“This important book is essential and mandatory reading for anyone affected by unwanted and intrusive thoughts, and their health providers. The authors crystallize decades of experience into a perfectly clear and readable guide. The solution to this misunderstood problem is in this book.” — Joseph A. Adams, MD, medical director at Baltimore Health Systems and Step By Step of Maryland, LLC, and past president at Smoke Free Maryland “I wish I would have had access to this book twenty years ago! Sally Winston and Martin Seif have put all the pieces of the puzzle together to help people understand and overcome unwanted intrusive thoughts. This is a must- read book, packed with information to help people suffering with anxiety- provoking intrusive thoughts, as well as clinicians who are trying to help them.” — Kimberly J. Morrow, LCSW, maintains a private practice in Erie, PA; specializes in the treatment of anxiety and obsessive- compulsive disorder (OCD); provides training and case consultation for clinicians through www.anxietytraining.com; and is author of Face It and Feel It “It turns out that commonsense approaches to stopping our worries, such as pushing thoughts away, arguing with them, or seeking reassurance, actually feed these worries and help them grow. Sally Winston and Martin Seif— two of the brightest minds in our field— deliver a simple yet powerful two- step process for change.” — Reid Wilson, PhD, author of Stopping the Noise in Your Head “Finally, here is an effective, neurologically based clinical approach to dealing with unwanted thoughts (without having to use a rubber band). The authors’ clear and distinctive voice should be widely heard by cognitive behavioral therapy (CBT) clinicians, and by those engaged in an ongoing and unrelent- ing struggle with undesirable ruminations.” — Ronald M. Doctor, PhD, professor emeritus of psychology at California State University, Northridge; author; active researcher; and practicing behavior therapist “In their book Overcoming Unwanted Intrusive Thoughts, Winston and Seif tackle one of the great mysteries of human distress and suffering: the seeming inability to rid our minds of unbidden, unwanted, and disturbing thoughts, images, and memories. Readers are given a rare glimpse into the nature of unwanted intrusive thoughts, as well as their origin and impact on emotional distress. Written in a warm, engaging, yet knowledgeable manner, this book provides new insights for consumers and professionals alike on why common sense fails to soothe the troubled mind. Readers will find practical, research- based guidance on how to subdue unwanted intrusions and overcome their emotional disruption. This book offers much- needed help for those who strug- gle with the torment of persistent disturbing thoughts.” — David A. Clark, PhD, professor emeritus in the department of psychology at the University of New Brunswick, and coauthor of The Anxiety and Worry Workbook and Cognitive Therapy of Anxiety Disorders with Aaron T. Beck “Tens of millions of people have bothersome intrusive thoughts, and most often these thoughts are so unacceptable or embarrassing that many people have trouble telling anyone about them— even their closest family members or friends. At worst, these intrusive thoughts are part of severe problems such as OCD, but we know that almost anybody under stress can occasionally experience intrusive thoughts. Now, at last, a state- of- the- art psychological program written by two of the leading clinicians in the country with years of experience treating this problem is available. The program in this remarkable little book may be sufficient to help you overcome your intrusive thoughts, if therapeutic assistance may be needed, to guide you to the best available resources. I recommend this program very highly as a first step for anybody dealing with this issue.” — David H. Barlow, PhD, ABPP, emeritus professor of psychology and psychiatry, founder, and director emeritus at the Center for Anxiety and Related Disorders at Boston University “Winston and Seif have done a wonderful job in providing sufferers of obses- sive intrusive thoughts with up- to- date and scientifically accurate informa- tion about this often crippling problem. This clearly written guide will serve both as a self- help resource, as well as a workbook to be used as an adjunct to psychotherapy.” — Lee Baer, PhD, professor of psychology in the department of psychiatry at Harvard Medical School, and author of Getting Control and The Imp of the Mind “An interesting and original account of a little- understood phenomenon— intrusive thoughts.” — Fredric Neuman, MD, director of The Anxiety and Phobia Treatment Center, and author of Caring, Fighting Fear, and Worried Sick? “What a great book for people who struggle with intrusive thoughts! Two highly skilled and respected experts in the treatment of chronic