Cocaine and methamphetamine-induced paranoia

By David Joel Miller.

Stimulant-induced paranoia isn’t exactly a diagnosis.

Fearfulness

Paranoia.
Photo courtesy of Pixabay.com

Paranoia is common among drug users. It’s especially common among stimulant users. When crack cocaine users first began to show up in hospital emergency rooms, there was a lot of confusion between drug-induced psychosis and the onset of schizophrenia and other psychotic disorders. For a while, it looked like there was an epidemic of new cases of schizophrenia. Then picture emerged, something was very different about these new cases of psychosis.

The key features of psychotic disorder, schizophrenia, and some other related disorders are delusions, hallucinations, disorganized thought and speech, and grossly disorganized or abnormal motor behaviors. Some loss of normal functioning called “negative symptoms” is also part of psychosis. People with drug-induced psychosis don’t show those same levels of “negative symptoms.”

What most of us think of as paranoia fits generally under a couple of types of delusions, persecutory delusions, and referential delusions. These are the beliefs that people are out to get them and that what others are saying and doing is directed at them. Researchers have discovered that symptoms of paranoid can fall on a continuum from some mild suspiciousness and trust issues to potentially dangerous psychotic paranoia.

Psychosis and presumably paranoia can occur at multiple points in the drug using experience. For any drug of abuse, we expect to see one set of symptoms while the user is under the influence and another set of symptoms during withdrawal. Some conditions will persist, sometimes for years, even after the drugs have left the users system. These conditions are called drug-induced. It’s also possible that a drug user had a particular mental illness before they began using or had a risk factor for an illness and the drug use was enough of a stressor to result in the appearance of that illness.

I should also mention here all these descriptions are based on the idea that mental illnesses are categories. That’s the way the diagnostic manual is designed. You either have the illness, or you don’t. Increasingly research has been suggesting that most of the things we are calling symptoms are on a continuum. You can have more or less of a symptom such as paranoia. This implies that counseling and the ways people think can result in changes in symptoms of something like paranoia, regardless of whether the person with paranoia has a diagnosable mental illness or not.

Paranoia among cocaine users.

Cocaine-induced paranoia is primarily reported during cocaine intoxication. It involves extreme hypervigilance for possible danger in the environment. Up to 70 percent of cocaine users exhibit temporary paranoia even after ruling out mental health diagnosis which would include paranoia. Cocaine users on average report developing paranoid symptoms after about three years of using cocaine. The quantity that was used or the patterns of use do not seem to affect the onset of paranoia (Rosse, et al., 1994.)

Methamphetamine-induced paranoia.

Studies of paranoia among methamphetamine users are generally newer than the ones involving cocaine. One noteworthy difference was that methamphetamine users who became paranoid were more likely to get a weapon and to attack someone. Meth users had typically been awake for 48 hours or more when the paranoia began. The majority experienced auditory and visual hallucinations. Almost 40 percent of the methamphetamine users also reported tactile hallucinations. These results not only overwhelmingly reported paranoia but fit more closely with the diagnosis of psychosis in the studies I found of psychosis in cocaine users (Leamon, M., et al., 2010.)

Other drugs probably cause paranoia also.

Most of the early research on stimulant psychosis was done using patients who had been addicted to crack cocaine. In the years since that research, it has become clear that other stimulants, methamphetamine and the so-called “bath salts,” also produce psychotic episodes and an increase in paranoia. Studies of paranoia among cocaine users were largely done in psychiatric settings while the studies of methamphetamine and paranoia were mainly done in outpatient drug treatment which leads me to believe that paranoia is probably much more common and more likely to lead to violence among those who develop severe methamphetamine use disorders.

Paranoia and hallucinations occur among users of dextromethorphan.

Since most drug users use multiple drugs as well as drink alcohol and many also have mental health issues, it’s hard to be sure about causes. One thing does seem certain almost all drugs of abuse and excess alcohol use result in an increased risk that you will develop some level of paranoia.

For more on this topic see:

Trust

Paranoia

Dextromethorphan and paranoia.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

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Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

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Coping with life’s regrets.

By David Joel Miller.

Don’t let regrets about the past ruin the present and future.

Regrets.

Regret.
Photo courtesy of Pixabay.com

Do you have regrets? Maybe they are small ones; you wish you bought the other color or model. Maybe your regrets are big ones, actions that caused you or others pain, things you wish you could go back and change. But you can’t change the past. Almost everyone has regrets, some small, some large, a few even gigantic. So, what to do with those regrets? How do you get past the pains of your past?

Fix the things you can.

You can repair some things. You said or did something that damaged a relationship. Sometimes you can apologize, say you’re sorry. If you owe somebody money you can pay it. Sometimes an apology is not enough. Maybe you need to do something to make it right, to make your amends to the person you have injured.

Undo yes and no decisions.

You can undo some decisions. You said yes to a job or attending a party and now you wish you hadn’t said yes. You’re entitled to change your mind. Call that person, send them an email. Maybe you said no to something or someone, and now you wish you had said yes. Check it out; sometimes it’s possible to change your mind.

Pick a new alternative from life’s menu.

