From eu.detroitnews.com
| Special to the Washington Post
Overthinking at night - about insomnia and other matters - is a common problem for many of my patients with sleep disorders. It interferes with falling asleep or going back to sleep, and prevents peaceful rest when they can't sleep anyway.
Overthinking usually refers to thought processes such as racing thoughts or perseveration. The content - such as worries or the next day's demands - may also be maladaptive. It may be fuelled by a diagnosable condition such as depression, generalized anxiety disorder, obsessive compulsive disorder (OCD), attention deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD) or hypomania. It can also be stimulated by intense experiences such as stress, exciting plans, perfectionism, insecurity, caffeine use or a painful or worrisome life event.
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Overthinking usually refers to thought processes such as racing thoughts or perseveration. DREAMSTIME, TNS
There are many psychological tools to help with overthinking, but two people with comparable struggles may not benefit from or prefer the same tools. We insomnia specialists try to have available sizable and diverse tool kits that address cause or manifestation without sacrificing specificity.
Irrespective of tools, there are some general principles that may help with overthinking:
-Suppressing unwanted thoughts may make them more determined, and they can come roaring back. Good techniques allow us to coexist peaceably with our thoughts.
-At night, it is best to use simple, calming techniques that do not re-litigate the content of our concerns.
-Issues that inflame overthinking - such as overwork, too little support, isolation, guilt, mental health concerns and insufficient exercise - matter. Why are you overthinking? What do you need more or less of in your life? These questions are best addressed during the day or early evening.
-Engaging in abundant negative or anxious thinking can condition unwanted habits of mind. The Buddhist teacher Thich Nhat Hanh cautions us to be careful which plants we water over and over in our minds. These are the plants that will grow big and strong and, in turn, demand more care and feeding.
One of my patients was a caring partner, mother and friend, and successful in a meaningful and demanding career. She had a child with mental health challenges and would lie awake at night worrying, questioning her own actions and gaming out possible scenarios.
The thinking was unconstructive and interfered with rest and sleep. Talking through her feelings of helplessness and fear was important. I also offered her some strategies that helped. Here are some of them:
Use a soothing distractor
During periods of insomnia, turn to more soothing thoughts to compete with your default thoughts. The human mind cannot entertain two narratives simultaneously.
Listen to peaceful audio books, podcasts or conversational radio programs, or read calming stories or books (with the light very dim and blue-blocked). Each time the unwanted thoughts arise, don't push them away. Let them recede into the background and gently return your attention to your soothing distractor.
If interior techniques such as visualizations last long enough for you (they don't for many people), walk through a calming and pleasant memory such as a vacation or the rooms of your grandmother's house. Don't choose a distractor that would keep you up, and don't focus on sleep as a goal while using it.
Schedule worry time
This is, at most, a 30-minute technique that should be used in the early evening, after the stressful part of the day but hours before sleep in case it leaves some residue of stress or worry.
By facing problems constructively, they are less likely to plague us at night. This technique also teaches us to tolerate not acting or ruminating when it isn't time.
List all your worries and stressors. For each one, ask yourself: Is there anything I can do about this in the next two weeks (even if I can't completely resolve the issue)? If yes, what can you do and precisely when will you do it? Action steps should mitigate either the problem itself, such as working out a payment plan for an overdue bill, or its emotional effect, such as reminding oneself that more income-generating work is forthcoming.
Update the list each evening and continue with the action steps until you no longer need the technique.
Give yourself a few optional minutes each evening to think any way you'd like about the items on the list. The rest of the day and night, when the thoughts arise, say, "Not now; I'll get to you during my scheduled worry time." If you have determined that there is nothing to be done about a certain problem, when thoughts about it arise, remind yourself that there is nothing to do.
Try exposure therapy for thoughts
This is a daytime technique. Variants are used for the thoughts that can accompany OCD, but I teach it for preoccupying thoughts more generally.
-Take a few days to list your recurrent negative and anxious thoughts.
-Record them into the audio recorder on your phone or computer three times in a singular long recording.
-The first time, recite the thoughts in the tone in which they naturally pop into your head.
-The second time, exaggerate that tone.
-The third time, make the tone absurd.
-Listen to the recording on a loop for an hour a day while you are doing something else such as playing a computer game that doesn't involve words or sound, or cleaning up.
You may feel a bit worse at first (and you can always abandon the technique if you need to). After several days, though, the recording should become boring and repetitive background noise such that when the thoughts arise in the privacy of your head, they are easily relegated to the background.
Examine overlooked feelings
This is a technique for getting in touch with buried feelings. I suggest it especially to those who are preternaturally competent and stoical, rarely letting themselves feel vulnerable. The feelings may catch up with them at night in the form of distress and overthinking.
Early morning is a nice, quiet time for getting in touch with underattended feelings. It is a listening task, not a thinking task.
Prompt yourself with half sentences such as: "What I'm scared of is" or "What I'm sad about is" or "What I'm disappointed by is" or "What I feel ashamed about is" or "What I regret is" or "What I've been most traumatized by is." Pick a few half-sentences per sitting. Commit to thoughtfully addressing what arises at a later time (not at night).
Think rationally
Cognitive-therapy techniques invite us to bring rational thinking - for instance, evidence for and against, and correction of cognitive distortions - to bear on our assumptions.
These can be excellent tools during the day for reappraising our worries and other upsetting thoughts. For example, if you are worrying about something, ask yourself what are the worst, best and most likely outcomes, in that order.
Self-soothe
Underneath the rational layer, there can be a primally frightened part of us. Children don't ask their parents for proof of their soothing assertions or ask what qualifies them to make those assertions; they bask in the soothing.
Cultivate more soothing language and a kinder tone toward yourself (day and night), and try to believe yourself. There are many other strategies for self-soothing as well.
I have written previously about repeatedly observing one's own overthinking to cultivate self-awareness and establish a competing habit of mind. There are many other useful techniques - from meditation to journaling to wind-down time to relaxation techniques such as breathing to slow your thoughts and Yoga Nidra to keeping a pad of paper bedside (to be used very sparingly) for jotting down things you want to remember tomorrow to worry exposure.
I hope some of my suggested techniques offer you a great start and help you reduce or eliminate overthinking and get restful sleep.
Lisa Strauss, PhD, is a clinical psychologist in private practice in the Boston area. She specializes in sleep disorders.
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