Thought suppression; The Return of the White Bear

1. Thought suppression; The Return of the White Bear Dr. Nic Hooper

2. Don’t think of a white bear!

3. What is thought suppression? • According to Daniel Wegner • ‘attempting to banish ones unwanted thoughts’ • In everyday terms • It is the attempted removal of unwanted thoughts from the mind. • A natural reaction • Rachman and Da Silva (1978) • 80% of people will attempt to suppress an unwanted thought

4. Why is thought suppression important? • Smoking cessation (Toll, Sobell, Sobell & Wagner, 2000) • Worrying (Mathews & Milroy, 1993) • Stress (Roehrich & Goldman, 1995) • Sleep impairment (Ree et al, 2004 ) • ASD (Harvey & Bryant, 1998), • OCD (Freeston & Ladouceur, 1997), • GAD (Beckner et al 1988 ), • PTSD (Foa, Steketee & Rothbaum, 1989; Ehlers & Steil, 1995), • Specific Phobias (Thorpe & Salkovskis, 1997) • Depression (Wegner, 1994)

5. Research outline • Why is it that we cannot suppress our thoughts? • What are the possible effects of thought suppression on behaviour? • What are the alternatives to thought suppression in the management of unwanted thoughts?

6. Why is thought suppression futile?

7. Taught Untaught bear Gedeer Boceem

8. Procedure • 1. Screening measures • 2. Equivalence training and testing • 3. Five minute suppression phase • 4. Induction of cognitive load • 5. Avoidance program

9. Hooper, Saunders and McHugh (2010)

10. GEDEER BOCEEM BEAR

11. Opposition Relations and TS • Opposition relations seem particularly interesting in this context • When a person is trying to suppress a thought then one strategy may be to think of something that is very different or opposite along some dimension • E.g., if I am trying not to think of something sad or depressing then I may think of something happy or uplifting • However, doing so may eventually fail for the same reason that any other distracter fails – because the association between the stimuli is strengthened

12. Relational Network Derived same Target (‘BEAR’) Control Taught same Derived Opposite Derived Opposite

13. Procedure • 1. Screening measures • 2. Same opposite training and testing • 3. Five minute suppression phase • 4. Induction of cognitive load • 5. Avoidance program

14. Stewart, Hooper and McHugh (under review)

15. But so what….. • According to our results it is likely that thought suppression is difficult due to environmental reminders • However, from an ACT perspective, we are not really concerned with whether we can suppress out thoughts per se • Instead we are interested in valued living • It is therefore more important to us to determine if thought suppression narrows our behavioral repertoire causing us to lose contact with our values

16. Thought suppression and behavioural avoidance

17. Procedure • Screening measures • Equivalence training and testing • Five minute suppression phase • Induction of cognitive load – (6-digit number) • Preference program

22. Hooper, Stewart & McHugh (under review)Bear

23. Hooper, Stewart & McHugh (under review)Trained/Derived items

24. What can we do instead?! • According to Relational Frame Theory (RFT) control based strategies like suppression only serve to enhance the relational network associated with an unwanted thought. • In order to avoid the unwanted thoughts, one will also have to avoid all thoughts in the relational network as a transformation of suppression functions will occur. (Hooper, Saunders & McHugh, 2010)

25. Recent Alternatives • Acceptance based strategies disrupt the transformation of stimulus functions • I.e. they alter the aversive functions of the stimuli in a relational network • Specifically, acceptance based strategies encourage the client to experience the unwanted thoughts without attempts at altering their form or frequency • Defusion • Defusion encourages people to distance themselves from their thoughts • Mindfulness • Mindfulness encourages present moment living, enabling people to come into contact with unwanted thoughts in a non judgemental manner

26. Intervention based research • Defusion intervention study – learned helplessness • Step one – screening questionnaires • Step two – instruction; thought suppression, defusion, no instruction • Step three - learned helplessness has been used in previous research to induce a depressed like state by exposing participants to an insolvable task. • Step four – the dependent measure; maze task

27. (Hooper & McHugh, in press)

28. Intervention based research • Defusion intervention study – food cravings • Step one – Participants told they are to refrain from eating chocolate for 6 days • Step two – Instruction; thought suppression, defusion, no instruction • Step three –Participants had to record the amount of times they ate chocolate across a five day period, they also recorded the amount of cravings they experienced. • Step four – Participants returned to the lab to complete a taste test, where rebound was measured.

29. Hooper, Sandoz, Ashton, Clarke and McHugh (2012) Defusion TS Control • Cravings 13.25 9.29 11.71 • Chocolate eaten 5.88 7.29 9.64 • Minstrels eaten 3.31 14.59 10.93

30. Intervention based research • Mindfulness based study – Spider fear • Step 1 – screening questionnaires • Step 2 – thought suppression/mindfulness inductions • Step 3 – Behavioural Approach Test (BAT) • Step 4 – anxiety measure

31. Behavioural Approach Test (BAT) • Move 1 metre to the table • Move 1 more metre to the table • Approach the table • Touch the jar for more than 10 seconds • Lift up the jar • Open the jar • Touch the spider with a pencil for more than 10 seconds • Remove the spider from the jar • Touch it with a finger for more than 10 seconds • Put the spider on their hand

32. Hooper, Davies, Davies and McHugh (2011) BAT data

33. Results – STAI data

34. Intervention based research • Mindfulness based study – Stereotype threat (female math stereotype) • Step 1 – Maths test 1 • Step 2 – Mindfulness versus no mindfulness exercise • Step 3 – Induction of stereotype threat • Step 4 – Maths test 2

35. Weger, Hooper, Meier and Hopthrow (2012)

36. Future Directions • Language and Behavioural Avoidance • Inclusion of appetitive stimulus – up the valence • Manipulation of values • Intervention Based Research • The development of different behavioural measures of the effectiveness of ACT component based techniques • Public speaking • Sports performance • Studying behaviour • Pain

37. Thank you