Overzealous Protector.” It might sound silly, but it can help you distance yourself from the thought and see it for what it is—an irrational fear.
  2. The Thought Olympics: Turn your intrusive thoughts into a mental game. Imagine your intrusive thoughts as contestants in the Thought Olympics, competing for your attention. Whenever a thought pops up, give it a score based on how absurd or irrational it is. This can help you see that these thoughts are just passing mental events, not reflections of reality.
  3. The Mindful Observation Deck: Imagine your mind as a bustling train station, with thoughts coming and going like trains. Instead of jumping on every train of thought, practice mindfulness by observing them from a distance. You can even picture yourself as a curious bystander, watching the trains of thought come and go without getting caught up in them.
  4. The Comedy Channel: Treat your intrusive thoughts like a sitcom script. When a thought pops up, imagine it being acted out by your favorite comedians. This can help lighten the mood and remind you that these thoughts are just thoughts, not dire predictions of the future. Or add a silly soundtrack to the movie in your mind.
  5. The Thought Swap: Replace your intrusive thoughts with absurd or funny alternatives. For example, if you’re worried about germs, imagine the germs wearing tiny party hats and dancing around. This can help reframe your thoughts and reduce their impact on your mood.
  6. The Comedy Club: Invite your intrusive thoughts to a comedy show in your mind. Picture them as stand-up comedians trying to make you laugh. By turning your thoughts into a source of humor, you can take away their power and reduce their hold over you.

Remember, managing thought OCD is a journey, and it’s okay to have ups and downs along the way. With a bit of humor, a dose of mindfulness, and a sprinkle of self-compassion, you can learn to manage your intrusive thoughts and live a more lighthearted life.

Suffer From Insomnia? Best Insomnia Drug Is Not A Drug, But Rather Cognitive Behavioral Therapy According to Consumer Reports

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Do you suffer from insomnia? Have you tried sleeping pills? When a major consumer ratings agency such as Consumer Reports endorses cognitive behavioral therapy over drug treatment for insomnia, it is big news.sleeping dog

In the May 2017 issue of Consumer Reports (CR), there is an article entitled Why the Best Insomnia Treatment Is Not a Drug.  In earlier versions of their articles on sleep and medications for sleep they had reviewed various different sleeping agents but in this updated article they conclude that at best, the newer sleep medications add only between eight and 20 minutes of sleep time, and don’t improve how people feel or operate the next day.

They also reviewed a recent systematic research study by the federal Agency for Healthcare Research and Quality (AHRQ) that compared multiple treatments for sleep problems including drugs, cognitive behavioral therapy, and alternative therapies. This study concluded that cognitive behavioral therapy (CBT) is a safe and effective way to treat insomnia, and is more effective and safer than other treatments.

So Consumer Reports’ Best Buy drug pick is actually not a drug at all! It is Cognitive Behavioral Therapy (CBT). They recommend at least one session and optimally suggest three to six  sessions of CBT with a psychologist.

They also have a good description of how CBT works for insomnia. They explain how you meet with a psychologist and work on changing your beliefs about sleep, as well as changing certain behaviors that may contribute to insomnia. CR also includes a concise chart about bad sleep habits and how to fix them. They have an excellent description of CBT for insomnia here.  If CBT was a sleep medication, promoted by a powerful drug company, it would be a multibillion-dollar product!

insomnia slide

I have previously written about CBT for the treatment of insomnia in the article Cognitive Behavioral Therapy for Insomnia (CBT-I) Outperforms Drugs for Insomnia,   Want to Sleep Better? Get Brief CBT-I Therapy for Sleep Instead of Sleeping Pills, and Good News! You May Be Getting More Sleep Than You Think, Especially If You Suffer Insomnia! so I will just summarize some of the conclusions from those articles.

The bottom line for these articles was that Cognitive Behavioral Therapy for insomnia was safe, effective and long-lasting in its effects. What is clear from virtually every study of sleep treatments is that CBT may be the only treatment for sleep problems that doesn’t have side effects and negative impacts into the next day. According to a 2015 Consumer Report survey, 36% of people who took a sleeping pill felt drowsy the next day. They also report a study of 410,000 adults published in the American Journal of Public health which found that those who took sleeping pills were twice as likely to be in automobile crashes. The researchers in this study concluded that people taking sleep medications were as likely to have car accidents as people with blood-alcohol levels above the legal limit!

