In obsessive-compulsive disorder, people are bothered by recurrent troublesome thoughts. For people with panic disorder, certain thoughts can help to precipitate severe anxiety attacks. Pretty much everyone else, to a lesser extent, has occasionally been bothered by repetitive thoughts. Depending on how these thoughts are handled, they may result in feelings of anxiety, sadness, worry, guilt and/or regret. How can an exercise in which one repeats "bothersome thoughts" actually decrease suffering?
My recent article in the March/April 2009 issue of The Therapist describes that the secret lies in how the thoughts are repeated. First for some background: to "decenter" is to take a figurative step back from our thoughts. Instead of a reality of "I'm not good," one learns that he had a thought "I'm not good." In cognitive therapy people are then taught to dispute irrational thoughts (sometimes called "cognitive distortions"). In mindfulness practice thoughts are non-judgmentally noticed and let go. So in both mindfulness practice and cognitive therapy it is key to learn that we do not need to believe all our thoughts. An important component of mindfulness practice is also to not resist our thoughts. Otherwise marked frustration may ensue. If we resist our thoughts, the object of frustration may change from "not being able to do anything right" to having too many thoughts that one can't do anything right. "If only my situation were different, I would be happy" becomes "If only I did not have so many distracting thoughts, I would be happy." Therefore, although decentering is an essential first step of mindfulness, it is only a first step. A second step is not resisting our thoughts.