Sometimes changing your decision is no longer a possibility. For example, you wanted to attend a concert but didn’t buy the tickets in time. Look for other options. Maybe the person or group you wanted to hear is performing somewhere else nearby. Maybe there’s some other event you would enjoy instead. Don’t stay stuck in regret over the relationship that didn’t work out, maybe it’s time to meet someone new.

Only take responsibility for your part of the problem.

A lot of life’s regrets are about relationships. Maybe it was an argument with a family member or friend, that conflict cost you a relationship. Take responsibility for your part of the conflict. You can’t take responsibility for what the other person did or said. If you can fix it do so, but not at the cost of ignoring the other person’s part in the problem.

Reevaluate the alternatives. You may have picked the best alternative you had.

Sometimes you must pick between two bad choices. Don’t be so hard on yourself. You may have made the best choice you could under the circumstances. Be careful of hindsight. If you would have had the information you have now back then, you might have made a different decision. But you didn’t have that information, and you had to choose. Don’t spend the rest of your life stuck in regret.

Learn from your mistakes.

Don’t be one of those people with tons of regret who keeps doing the same things over and over. Stop piling up new regrets by learning from your mistakes and making improved decisions in the present.

Practice extreme acceptance.

Staying stuck in regrets can use up a lot of energy. Practice accepting that what happened is in the past. Avoid ruminating and allowing your mind to enlarge the pain. Shift your focus from regrets about the past to opportunities for better future.

Stop looking over your shoulder at the past.

The past is gone. Don’t keep looking back at the things that can’t be altered. When the thought of that regret comes up, practice shifting your focus to the future. As long as your alive there will be more events ahead on the road of life. Look forward to making your future the best it can be. If you only look for the bad in life, you will find it. It’s quite possible that all around you are opportunities for happiness here in the present and in the future.

Do some psychological repair.

Make healing from life’s regrets a priority. Sometimes you will have a close friend with whom you can talk it through. You may need to be careful about who you tell what. Telling family or friends about things you regret may damage your relationship. If you are not sure how someone will react to hearing about your regrets, that person may not be the one to talk with. Once you tell that secret, it can’t be untold. Some people find it useful to journal, write out how they feel in a document meant for only them to see.

If you’re having trouble processing and dealing with regrets, you may need to seek professional counseling help. Don’t stay stuck in a life dominated by regrets. Use some of these approaches to change what you can, and accept what you cannot change.

You find more about this topic under Regret.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Preventing life’s regrets.

By David Joel Miller.

How can you prevent accumulating painful regrets?

Regrets.

Regret.
Photo courtesy of Pixabay.com

Are there any ways you can anticipate things you might regret and live your life in ways that would prevent having to recover from regrets?”

Here are some of the ways you can prevent a life filled with regrets and some thoughts about what to do when you discover your regrets.

Consider potential regrets before acting.

Most of the things people regret fall into one of 2 categories, things they did they wish they hadn’t and things that didn’t do they wish they had. Before taking any major action, ask yourself, will I regret this? If the answer is yes I will regret it, this course of action bears some more thought. A lot of the things people regret were those impulsive “spur of the moment” decisions. Often these are the result of jumping to conclusions or acting on impulse without considering the consequences.

Can this decision be undone?

Some decisions can easily be undone. You sign up for class and wish you hadn’t; you can drop that class if you do so quickly. Make a date with someone and get cold feet, you can cancel that date. For some things undoing that action may have a cost. But it’s often wiser to cancel that purchase and pay the fee, than to be stuck making payments on a car or house you don’t want, for years to come.

One of the major areas which can’t be undone is relationships. Once you’ve slept with someone, it is harder to break up. You can break up with a boyfriend or girlfriend, but your baby’s mother or father is forever. Once you’re married, with or without children, ending that marriage comes with both emotional and financial costs.

Delay your decision until you have more information.

Many of the decisions people regret having made were a result of not giving yourself enough time to think it over. In some places, buyers have a time period to void the sale of a major purchase. I don’t recommend you count on this. I think it’s a good idea to give buyers of expensive items time to check their purchase out and rescind the transaction is there something wrong with the item they bought. But don’t expect to return something just because you changed your mind. Once you have used something you can’t return it in the same new condition it was in when you bought it. There are lots of other actions in life, especially when it comes to relationships with other people, where you don’t have to act the moment the idea enters your head.

Think carefully about possible outcomes.

Regret often comes from the human tendency to think all your ideas are great ones when you first think them. Where possible, before you act on your inclinations, ask yourself what are the possible outcomes? Are any potential negative outcomes so severe that you’re not willing to take the chance? Regardless of how good or how exciting this possible action is if there’s a large chance it could result in a death or ruin the rest of your life you must be realistic in evaluating the risks. Be careful of the natural human fallacy to believe that you’re lucky or smart and that only the good outcomes will happen to you.

Don’t waste time on the impossible. What alternatives are available to you?

Don’t make the mistake of choosing between an action and an impossibility. Sometimes you will be forced to pick the best of 2 bad options. Sometimes you’ll hesitate because your preferred choice turns out to be an impossibility. If you are choosing between 2 very likely, very good options, use some of the other decision-making rules coming up. But, if you don’t feel comfortable with any choice, make sure you have ruled out all the impossible choices.

