Symptoms of intrusion are one of the markers of posttraumatic stress, as well as other mental health struggles such as anxiety, depression and Obsessive-Compulsive Disorder. According to the National Alliance of Mental Illness (NAMI), “Intrusive thoughts are unwanted thoughts that can pop up in our minds unannounced, at any time. Their repeated occurrence can make it hard to focus on daily tasks and sustain healthy relationships.” These types of thoughts can be quite distressing, since they hinder our ability to function normally.
We know that God desires to come toward us in our distress and offer kindness, care and wisdom. He calls us to cast our anxieties upon Him (1 Peter 5:7) and take our thoughts captive in order to make them obedient to Christ (2 Corinthians 10:5). So how do we help those who are suffering from intrusive thoughts regain stability and think clearly about how these thoughts affect their lives? When I’m working with clients, I often do an exercise with them that seems to help us slow down and consider what intrusive thoughts and feelings are telling us. I’ll give this example:
I’m driving on the highway, and an eighteen-wheeler comes up beside me driving very fast. I am in the left lane with no shoulder to my left. Suddenly my body tenses up and my thoughts begin to race. I don’t even know quite what I’m thinking – I just grip the wheel and wait for him to pass me. It takes me an hour or more to settle my thoughts and emotions down. This happens to me every time I get in this situation while driving, and it makes me want to stay off the highway.
With my client, I talk through the elements of what I was experiencing, and we write them down.
- What happened? An eighteen-wheeler drove up beside me going very fast.
- What was I thinking? He is not paying attention. He is going too fast. I don’t have a way to exit. I am helpless.
- What was I feeling? Terror, frustration, despair, anxiety
- What did I notice in my body? My shoulders became tense, I gripped the steering wheel, my heart sped up, and my spine straightened.
- What did I think would happen as a result? I will get run off the road. I will die. My loved ones will drive up on the scene and be mortified.
- What helped me regain stability? I took deep breaths after I got to work. I distracted myself with tasks. I complained to my co-worker about the stupidity of other drivers. I prayed for peace.
Once I give my client this example, we try doing this same exercise using one of her moments of intrusion. It helps to write her answers down during the session and give them to her when she leaves. Practicing together gives her confidence to complete the exercise again on her own. I advise her to complete the exercise at least once before our next session, giving her this instruction:
Obviously it’s really difficult to think about answers to these questions while the intrusive thoughts are happening. But you can set aside time when you’re more relaxed to sit down and answer each question. Perhaps you can pray about the experience and bring the struggle before God, knowing that He cares for you when you are struggling. Then we can talk about it in our next session.
When we come together again, she will share the answers to the exercise that she did at home. I ask her if she notices any patterns between the exercise we did in the session and the one she did on her own. When we notice commonalities, we can talk about what’s behind her answers and perhaps even discover where the thoughts, emotions and predictions originate. Gaining awareness of these things allows her to ‘talk back’ to her intrusive thoughts and create strategies to be empowered in moments of distress, rather than just distracting herself or avoiding the situation that caused the intrusion. It also gives us a sense of how to pray for God’s strength and wisdom to abide in Him and take refuge in His steadfast love.
We can also talk about whether this intrusion is connected to a previous situation that was distressing. In my example of the eighteen-wheeler, my counselor could ask me whether I’ve encountered a situation in which I was actually helpless and threatened with death. It could be a situation with driving a car, or it could be a different situation entirely. My mind may be associating the helplessness of driving next to a much larger vehicle with feelings of terror and dread that occurred in a traumatizing situation. This is not always the case, but we would be wise to ask good questions so that we can pay attention to any past wounds that need healing.
I have created a worksheet for the Intrusive Thoughts Exercise available to all CTHN members.
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