Thought Suppression

It is important in the treatment of OCD to understand what thought suppression actually is. This is different from rumination and attention—which I will discuss elsewhere, and which Dr. Michael Greenberg has explained very well on his website OCDassociates.com.

Thought suppression is the active rejection, pushing away, or forceful disconnection from thoughts arising in consciousness. These thoughts can be images, felt senses, words, or anything fleeting yet unwanted (in the case of OCD, often intensely unwanted). What is important to know is that you cannot force a thought out of consciousness. This backfires. As demonstrated in the famous “White Bear Experiment” by Daniel Wegner (1987), the more people tried not to think about white bears, the more often white bears showed up in their minds. This is known as ironic rebound.

This is true for all humans. What happens in OCD is that the person misinterprets the thought as dangerous or meaningful and tries to push it out of consciousness as a strategy for solving the problem. It’s different from rumination, but still a strategy. The problem is:

a) Trying to suppress something actually directs attention toward the very thing you’re trying to suppress, which keeps it in consciousness longer.
b) Your brain doesn’t care whether you like something—it cares whether you find it dangerous. If you label a thought as “bad,” it becomes “dangerous,” and your brain will bring it up more often to protect you.

So suppression doesn’t work. In fact, it makes things worse.

The only way for a thought to eventually pass is to allow it to be there. Paradoxical—but that’s how it works with the other ~36,000 thoughts you have every day. They come, they go. Because you don’t try to suppress them. Notice that I did not say you must “not care” about them. Care is a feeling, and we cannot directly control feelings. You may care that you have a thought, but that does not mean you have to suppress it. Big difference. The more you allow—really allow—the thought to be there, the more it exits consciousness on its own over time.

Some of you might say, “But it’s hard.” My response is: it is harder to do the opposite. Suppressing thoughts all day is like trying to hold a beach ball underwater. Exhausting. That’s why I often see clients in despair—this constant suppression can make every moment of life feel overwhelming.

Let’s make this tangible. I see this over and over in my practice working with OCD. Sensorimotor OCD is an excellent example of how thought suppression can create ironic rebound. Clients come to me in distress about their inability to stop focusing on their physical body. Alongside rumination, the core issue in these cases is the rejection of thoughts, feelings, and sensations in consciousness. That rejection directs attention toward the very thing they want to escape from.

Paradoxically, openness to these thoughts, feelings, and sensations sends a signal to the brain that they are not dangerous or meaningful. When the brain discovers there is no threat, it eventually gets bored and moves on.

This is why there is no choice but to allow the thoughts. You have to allow them. There is no alternative that works. Allowing a thought does not mean the thought is meaningful, real, important, or dangerous (those interpretations are addressed in ERP or ICBT). It simply means the presence of the thought must be allowed before it can leave on its own.