Consider how you feel about possible outcomes.

Many people make the mistake of trying to be totally logical and rational about the choices. Choose with your head, and you will feel the regret in your heart. While your feelings shouldn’t rule you all the time, feelings do provide valuable information. If in your heart, this doesn’t feel right, you probably should not do it.

Search for other alternatives.

Before you decide something, ask yourself are there any other possible choices? A significant source of regrets are times people chose between 2 options, say picking A instead of B, neither of which were that good a choice. Where they went wrong was failing to think about some of the other letters of the alphabet that might have been better choices.

What would a good decision maker do in this situation?

When faced with a difficult decision think about the people you know. Who that you are aware of appears to be exceptionally good at making decisions? What would that person choose?

How does this decision relate to your life goals and values?

Don’t get distracted by things the promise short-term pleasure and excitement, the next bright shiny thing. You will make better decisions when you pause to think about what are your personal values?

Once you decide against an alternative stop looking for evidence to support it.

Seems to be a part of human nature to doubt yourself. There is a problem with the way the human brain works. It’s called confirmatory bias. If we want to do something all we are likely to see re other reasons in favor of it. Unfortunately, people who decided against an alternative keep going back to that thing they decided against and looking for other reasons to go ahead and do it anyway. Once you have decided no, it is probably best to stay with that decision. On the other side of the coin if you decided to do something and suddenly get some new information that makes that decision look like one you’ll regret, don’t disregard that new information.

Use an outside expert’s advice and feedback.

Sometimes we get hung up on our own thinking. Because we think something, it must be true. When the decision has huge consequences, costs a lot of money, or might get you stuck in a situation that would be hard to get out of, it pays to seek advice from an expert. If that expert is a counselor they probably won’t, and shouldn’t, tell you what to do. What they can do is help you sort out your conflicted feelings and provide you information about what has happened to other clients faced with this decision. Sometimes it helps just to know you’re not the only one who has had trouble making this decision.

Weigh the consequences of not deciding.

If it’s a tough decision, you need to ask yourself, what will it cost me to put the decision off? Not responding to a lawsuit or a bill may make the situation worse. Just because it’s the “best price of the year” doesn’t mean you should decide to make that purchase today. It is quite possible that the difference between today’s “best price of the year” and next week’s “sale price” won’t be all that different. Don’t convince yourself that if you don’t get into a relationship with the person you’re out with now, you will never have another chance and you’ll be alone the rest of your life. If you have doubts about relationships, it may save you a lot of pain to wait until you are sure.

For many people, life’s greatest regrets are the things they wanted to do but never did. Don’t live your life putting off getting the education you want. Reach for your dreams. Try out for that acting job. Write your book. Have you let fear keep you from deciding to do things that are especially important to you?

Talk your decision through with an empathetic person.

Besides professionals, most of us have close friends and family we can talk to about the decisions we are struggling with. Ask yourself who among them are empathetic and can understand the struggle you’re going through to make this decision. It can help to talk it out with an understanding person. Pick that person carefully. You don’t need somebody telling you what to do or putting you down for what you’re thinking.

Expect to have regrets; they are an unavoidable part of life.

Nobody gets through life without having some things that they regret. Accept that you must live life and you will never have all the information before the decision that you will have afterward. Everybody must make some decisions, and they will regret some of those. Expect those crystal balls to be cloudy and hard to see into.

If you have regrets, make repair efforts a priority.

As you move through life, you will accumulate some regrets. Where possible, try to make repairs. Forgive yourself for your mistakes. If you have regrets because you have harmed others, do your best to make your amends and make things right with them.

Learn from your mistakes, improve decision-making skills.

Make conscious decisions. Consider each decision you make in life another learning opportunity. Learn from your mistakes. Watch how others around you live and learn from their mistakes. Become aware of how you make your decisions and make them consciously. Most importantly learn from those things that you regret and try to stop making the same mistakes repeatedly.

Some additional posts about regrets:

Top 6 life regrets

Will you regret doing that?

Top regrets after the breakup.

Regret. 

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

How do you stop unwanted thoughts?

By David Joel Miller.

How do you get rid of painful, unhelpful thoughts?

Thought Stopping.

Thought Stopping.
Photo courtesy of Pixabay.com

Changing unhelpful thoughts is an important part of the process of recovery. These techniques are commonly used in cognitive behavioral therapy, a proven, effective, treatment for emotional problems. Thought stopping is one of the common ways of attempting to prevent the impact of recurring negative, unhelpful thoughts. In a previous post, I wrote about what thought stopping is, when you might want to use it and some of the problems you might encounter. Now let’s look at some specific, related methods you might use to stop those unwanted, unhelpful thoughts. Different theoretical orientations and the various mental health specialties may use different names for these techniques, but the ideas are essentially the same.

Distracting yourself from negative thinking.

As a short-term solution, thought distracting, can interrupt the train of unhelpful thoughts (Wegner et al., 1987). Be careful to not to look all around your environment at a lot of things which might later become cues for the unwanted thought. Use a transitional object that has helpful, positive associations. Religious symbols, a piece of jewelry that brings back positive memories, inspirational quotes can all be helpful in interrupting the current negative thought.

