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Posted by DeadMan on October 06, 2010 at 20:42:37:
This is a post I wrote for Sleepnet's Insomnia Forum. You don't need to be an insomniac to have problems with thoughts.
Recurring Thoughts Part 2 -unedited
I've been losing sleep working on ideas for this post, "How to control your thoughts". It was due to feeling anxious after setting a deadline for something I really didn't have total control of. Rule number one, never give a deadline that you are not 100% certain you can make.
Many will find this post a little confusing. You are not alone. Every time I read it, I get confused and make changes. I could spend days and not be totally satisfied. One of the problems is trying to explain something that is complex using the limits of the English language. We all have different experiences with words which effect their meaning so try not to focus on the words, look for the gist of what I'm saying.
My first comment is related to the focus of many postings lately. The argument over medication, advising people to stop what they are taking, etc.. There are so many causes of insomnia that the odds of someone telling you the right thing to do is about 50 to 1.
Here is a partial list of causes, by category, of insomnia in no particular order
1. Physical - (internal problems during sleep) - breathing, pain, plms, cricadian.......
2. Environmental (external) - room temp, bed surface, snoring partner, lighting........
3. Cognitive (mental) - anxiety, stress, what if, wrong attitude..............
4. Psychiatric - bipolar, lost contact with societies definition of real world.........
5. This list goes on.
One reason most sleep docs don't really like treating insomnia is because it is the most difficult complaint to diagnose. So many variables and usually by the time someone with insomnia decides it's time to go to a sleep lab, they are at their breaking point. Can't handle it anymore and have tried everything else including melatonin enemas (one thing that hasn't been mentioned in the forums, I just made it up so don't go there). And now it's Oh my god, if I don't get some sleep I'm going to die time, etc...
So when your typical pulmonary sleep doc sees someone like this, what do you think is going through their mind. Maybe something like Oh my god, why did I decide to become a sleep doc. Actually, a smart sleep doc will ask a few questions, review the medical history, look at the facial/airway anatomy, and do a quick physical exam. If there are no signs leading to a physical problem with sleep, he/she will have a questionnaire that should help decide which category the sleep problem falls in to. If it points to a cognitive problem he would refer you to a good psychologist who specializes in insomnia. If it points to a psyche problems he would refer you to a psychiatrist who is boarded in sleep, etc. The process takes time and many docs are in a hurry.
The bottom-line, what I'm trying to say, is insomnia is the most difficult complaint to diagnose even with the person sitting right in front of you with all their medical history and all the meds and herbs they are taking.
Now, if a person goes to the doctor complaining of chest pains the doctor would never make the diagnosis of chest pains and prescribe pain pills. He would do all the test necessary to determine the cause and then the diagnosis would be made and treatment would begin. When a person complains to their doctor of having insomnia and all the doctor does is prescribe a sleep medication without knowing the cause, we have a major problem which can get worse. What if patients were consistently given pain pills when they complained about chest pains and sent home?
Why the complete opposite response from the medical field, again, treating insomnia is the most difficult sleep problem to diagnose and treat correctly due to the huge range of causes, patients not always following or understanding instructions, and the end result may be no change or the person may actually get worse. So send them home with pills.
Ok, I just needed to vent on the medical field which has contributed to some of the advice in recent postings.
Back to the subject at hand. Part II - How to control your thoughts? Hopefully you are not thinking I'm crazy by now. LOL This would fall under Cognitive problems. I wouldn't call it CBT, maybe a small part of it.
I mentioned in Pt. 1 that thoughts can be addicting, good and bad. Thoughts work just like many insomnia related drugs/meds, by changing the chemistry of the brain. I'm not going into the details, so below is a very ruff description of what happens. (One good source, if you want details, is the "What the bleep do we know?" DVD.)
Thoughts produce peptides (there are dozens of types) which make a connection to the brain and stimulate neural pathways, producing chemical changes in the brain that results in an emotion reaction. The type of emotional reaction is directly related to the specific peptide the thought produces.
Any chemical change in the brain will become addicting if it is repeated over and over. We all know people who are always negative and seem to enjoy telling depressing painful stories. Most of these people are addicted to the drug that the thought produces and are unaware of why they seem to be negative or angry all the time.
The brain doesn't decide if an emotion or feeling is good or bad and reject one over the other. It just reacts by changing our mood and sends out signals to the body. Some of these signals may cause rapid shallow breathing, raise our blood pressure, cause stress, etc..
So the premise is, thoughts are causing stress, anxiety, sadness, anger..... And some thoughts are causing pleasure, peace, happiness and joy. Wouldn't it be nice to be able to choose your thoughts. For many they don't have the ability to choose, they have been experiencing the drug from a certain type of thought for so long it is nearly impossible to change to the opposite. Changing your thoughts will be dealt with in Part III and I can't say when it will be posted.
One last point, not being able to turn off positive thoughts can be as difficult as trying to turn off negative thoughts when wanting to get to sleep. So all thoughts a capable of becoming addictive and when they get to the point that they interfere with daytime and nighttime function, including sleep, we need tools to deal with them. Here are a few that I think are good to begin with.
There is the extreme emergency when a thought is beating you up and you can't stop it. We've all been in the place where you are watching a DVD and every 10 mins you have to back it up because you don't remember anything that has happened for the past 9 mins. You know what is in control at that moment, it's the thought that keeps pushing it's way back into your head.