So what are the recommendations and interventions used in CBT for insomnia?

  1. Spend only seven or eight hours in bed, and don’t compensate for insomnia by lying in bed for ten or eleven hours, as that just teaches you to be an inefficient sleeper.
  2. Go to bed and get up at the same time every day.
  3. Don’t go to bed unless you actually feel sleepy. If you can’t fall asleep get out of bed and do something peaceful and relaxing until you are sleepy, and then go back to bed.
  4. Try to get regular exercise but don’t exercise in the evening.
  5. Use your bed only for sleeping (or sex), don’t read or watch TV or look at your smartphone in bed.
  6. Don’t nap.
  7. Reduce your intake of caffeine, nicotine, and alcohol, especially later in the day.

Now it’s time for my nap—no, my mid-day exercise!

Good News! You May Be Getting More Sleep Than You Think, Especially If You Suffer Insomnia!

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The Wall Street Journal today had a very interesting article about how people with insomnia tend to greatly underestimate how much sleep they get and overestimate how long it takes them to fall asleep. They also overestimate how often they wake up at night.

Roughly 30% of adults have some insomnia each year. About 10% of people have chronic insomnia which means that you have trouble sleeping three times a week or more. According to the Journal article, 42% of insomniacs who actually slept the normal amount (6 hours or more) underestimated how much they slept by more than an hour. I looked up the research article which was published in Psychosomatic Medicine. According to this research, insomniacs who slept six hours or more typically showed a profile of high depression and anxiety and low coping skills according to psychological testing.

What’s also interesting is that even though insomniacs may be sleeping six or more hours a night, there does appear to be some real differences in their brainwave activity compared to good sleepers. Even though they are asleep, their brains are more active, which may account for why they perceive their sleep to be less than it really is.

Another interesting factoid was that normal people tend to overestimate how much sleep they get. Most people when asked how much sleep they get will answer between seven and eight hours, but they are actually getting six hours. That’s why people tend to be so sleep deprived. For most people six hours is not enough sleep to feel really good.

So what’s the answer to this sleep estimating dilemma? It turns out there is a very simple answer. The two gold standards for measuring sleep are brainwave measurements and activity measurements. While brainwave measurements are difficult to come by in the home, activity measurements are very easy and inexpensive to obtain. Many of the current fitness tracker’s have a sleep tracking function. For instance, according to my Xiaomi Mi Band, which cost me the grand sum of $15, last night I was in bed for seven hours and 58 minutes, and got three hours 20 minutes of deep sleep and four hours and 38 minutes of light sleep. I was awake for one minute. (Yes, I know, please don’t hate me all you insomniacs!)

For insomniacs who worry about how much sleep they are getting, I recommend buying a fitness tracker and wearing it every night. The best ones automatically track sleep without having the requirement that you push a button to activate sleep mode. This is pretty important as most people forget to press the button. I have been pretty happy with my Xiaomi Mi Band, which you can buy directly from the company  but I’m sure there are other brands of fitness trackers which offer similar features.

Also, as I’ve written about previously here and here, cognitive behavioral therapy for insomnia (CBT-I) may also improve the quality of sleep as well as the quantity. Some studies show that CBT-I improves people’s ability to accurately estimate their sleep time, and it also may calm  the over-activity of the brain that occurs when insomniacs sleep.

So here’s the executive summary for all of you sleep-deprived folks:

1. If you are an insomniac who is anxious and depressed, then you are probably getting more sleep than you think. Buy a fitness tracker with a good sleep tracking function, and you will see how much sleep you are actually getting.

2. If you want to improve the quality of your sleep, either practice meditation or see a CBT psychologist for CBT-I, as both of these interventions seem to lower the activity of the brain during sleep, which will improve your perception of your own sleep.

3. If you consistently feel anxious or depressed, consider getting some cognitive behavioral therapy for these problems, as they may contribute to sleep difficulties.

I’m off to bed now and hope I don’t have insomnia now that I’ve written about it!