Thought substitution – think about something else.

Shifting your thinking to something more helpful has been shown to result in forgetting the thought you were trying to stop. One approach to grief work is to shift your thinking from the pain of the loss to the happy memories that you have of the person who is no longer in your life.

When dieting, rather than trying to not think about food, try to think about the improved health towards which you are working. Think about how much money you’re saving by not buying cigarettes, not about your efforts to stop smoking.

Think about a hobby or project you want to work on. When you’re busy thinking about redecorating a room or fixing your car, there’s less mental space to ruminate about unhelpful thoughts. If you’ve ever experienced flow, you have been so engrossed in an activity that you lost track of time; you may have noticed that thoughts of problems, addictions, and worries disappeared.

Moving towards positive, helpful thoughts is much more effective than trying to sit and not think unhelpful thoughts.

Use stress reduction behaviors.

Mindfulness and meditation can be helpful in reducing the tension you would feel while wrestling with unhelpful thoughts. Physical exercise can also be helpful. The human brain doesn’t like to do the slow, tiring work involved in deep thinking. As you begin to walk faster, your brain is more likely to drop the unhelpful thoughts to stay focused on your exercise routine.

Make friends with your feelings.

Efforts to avoid negative feelings by suppressing them don’t work. Neither do efforts to solve your emotional pains by focusing on them, ruminating over them, constantly asking yourself why. Trying to avoid sadness by not feeling can render you numb and unable to feel happiness.

Come to recognize that feelings you don’t like are likely to come and go, but they do provide you information. Feeling lonely can motivate you to seek out other human companionship. Learn to surf the waves of emotion in your mind rather than insisting that you shouldn’t be feeling what you’re feeling.

This approach is sometimes called monitoring your thoughts and feelings. You simply note that the thought has come, and then you watch it go. Not wrestling with your feelings allows you to escape their grasp.

Cognitive restructuring can help you change unhelpful thoughts.

Cognitive restructuring often begins with keeping a thought record or journal. The goal is to learn to recognize your own mental processes. Not every thought you have requires an action. Just because you think it, doesn’t make it so. Rather than getting carried away by unhelpful thoughts, learn to evaluate your thinking. Practice increasing your helpful thoughts and becoming more optimistic.

Practice reframing your thoughts by setting positive goals you wish to approach rather than giving unhelpful thoughts more prominence by focusing on the things to be avoided.

Disputing unhelpful thoughts.

Many negative, unhelpful thoughts are based on faulty assumptions. You walk into the room, and people start laughing, it’s easy to think they’re laughing at you. Learn to argue with these unhelpful thoughts. Maybe someone just told a joke, maybe they’re all having a good time.

Remember, you don’t have to believe everything you think. If you have a magic, magnifying mind probably you have had many experiences of thinking that other people’s behavior has something to do with you. If they look at you, did you think they were judging you? Check these thoughts out with someone you can trust. There’s a good chance they looked at you because you were there.

Evaluating the evidence for the thoughts you have.

People who are depressed or high in anxiety, frequently have a lot of negative, unhelpful thoughts. You get a bad grade on the test, and you may have told yourself you’re stupid or a failure. If you look carefully at the evidence, you may find that your scores on tests are about the same as other students in your class, possibly even better. Getting a “B” on the test is not the same thing as failing.

Think you’re extremely fat? Sit for a while outside the shopping mall, preferably with a reliable friend, and keep track of how many people entering the mall appear to weigh more than you do. If you tell yourself the truth, you may find out you’re about average. Certainly, you may have room for improvement, but calling yourself names and judging yourself is unhelpful. If you want to motivate yourself to exercise and get into shape, you will do it more effectively by praising yourself for the efforts you make to eat healthily and increase your exercise.

Train your brain to stop thinking those thoughts.

You can use conditioning techniques to train your brain to avoid unhelpful thoughts in the same way you might train a child not to do something dangerous. When the unhelpful thought enters your mind, yell “STOP” either verbally or mentally. Pair thoughts of smoking with pictures you have seen of seriously ill people.

For some conditions, professionals recommend keeping a rubber band around your wrist and snapping it to remind you not to think that thought. This kind of conditioning probably works better for helping you not do things that may seem enjoyable in the moment but have long-term negative consequences.

In using conditioning techniques be careful to avoid behaviors that might be harmful or addicting such as cutting or other nonsuicidal self-injury.

For the alcoholic, when the automatic thought “I need a drink” occurs they can automatically tell themselves “no I don’t, I’m in recovery and can handle this situation without a drink.”

Coupling these self-conditioning methods with some of the other techniques above can train your brain to automatically shift from an unhelpful thought to a positive, helpful thought.

Which of these thought-changing methods do you think would help you?

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Does thought stopping work?

By David Joel Miller.

What is thought stopping and does it work?

Thought Stopping.

Thought Stopping.
Photo courtesy of Pixabay.com

Thought stopping is a common cognitive behavioral therapy technique. Some people, clients, and counselors alike report that thought stopping can be very helpful for reducing or avoiding rumination, catastrophizing, and other unwanted thoughts. Learning to stop unwanted thoughts can be helpful for reducing depression, anxiety and recurrent thoughts of substance use. Others have reported that thought stopping was unhelpful and did not work. Why does thought stopping work for some people and not others?