anxiety explain how intrusive thoughts work, what they mean and don’t mean, why they defy your best efforts at getting rid of them, and most importantly, how to change your relationship with these thoughts so they don’t remain a persis- tent, negative focus. They help the reader understand that intrusive thoughts don’t persist despite your best efforts; they persist because of your best efforts at arguing with, struggling against, and seeking to avoid these unwanted thoughts. Their book offers plainspoken instructions with lots of good exam- ples that will help you let go of the guilt, fear, and confusion that so often accompanies intrusive thoughts. This is a must- read for anyone experiencing such thoughts, as well as the professionals who seek to help them.” — David Carbonell, PhD, is a Chicago- based psychologist specializing in treating chronic anxiety for over thirty years, author of Panic Attacks Workbook and The Worry Trick, and “coach” at www.anxietycoach.com “Winston and Seif have written an important and much- needed book. It speaks to those who suffer intensely from unwanted intrusive thoughts and, as a result, descend into a world of anxious isolation. The authors lift the sufferer from a frightening darkness into a world of understanding and onto a path to freedom. This is necessary reading for anyone suffering from the tyranny of unwanted thoughts, and it should be required reading for helping professionals.” — Bruce Shapiro, MD, clinical professor of psychiatry at Columbia University College of Physicians and Surgeons “If you live in fear of thoughts that pop into your head, this is the book for you! Two expert psychologists explain unwanted intrusive thoughts, and show you how to break free from the cycles that strengthen their grip on you. You don’t have to suffer because of your thoughts, and Winston and Seif show you the way out of your suffering. The information, strategies, and abundant examples within these pages make this a must- read for anyone trying to make sense of frightening intrusive thoughts, and wanting relief from the distress they cause.” — Joan Davidson, PhD, codirector of the San Francisco Bay Area Center for Cognitive Therapy, and assistant clinical professor in the clinical science program at the University of California, Berkeley “As humans, we often pride ourselves on our ability to think ourselves out of the distress and difficulties that we encounter. But these authors help us rec- ognize that we aren’t in complete control of our thoughts, and help us to approach our thought processes from a more realistic and healthy perspective. They assist us in identifying common myths about our thoughts, and teach us that fighting thoughts is not the answer— it is part of the problem! With the strategies in this book, we learn how to reduce the stress and distress thoughts can trigger, and this takes away the power of those thoughts. The authors present clear explanations of the brain processes underlying intrusive thoughts, but even more importantly, explain why our typical efforts to overcome these thoughts fail. Finally, they provide a detailed guide of what we can do to reduce distress about unwanted thoughts, and to develop a more accepting relationship with the mind.” — Catherine M. Pittman, PhD, HSPP, licensed clinical psychologist, associate professor of psychology at Saint Mary’s College Notre Dame, and coauthor of Rewire Your Anxious Brain Overcoming Unwanted Intrusive Thoughts A CBT-BASED GUIDE to GETTING OVER FRIGHTENING, OBSESSIVE, or DISTURBING THOUGHTS SALLY M. WINSTON, PSYD MARTIN N. SEIF, PHD New Harbinger Publications, Inc. Publisher’s Note This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the pub- lisher is not engaged in rendering psychological, financial, legal, or other professional services. If expert assistance or counseling is needed, the services of a competent professional should be sought. Distributed in Canada by Raincoast Books Copyright © 2017 by Sally Winston and Martin N. Seif New Harbinger Publications, Inc. 5674 Shattuck Avenue Oakland, CA 94609 www.newharbinger.com Cover design by Amy Shoup Acquired by Jess O’Brien Edited by Gretel Hakanson All Rights Reserved Library of Congress Cataloging-in-Publication Data on file To Mort, Carla, Maggie, and Molly — S. W. To Samantha, Laura, Sam, Clare, Ruta, and Adam — M. S. Contents Introduction 1 1 Recovering from Unwanted Intrusive Thoughts 7 2 Varieties of Intrusive Thoughts 25 3 What Thoughts Mean: Myths and Facts 49 4 Unwanted Intrusive Thoughts Q and A 63 5 How the Brain Creates Unwanted Intrusive Thoughts 75 6 Why Nothing Has Worked 91 7 How to Handle Thoughts When They Happen 113 8 Getting Over Unwanted Thoughts for Good 137 9 What Does Recovery Mean? 155 10 When to Seek Professional Help 163 Acknowledgments 169 Appendix: A Recipe for Unwanted Intrusive Thoughts (What Not to Do) 171 Bibliography 179