Book Review: Overcoming Unwanted Intrusive Thoughts

I read this book for several reasons.  The first is that we sometimes have individuals referred to us for potential sexual addiction who have intrusive sexual thoughts.  Frequently these individuals are not dealing with a problematic sexual behavior, but intrusive sexual thoughts and we refer them out to a great area clinician who specializes in treating Obsessive Compulsive Disorder.  Secondly, we do have a lot of clients who have some version of intrusive thoughts.  So, I thought the more I could learn about it the better.

The subtitle of the book is A CBT based guide to getting over frightening, obsessive or disturbing thoughts.  My initial assumption was that the book was going to more traditionally CBT focused, and I did not find it so.  It reads more like a book that is advocating some level of mindfulness-based practice.  This is perfect for me as we often use this in our practice. 

One helpful part of this book is how much it normalizes intrusive thoughts.  Many people have thoughts that pop into their heads that are about violence, sexualized content or doing or engaging in what the author calls “disgusting” acts.  Anytime we can work to reduce shame it is a great thing! 

I want to focus this review on the authors six steps to reduce distress over a thought.  They are very mindfulness based and are also extremely applicable to dealing with urges and cravings in any type of addiction. 

The steps are: 

R            Recognize

J             Just Thoughts

A            Accept and Allow

F            Float and Feel

T            Let time Pass

P            Proceed.

The first step is to just recognize that an intrusive thought is just a thought.  To adapt this to addiction recovery, a craving is just a craving.  We can recognize it for what it is.  That means we pause and label it.  Thought.  Craving, etc. The next step is to remind oneself that it is just a thought or craving.  From there we Accept and Allow the thought or craving.  The author says that this means we actively allow the thoughts to be there.  We don’t act on it, but we also do not need to give the thoughts or cravings attention.  For example, someone in recovery might say to themselves, this is just a craving.

The Float and Feel step requires perhaps a bit more explanation.  The author says to float above the fray and allow the feelings to just stay there.  This is described as an attitude of “non-active, non-urgent, non-effortful observation.”  This is also called the Wise Mind.  Float and Feel is to passively allow the thought or craving to be and not engage with it.  Perhaps one of the hardest steps is to just let time pass.  This is to learn to sit with the feelings that come up and not try to immediately do something to get rid of them.  Recognize that a thought or a craving is just a false message from our brain.  The last step is to Proceed or just keep going.  Continue with whatever it was that you were doing. 

Of course, as with most difficult things we need to change, this process is much easier said than done.  These steps take time to learn and even more time to master.  A good first step is to just be able to recognize a thought or a craving and label it for what it is. I am having a craving.  I am just going to try to sit with it as long as I can without judging it.  Thoughts and cravings pass.

Overcoming Unwanted Intrusive Thoughts is a nice primer to help individuals start to understand their intrusive thoughts.  It also helps them come to understand if the thoughts are simply intrusive thoughts or indicative of something else, such as OCD, that might require professional help to master.

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