Not thinking about something does not work.

There’s a big difference between trying not to think about something and getting your mind to stop going over and over the thought once you have it. The human brain doesn’t work well at preventing thoughts. Setting up a list of things to “not think about” does not prevent those thoughts from reentering your mind. That no-think list will keep your mind occupied looking for the very thoughts are trying to avoid.

If you have had a history of negative thoughts, negative self-talk, or the kind of recurrent negative thinking that damages your self-esteem, you will find the thoughts recur whether you want them to or not. People in drug and alcohol recovery find that their default thought, no matter what happens, is likely to be I need or want a drink. Maybe I could do a little drug just this one time.

In a past post, I wrote about “don’t think about elephants.” What people find is that the effort to “not think about” anything keeps that thought right at the edge of consciousness waiting for its chance to pop back into your current thinking. If you’re not sure about this, sit for a while and don’t think about something. You will find that every time you tell yourself to not think about it, the thought miraculously enters your mind.

Researchers have used both “white bears” and “red Volkswagen’s” in various combinations to study the effects of thought stopping. The studies are enlightening, but make it hard to set firm rules for when and how to use thought stopping. If you’re someone who has recurrent, unwanted thoughts, you need to practice and probably work with a professional to become proficient in using thought stopping to make your life more manageable. There are some other techniques you can learn that are probably more effective than thought stopping.

Thought stopping is most effective when used briefly in crisis situations. Telling yourself not to reach for that drink or drug can help in the moment. When your mind tries to take into a dangerous neighborhood telling it to “knock that off” may keep you out of trouble for the moment, but it won’t last for very long if you don’t change some of the things.

Suppressing unwanted thoughts requires cognitive effort. When you put a lot of effort into something, you get tired. Humans are cognitive misers and customarily revert to patterns that don’t require a lot of effort. Letting your guard down against unwanted thoughts can happen quite quickly.

Your mood impacts the effort needed to suppress unwanted thoughts. When you are depressed, it is harder to stop negative, painful thoughts. Being in a happy, optimistic mood makes it easier to suppress negative thoughts.

You need to remember some things and forget others.

Forgetting important things can be very frustrating. It can be equally upsetting if you find you can’t forget the painful past. Unwanted and intrusive memories are characteristic of several mental illnesses. People who have been victims of trauma, those with PTSD especially, wish they could forget. There are a lot of materials available to help people improve memory, but far fewer to help people forget the painful, unhelpful memories. Change your thinking techniques are one of those few tools that may be helpful in preventing unhelpful thoughts from taking over your consciousness.

Researchers have found that remembering feelings from the past can influence how we feel in the present. The more you think about an unhappy memory, the more depressed or anxious you may become right now. So, if telling yourself not to think about your ex just brings the sadness you experienced during the breakup into your mind, how do you prevent spending all your time thinking about the things you wish had not happened. Thought changing methods may reduce the amount of time you spend caught in the downward spiral of unhelpful thinking.

Euphoric recall – thoughts that need to be stopped.

Some thoughts that seem positive at first glance turn out to be highly inaccurate and unhelpful. It’s common in addiction for people to suddenly experience thoughts of the good times they had when drinking or using. Remember that time you partied? What’s hard to remember is that you got into a fight at the party, took off in a hurry, maybe got arrested for driving under the influence. The same thing happens when dysfunctional relationships end. You tend to remember the good times in the beginning and not the bad events later.

What is thought stopping?

Thought stopping is the process of monitoring your thinking, detecting unhelpful or unwanted thoughts and getting your mind off that thought and back onto something more helpful. It’s important to take active steps to prevent unwanted, intrusive thoughts from taking over control of your mind.

One way of thinking about thought stopping is a process of transforming automatic unhelpful thoughts into cues to activate your thought stopping and thought transforming mental systems.

Thought stopping is a skill that needs to be learned and practiced.

“Recent research indicates that people control unwanted memories by stopping memory retrieval, using mechanisms similar to those used to stop reflexive motor responses” (Anderson, M., Levy, B., 2009.) The article goes on to say that the control of unwanted thoughts and memories happens in the lateral prefrontal cortex, the executive function of the brain. If your brain has an effective CEO, he can control the activity in the hippocampus, the part of the brain that regulates storage and retention of memories. Learning what to remember and what to forget is a skill you can develop.

As people grow and develop, they could become better at regulating which memories are prioritized for storage in which are slated for deletion. We would expect it to be harder for young people to forget the painful memories. Life events that alter your brain chemistry, trauma, depression, anxiety, or a substance use disorder appear to reduce your control over memory storage and retrieval. For example, people who are addicted to methamphetamine had “lower grey matter intensity in the brain region associated with performance” on both thought stopping and the ability to look at past events in another way, a skill called reappraisal or reframing (Tang, D., Schmeichel, B., 2014)

Thought stopping shouldn’t be the only tool in your self-help toolbox.

So, not thinking about things often does not work. You can use thought stopping to interrupt the flow of an unhelpful thought. Anyone who’s tried to do mindfulness or meditation knows that as soon as you empty the mind, a mob of thoughts tries to reoccupy that emptiness. The more you practice, the better you can get at keeping unwelcome thoughts out of your head. In the short run, you may need some mental protection from other skills.