There are many known ways to deal with this type of problem. Most of them require some training and a mentor. If we were able to meditate, which I personally think is a great practice, thoughts would lose control. For anyone who has the time and the desire, this is a good option but isn't a quick fix. Takes time and practice. There are other methods which take time and practice which I'm not going to mention here.
In Part II I am going to describe 2 forms I've used to have some control of recurring thoughts.
In an emergency situation where you need immediate relief from thought/thinking sit or lie down and stare at a spot on the wall or the ceiling. In order to think your eyes must be able to move. Their movements corresponds to the type of thought, eye movements access different parts of the brain. So looking up my correspond to thinking about a place, looking right when thinking about numbers, etc. (didn't have time to look this up so don't hold me what corresponds to what).
The key is, if you can stop and stare at a spot, any spot, as long as you keep your eyes still you can not think, no matter how hard you try. You may be able to come up with a word or two, maybe a vague thought, but if you really focus all you energy on the spot, thoughts/thinking will disappear. The problem with this is how long can you stare at the spot. Sooner or later you have to get back to life and the thoughts haven't really gone anywhere. However, just being able to have some peace, even for a short while, can be helpful. I will add, if you can stare at on spot long enough, 15-30 mins on average, some amazing things can happen and that's all I will say about that.
This next exercise may be more practical.
You are being bombarded by thoughts/thinking, positive or negative, some you want to remember some you want to forget, you keep trying to think about something else or the thought leads to another thought ending up back at the original thought, going in circles and it is wearing you out and they won't stop so you can sleep, here is another practice I use from time to time when needed.
Thoughts are coming, positive and negative, you want to focus on the positive to try and keep the negative out but thoughts are powerful and will only be ignored for so long, so here is what you do.
Keep a note pad and a pencil by your side or in your pocket. When a thought starts to recur and continues to recur write it down word for word. The next time it comes up, just say to yourself, ok I've gotten that one written down, no need to think about it or to worry about forgetting it, and let it go. It may try a couple more times, changing itself a little bit, and if it does, note the change in your note pad and tell the thought ok, got it. Believe it or not, at some point the thought will move on to another unsuspecting person where it can get it's energy to continue.
Treat thoughts as if they are real, only because our brain can't tell the difference between the thought of a thing and the thing itself. So don't argue with the brain and try to tell it they are not real, it will just cause stress and anxiety. Treat them as real and also know that having them written down is the act of physically taking them and putting them in another place, away from your head.
In the beginning it will seem like you are spending all your time writing, and you actually will if you are having a bad day, however, the longer you use this technique the less you will need to write. The thoughts will find another place to go where they are more welcomed very quickly.
For anyone who has problems with writing or want to try something a little bit different, I've found this to work also. Let's say you’ve had a revelation that explains something you have been thinking about off and on for years and thoughts are flowing and you want to continue or stop the thought process on a particular subject, try using a voice recorder and just speak the thoughts/thinking into the recorder real time if possible. At some point, usually not very long, the thoughts stop coming in and you may want to continue, the tape or digital recorder is still running and you want to finish, you may have to work hard at continuing the thought process you were in to finish it.
Does this mean the thoughts will not come back, no, thoughts are smart, they will wait until you are off guard. So keep you note pad or recorder with you at all times. With the note pad, if a thought keeps recurring that is in the pad, the next time it starts, just read what is written in the pad instead of thinking about the thought. If you are using a recorder, listen to your recordings, you'll be amazed at times at what you have recorded. It will turn out to be better than the returning thought and will replace it.
With any technique you have to go into it with the belief that it will work. If you have the thought that it isn't going to work guess what, the thought usually wins, so write them down and let'em go. Keep writing or recording and at some point you will be left alone to fall asleep.
One final message to end Part II
Stress and anxiety typically appear when something negative happens that you have no control over. Example, you are driving you car headed for an appointment you don't want to miss so you leave early. Your on the freeway one exit away from your destination and there is an accident that stops all traffic. Oh my god thoughts run rampant, you breathing becomes shallow, your blood pressure rises, you think bad thoughts about the person who was driving the car that caused the accident, you are freaking out about missing the appointment................ There is nothing you can do to change what is happening at that moment in time so if you can "accept" it consciously and say ok, this is the way it is right now, it will help. You will feel the changes going on in your brain and body, acknowledge them and be ok with them in the moment. If you can do this, stress and anxiety will be reduced and your awareness of what is happening to your body will allow you to notice your breathing and you can change the fast shallow breaths to slow deep breaths which will also help to reduce all the negative side effect of the moment for which you have no control over.
At times there is nothing you can do to get to sleep when you want to. Accept it, surrender, and you should feel better in the moment. What about when we are not in the moment? There is nothing but the moment, the past and future are just like thoughts, the brain can't tell the difference. Think about it. LOL For many of us we live most of our lives outside the moment thinking about and controlled by thoughts of the past or thinking about the future. One day we will realize there is only the present.
I will end with a line from the Serenity prayer
God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.
P.S. Crazy thoughts have been beating me up, trying to keep me from making this posting. I'll let you draw your own conclusion.
Dazed and confused.
It was really hard to click Post Message. LOL
Disclaimer, I am not an MD and my opinions should not be taken as medical advice. If you feel that you need assistance with medications and/or diagnosis, you should seek medical advice from a qualified physician.
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