How to manage intrusive thoughts through Acceptance and Commitment Therapy (ACT)
Intrusive thoughts are unwanted, disturbing, and recurring thoughts that can appear in our minds involuntarily. They attack you unexpectedly, as if they were a sudden shot. These thoughts cause distress and often involve unsettling ideas, many times related to violence, fear of causing harm, feeling inadequate, or any other type of irrational worry that causes anxiety and even keeps you awake at night. Although we have all experienced them at some point, for some people, they can become so frequent and intense that they interfere with their daily lives and emotional well-being.
How do intrusive thoughts work?
Humans are constantly generating ideas, memories, and images. However, when those ideas or images are disturbing, we start to fight against them and try to eliminate them. This approach often increases their negative impact, leading to a cycle of anxiety and discomfort.
Is there a way to neutralize their power?
Fortunately, Acceptance and Commitment Therapy (ACT) offers a different perspective on how to manage intrusive thoughts. It’s not about engaging in a rational exercise where we try to negotiate a losing battle against a super-powerful enemy. Instead, what we do in ACT is teach patients to accept the presence of these thoughts without letting them define their actions. In other words, patients learn to observe their thoughts in a detached manner and focus on what they truly value in life.
A practical example to reduce the power of intrusive thoughts
Imagine you’ve been struggling with an intrusive thought for a while, such as “I’m not good enough for this job” or “I’m not a good parent/friend…” The first thing we would work on is introducing the concept of accepting these thoughts instead of fighting against them. How? By using a metaphor. Imagine a river with leaves floating on its surface, carried by the current toward the sea. Now, imagine that on each of those leaves, you place a thought. Behind one leaf, another follows, and then another. Behind one thought, another comes, all floating downstream. You simply observe them without getting involved, allowing them to drift away.
Shifting the focus to values
The goal is to reduce the power that intrusive thoughts have over you because the more you struggle to eliminate them, the more they cling to you. Therefore, give them permission to show up and even thank them for the function they aim to fulfill (perhaps to protect you from a perceived threat). Remember, you are not your thoughts; you are much more than them. So, don’t identify so strongly with these ideas that you end up acting as if you were them.
In later sessions, we would identify your core values, such as being a good leader for your team or being a good parent. These values act as a guiding light, directing your actions even when intrusive thoughts are present.
How ACT connects values and actions
What ACT therapists do is help patients connect their daily actions with these values, allowing decisions and behaviors to align more closely with what is truly important, rather than being dictated by disturbing thoughts.
Acceptance and Commitment Therapy (ACT) uses various metaphors and exercises to help patients manage their intrusive thoughts. A useful resource for ACT therapists is The Big Book of ACT Metaphors which provides a comprehensive guide to applying these techniques in clinical practice.
For example, if being a good leader means being present and supporting your team when things get tough, or if being a good parent means playing with your children every afternoon, when the intrusive thought appears, catches you, and paralyzes you, you could say something like, “This thought is here, but it doesn’t have to stop me from spending quality time with my team or my children.”
Conclusion: A process of acceptance
Remember, this is a process. Every time you choose to act according to your values rather than being swept away by intrusive thoughts, you are taking a step in the right direction.
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