Practice becoming more optimistic. Learned to fill your mind with positive thoughts that can guard the space against the return of unhelpful thoughts. Distracting techniques, filling your mind with other helpful thoughts, appears to make thought stopping more effective.

Are there times you shouldn’t use thought stopping?

Turns out that there are times when thought stopping is not helpful. People have experienced a loss in their life, the death of a loved one, may find that simply trying not to think about that death leaves unresolved grief which they may need to deal with later. While going on with life may work temporarily, eventually you need to come to terms with the loss and find a way to make meaning out of that experience.

If you have a problem that needs to be solved, not thinking about it is likely to interfere with solving the problem or dealing with the consequences. Thought stopping is not effective when eventually you will have to solve the problem.

People who were on a diet and tried to simply not think about eating are at increased risk to binge eat when the thoughts of food return (Sarah L. Gaskell et al., 2001.)

Thought stopping is a verbal technique which works best to correct unhelpful self-talk. Thought stopping is less effective when physical objects such as people, places, and things try to the unhelpful thoughts. For those objects, you need to avoid places where you’ll see them. It’s hard to avoid thinking about having another drink when you’re sitting in a bar.

Some additional cautions about thought stopping.

When trying to stop unwanted thoughts, people tend to look around the room. Be careful what you look at, the things you look at while trying to avoid thinking about something, get paired with the original unwanted thoughts. You look around the room and see a particular lamp or picture, the next time you look around the room those objects are likely to bring back the unwanted thoughts.

When doing thought stopping, look at something positive and reinforcing. If you wear a religious symbol, look at that. Twelve-step groups often have quotes from the recovery literature and helpful sayings on the walls so that people who are trying to avoid thinking about their issues find it easier to shift from unwanted thoughts to helpful thoughts.

If you do have recurrences of unhelpful thoughts, don’t beat yourself up and create those thoughts being triggers for negative self-talk. Dismiss the unwanted thoughts as quickly as possible and shift your attention to helpful thoughts.

My take on thought stopping?

I think of thought stopping like being in the swimming pool and trying to hold that water polo ball under the surface. The harder you try to hold it under the more it pops back. Eventually, you get too tired to keep holding it down. What you need to do with that ball of unwanted thoughts is toss it out of the pool of your life, or get out of the pool and moved to a better environment.

In an upcoming post, I want to walk you through some techniques that should be more effective at helping you get rid of those unhelpful thoughts on a long-term basis than simply trying to “not think about it.”

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Will you regret doing that?

By David Joel Miller.

Does anticipating regret increase protective actions and reduce risky behaviors?

Regret.

Regret.
Photo courtesy of Pixabay.com

Regrets happen when you find out, or imagine, that the results would’ve been better if you had made a different decision. What behaviors are you doing today that you may regret in the future? What positive, healthy, activities did you leave undone today that in the future you will wish you had done?

Thinking about the positive advantages of exercise and healthy diet doesn’t seem to be enough to get many people to engage in these activities. Thinking about the regrets you will have in the future provides additional motivation to do proactive healthy behaviors and to reduce risky behaviors. People who think about the regrets they will have the morning after casual sex are more likely to alter their behavioral plans.

Will you regret not protecting your health?

People who have thought about the need to maintain good health and could anticipate the regrets they will have in later life for not protecting their health are more likely to make the effort to eat a healthy diet.

We all know that getting more exercise would benefit our health. Being able to anticipate the regrets you will have about your appearance and your health in the future because of not exercising increases the chances that you will exercise today to avoid those painful regrets in the future. It takes a long time for regrets about not protecting your help to develop. People go through life not exercising or eating a healthy diet, telling themselves there’s always time to start healthy living tomorrow. The regrets take up a lot of your time when you’re older and out of time to have lived a healthy life.

There has been a lot of controversies recently about vaccination. Regardless of how you feel about getting your family members vaccinated, it’s important to think about the regrets you might have if you fail to get vaccinated. The larger regret is not that you might catch the flu, but that because you did not get vaccinated, you might transmit an infection to a baby, young child or older adult. Thinking about the possible regrets of infecting others might be just the motivation you need to get yourself vaccinated.

Will you regret not helping others?

When you’re busy with your life, you’re likely to forget about donating blood or designating yourself an organ donor. Thinking about possible regrets you might have because you didn’t donate blood and someone died may motivate you to make that donation.

Will you regret risky sexual behaviors?

Recent research tells us that the possibility of regretting unsafe sexual behaviors has strongly influenced some people’s sexual practices. Thinking beforehand about the possible regretted consequences of unprotected sex, both from contracting sexually transmitted diseases and unwanted pregnancies increase the chances someone will use protection or abstain.

Will you regret your use or abuse of nicotine, marijuana, alcohol, or other drugs?

Prevention efforts around alcohol consumption and drug use have been generally disappointing. Having people think about drinking or drug use is unlikely to reduce the risk they will consume substances. One promising prevention effort has been having people think about possible regrets. Are there things you might do while drunk or high that you would later regret? As you grow older, raise your children and live your life, will you regret having abused drugs or becoming addicted to them?

