Suppression is one of various mental control techniques that people may use to manage unwanted thoughts. Evidence suggests that it is at best unsustainable and at worst counterproductive. This leads to the question: If suppression is a futile way to respond to unwanted, intrusive thoughts, what is a more effective alternative? In the current study, we evaluated the relative effectiveness of suppression and two alternative mental control techniques—focused distraction and acceptance—on the frequency of intrusions and distress associated with them. Results support the claim that suppression is a counterproductive technique for dealing with unwanted, intrusive thoughts in OCD. However, the harmfulness of suppression was reflected primarily in the magnitude of distress and not in intrusion frequency. Focused distraction and acceptance were the more effective techniques for managing clinically significant intrusive thoughts. We discuss implications for the cognitive treatment for OCD.
There exists a large body of evidence to suggest that the management of intrusive thoughts is a tricky enterprise both in normal experience and in disorders of perseverative thinking, such as obsessive–compulsive disorder (OCD). For instance, suppression is a commonly used tactic for responding to unwanted thoughts. However, evidence suggests that it is at best an unsustainable and at worst a counterproductive way to deal with non-clinical and clinical obsessions. A question that remains unanswered is: If suppression is a futile way to respond to unwanted thoughts, what then is a more effective alternative? In this research, we assessed the relative effectiveness of suppression and two alternative mental control techniques—focused distraction, and acceptance—on the frequency of intrusions and distress associated with them.
Defining unwanted intrusive thoughts
Unwanted intrusive thoughts (UITs) surface as symptoms across a surprising range of disorders, from generalized anxiety and OCD to depression and beyond (Clark, 2005). UITs can take many forms. The focus of the present research is on discrete, unwanted thoughts that enter conscious awareness, and that are experienced as non-volitional, ego-dystonic, distracting, discomforting, and difficult to control.
Suppression of unwanted intrusive thoughts
Thought suppression is one of a range of strategies that people may use to manage or control thoughts when they trigger unpleasant emotions (Wegner, 1989 and Wells and Davies, 1994). According to the ironic process theory of mental control (Wegner, 1994), any individual engaging in thought suppression is likely to encounter the frequent intrusive return of that thought. This rebound effect—the increased frequency of the thought that was previously the target of suppression—has since been observed with a variety of target thoughts (see review by Wenzlaff & Wegner, 2000). Wegner and Gold's (1995)defensive suppression hypothesis states that thought suppression is more likely to occur for emotional thoughts, both spontaneously in daily life and in the confines of an experiment. Moreover, when thoughts are associated with unpleasant emotions, people are likely to engage in chronic thought suppression ( Wegner & Zanakos, 1994). The counterproductive effects of thought suppression have been observed in experimental studies of UITs (see review by Rassin, 2005), posttraumatic stress disorder ( Shipherd & Beck, 1999), acute stress disorder ( Guthrie and Bryant, 2000 and Harvey and Bryant, 1998) and depression ( Dalgleish and Yiend, 2006, Wenzlaff and Bates, 1998, Wenzlaff and Eisenberg, 2001, Wenzlaff et al., 2002 and Wenzlaff et al., 1988). These studies suggest that although suppression may seem to be an effective solution, it can have profound and unexpected consequences for the psychological influences of the unwanted thoughts.