Knowing that tobacco consumption is hazardous to your health is almost universal. That hasn’t been enough to keep most young people from trying cigarettes or other products containing nicotine. One promising approach has been asking people early in the nicotine using experience about possible, anticipated regrets. Thinking about health risks off in the future is not much of a deterrent. Thinking about the anticipated regrets from having contracted emphysema, heart disease, or cancer offers a different perspective.

Thinking about anticipated regrets from binge drinking has been shown to reduce the rates of intending to binge drink (Cooke, Sniehotta, & Schuz, 2007). There has been limited recent research on whether anticipated regrets related to substance use changes behavior. What little research there has been, shows that anticipating future regrets increases the intent to avoid or stop using substances.

Will you regret not keeping yourself safe?

In the spur of the moment, it’s easy to ignore the risks from taking a phone call or answering a text while driving. Take a moment to think how you will feel if your distraction results in an accident and someone loses their life.

When we don’t think about risks, they don’t alter our behavior. Considering possible risks in life and anticipating the regrets you will have from engaging in risky behaviors and neglecting to engage in healthy ones may help you put the way you are living your life in perspective.

Why doesn’t anticipating regrets change behaviors?

People who drive dangerously, speed or weave in and out of lanes, report they would have severe regrets if that behavior resulted in an accident. Unfortunately, in the moment, the urge to get somewhere more rapidly and the excitement of the speed, outweigh the anticipated regrets of a potential accident. Excitement and pleasure also offset the anticipated regrets from alcohol and drug use.

Any behaviors whose consequences will happen far in the future, such as poor health behaviors, tend to remain unchanged because people tell themselves that they will begin living in a healthy manner in the future.

Potential regrets from risky sexual practices respond poorly to potential regrets when people tell themselves that it will not happen to them, but sex will be less enjoyable when they use protection or that stopping for protection will ruin the spontaneity.

Stop and ask yourself what things you are doing today you regret in the future. Consider the things you’re not doing now which will be major sources of regret as you get older. The more aware you become of anticipatory regrets more likely you will be to change your current behavior.

The things you may be regretting now may be very different from the things you will regret in the future. You might want to look at the things that older people say with their biggest regrets in life which were described in the post – Top 6 life regrets.

You find more about this topic under Regret.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Is catastrophizing ruining your life?

By David Joel Miller.

What is catastrophizing?

Catastrophizing

Catastrophizing.
Photo courtesy of Pixabay.com

Catastrophizing is a way of looking at life, always searching for the “worst case” possibilities. In recovery circles, this can be described as having a “magical magnify mind.” There are times when considering the worst possible alternative can protect you from bad life outcomes, other times it can make you miserable. Adopting catastrophizing as your default way of thinking has been tied to pessimism and many mental illnesses.

Wikipedia defines catastrophizing as “Giving greater weight to the worst possible outcome, however unlikely, or experiencing a situation as unbearable or impossible when it is just uncomfortable.”

Catastrophizing and mental health.

Ellis (1962) created the term ‘‘catastrophizing’’ to describe a tendency to magnify a perceived threat and overestimate the seriousness of its potential consequences.

Beck in his work on cognitive behavioral therapy created a list of “cognitive distortions,” which are factors in creating and maintaining some mental illnesses. Recently cognitive therapists, have begun referring to these thinking patterns as “unhelpful thoughts.”

One of these unhelpful thoughts is magnification, a cognitive process in which people who are depressed create exaggerated beliefs which bias their thinking in a negative direction (Beck 1963, 1964.)

When you don’t know what causes bad events, the consequences are magnified. Catastrophizing is an unhelpful way some people use to try to find the causes of bad events in their life and to try to prevent future unpleasant consequences.

Other definitions of catastrophizing.

Catastrophizing involves focusing on the difficulty and negative aspects of a stressor. Catastrophizing is envisaging the worst results of a negative event.

Catastrophizing is an automatic “what if” questioning style, causing an individual to iterate about a particular problem and perceive possible outcomes as threatening (Kendall & Ingram, 1987; Vasey & Borkovec, 1992).

Mental illnesses are connected to catastrophizing.

Many of the things we call mental illnesses lie on a continuum from mild to severe. It’s quite common for people with one mental illness to also show symptoms of other mental illnesses. How a specific mental illness will affect you is also the result of the interaction between that illness and you. Your life experiences, your genetics, your personality, and how you go about thinking about the world, all play roles in your risk for having a particular mental illness and your path towards recovery from that illness. Below is a brief review of some the research about the connections between catastrophizing and mental illnesses.

Chronic pain is made worse by Catastrophizing.

Many studies have found a connection between catastrophizing and disability from chronic pain. Catastrophic thinking in the pain field was defined as ‘‘an exaggerated negative orientation toward pain stimuli and pain experience’’ (Spevak and Buckenmaier 2011.) Focusing on your pain seems to magnify it. Catastrophizing about your pain, imagining all the possible connections between your pain and serious illness, increases the pain’s impact on your life

Stanford Pain Management Center conducted a pilot program which involved a 2-hour class on pain and pain catastrophizing. The class significantly reduced patients catastrophizing about pain. I have to wonder if more information about mental and physical issues wouldn’t reduce people’s worry and result in significantly less catastrophizing.

The connection between chronic pain and catastrophizing is especially strong in the research on fibromyalgia. “Several factors of pain appraisal contribute to the pain experience. The most outstanding ones are pain catastrophizing, fear of pain, and vigilance to pain. In FM patients, pain catastrophizing has been associated with pain intensity and impairment” (Mart´ınez, S´anchez, Mir´o, Medina, & Lami,2011.)

“Among the most widely researched psychological factors in recent years, pain catastrophizing has shown consistent and robust associations with acute and chronic clinical pain as well as experimental pain responses” (Fillingim.)

Panic disorder is fueled by catastrophizing.

“People with panic disorder misinterpret their physical symptoms as catastrophic and indicative of imminent danger, leading to panic attacks” (Ottaviani and Beck 1987.)

Phobias may be created and maintained by catastrophizing.

The pattern of jumping to the most negative consequences, catastrophizing, is common in social phobia, agoraphobia, and specific phobia. In social phobia, people expect to be judged negatively and are on the alert for clues of rejection. This can result in being socially awkward and creating the social rejection they fear. Agoraphobia, the fear of the marketplace, or the fear of being out in public, is characterized by a fear that something bad will happen and the person will not be able to escape or get help. Specific phobias frequently involve overestimating the chances the thing that scares you will be present or will harm you.

Somatic Symptoms and Related Disorders are connected to catastrophizing.

In the past, this was often called Health Anxiety Disorder. Recently this was reorganized and is now considered a group of disorders. Somatic Symptoms Disorder (300.82) involves a focus on one or two symptoms which the patient comes to believe indicate they have a serious undiagnosed medical illness. Illness Anxiety Disorder (300.7) is a constant preoccupation and worry that you will contract a serious illness. Catastrophic thinking plays a role both in creating and in maintaining all the health-related anxiety disorders. This group of disorders frequently involves intrusive, distressing images of being sick or dying.

Obsessive Compulsive Disorder involves catastrophizing.

OCD has two main components, intrusive thoughts, and the need to perform rituals to prevent those imagined consequences. These intrusive thoughts are primarily catastrophic in nature. When you continue to imagine worst-case, dire consequences which can only be prevented by your performing some ritual, it becomes hard to resist the impulses.

Posttraumatic Stress Disorder is connected to catastrophic thinking.

Catastrophic thinking appears to contribute to the creation and worsening of all the trauma and stressor-related disorders. Having experienced a traumatic event, you are more likely to imagine similar events occurring again. Constantly checking your environment for potential danger and then catastrophizing about what you see appears to contribute to the maintenance of PTSD.

Not everyone who experiences a traumatic event develops PTSD. People who habitually practice catastrophic thinking are at increased risk of developing PTSD should they experience a trauma (Bryant, Guthrie, 2005.)

Some studies have reported a connection between catastrophizing and fatigue.

Catastrophizing is often observed in anxiety.

“Chronic worry is known to be a feature associated with most of the anxiety disorders and most specifically with generalized anxiety disorder (GAD)” (Brown, Antony, &Barlow,1992).

According to the most recent diagnostic categorization, the cardinal diagnostic feature of GAD is “excessive anxiety and worry (apprehensive expectation) … which the individual finds difficult to control” (APA, 2000, p. 476).

Catastrophizing creates Hopelessness Depression.

Hopeless depression is not a specific diagnosis. Counselors see a great many people who have lost hope. Hopelessness and a sense that the future will never be any better are common symptoms reported by people suffering from depression. Even before it reaches the level of clinical depression, a lack of hope and catastrophizing greatly increase the risk that today’s problems will become tomorrow’s depression.

“Catastrophizing (consistently inferring catastrophic consequences resulting from a negative event), has been posited as a specific risk factor for depression” (Abramson et al. 1989).

Paranoia and catastrophizing.

The emotional regulation strategies “blaming others and catastrophizing were positively correlated with paranoia and anxiety” (Westermann, et al., 2013.)

“Worry is a significant concern for patients with paranoia. Worry in paranoia is likely to be caused by similar mechanisms as worry in emotional disorders. The results support the recent trial findings that standard techniques for treating worry in anxiety, suitably modified, are applicable for patients with paranoia” (Startup, et al., 2016.)

Poor sleep is caused by Catastrophizing.

Many research studies have shown direct connections between rumination, catastrophizing, and impaired sleep. Here are a couple of quotes from the research literature.

“Poor sleep quality, including difficulties falling asleep and waking during the night, commonly occur in early adolescence” (Carskadon, 2010).

“Up to 40% of adolescents experience some form of sleep difficulties at some point during adolescence” (Meltzer & Mindell, 2006)

Rumination magnifies your problems.

If your thinking style involves catastrophizing, looking for the worst-case scenarios, try to limit the time you spend considering alternatives. Unfortunately, people who catastrophize also tend to ruminate, going over and over the same material finding ever-increasing awful consequences. If catastrophize and ruminating are destroying your mental health, consider professional help before the problems of daily living become a serious mental illness.

More information about this topic and related subjects is found under Psychology

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.