The Imp of The Mind - Obsessions and Compulsions

The Imp of the Mind: Exploring the Silent Epidemic of Obsessive Bad Thoughts
By Lee Baer, Ph.D.
The Imp of the Perverse, as Poe described it.

o We perpetrate them merely because we feel that we should NOT.
Visits everyone from time to time with one of two outcomes:
1. We give little attention to the thoughts and move on.

2. We are strongly affected by the bad thoughts, causing them to occur more and
interfere with functioning
To cure the bad thoughts, one must understand one key fact
You are not so abnormal as you think. Every human being is visited from time to time
by the Imp of the Perverse, who makes you think the most inappropriate thoughts at
the most inappropriate times.
This urge is universal and historical

o Pandora could not stop thinking about what she was told to forget.
o Eve in the Garden of Eden
The Imp of the Perverse will try to torment you with thoughts of whatever it is you
consider to be the most inappropriate or awful thing that you could do.
The thing we imagine to be the worst possible thing can and does change over time.
Exacerbating effects:
o The thought to suppression effect.

The person tries to suppress the thought, which leads to an increase
in the thoughts.
o Most people suspect they are a very dark person, deep on the inside.
The first appearance of the Imp of the Perverse signals an
awakening of this evil part of the self.
They then suppress, which seems logical, but results in an increase
in thoughts.
Bad thoughts do not signify that you are truly evil deep down, and voluntarily
suppressing these thoughts will only make them stronger.
The very fact that these people have not done any of the things they are worried about
doing is cause for reassurance.
o The best predictor of future behavior is past behavior.
People for Whom These Stay Around Tend to Be:
Overly conscientious and inflexible about moral and ethical issues
Preoccupied with rules
Prefrontal Cortex the guilt and distress they suffer is the result of the prefrontal
cortex doing its job by energetically suppressing the bad thoughts.
When Are Bad thoughts Dangerous?
If you do not feel upset about the thoughts but instead find them pleasurable.
If you have ever acted on violent or sexual thoughts or urges in the past
either while sober or under the influence of alcohol or drugs.
If you hear voices, think people are against you, or see things that others do
not see.
If you feel uncontrollable anger and find it hard to resist urges to act on your
aggressive impulses.
What Causes Bad Thoughts?
Evolutionary History extravigilant mothers increased chances of their offsprings
survival and passed down their hypervigilant genes to future generations.
When Problems Arise
1.) They cannot accept that such thoughts are part of being human, 2.) They fear
their orbital-frontal cortex will not be able to inhibit their thoughts and urges.
Why Bad thoughts Get Out of Control
Depression
Tourettes Syndrome ECD and Tourettes Syndrome are thought to be
genetically linked and to share neurological pathways.
OCPD sensitive conscious
OCD
o They are unable to pay sufficient attention to events that are not actively
focusing on.
o As a result, these events are not stored in their memories, as happens
automatically for most of us.
o This is why it doesnt register in their minds that they have done
something, like turn off the light switch. May stare at the switch it hasnt
registered for them.
o This is why they cant feel certain that they havent done something
inappropriate, because they can not remember not having done it.
o Being conscientious, they search memory for proof of not doing it, but in
vain.
o They then conclude that they must have done the terrible thing.
Brain Imagery
When people think bad thoughts specific parts of the brain become more active:
orbital-frontal cortex, caudate nucleus, anterior cingulum all part of the limbic
system part of the brain associated with strong feelings.
This is why people obsess about things involving danger or humiliation.
A truly dangerous persons brain acts exactly opposite that part of the
brain is underactive.
Visual Images
Some people report actually seeing images of what they fear happening.
o Clearly not psychotic, but it is something like a hallucination.
o When you form a mental image in your head, you are activating exactly
the same areas of the brain that would be activated is you were actually
seeing the event.
PTSD, not OCD
The memory is of a real event.
The trauma becomes encoded in an abnormal form of memory, which breaks
spontaneously into consciousness as flashbacks and nightmares.
Why Do People With OCD Worry So Much About Their Thoughts?
Childhood:
o Highly sensitive
Social situation
Loud sounds
Strong emotions
Generally shy
Sensitive to being picked on by others
Difficulty expressing anger towards others
The Highly Sensitive Person by Dr. Elaine Aron
o 15 20% of the population is highly sensitive to stimulation
They are: 1.) highly conscientious, and 2.) often thinking about
their own thinking.
Exposure Therapy
Expose yourself to the thing that most triggers your fear or discomfort for 1-2
hours without leaving the situation, or doing anything else to distract or comfort
yourself.
o This is the first nondrug treatment that shows a change in brain chemistry.
Why this works: Habituation

o Similar to living near the train tracks but not hearing the train any more.
o Children afraid of the dark: With our parents help, we stay in our room at
night in the dark even though we are afraid. Eventually we are not afraid
any more.
o Through changing our behavior (staying in the dark room) we indirectly
change our thoughts (monsters) and feelings (fear).
Exposure: In Vivo
o Have the person expose himself or herself to what they fear for one hour
per day.
o Audio Tape: make a script of the fear, record it on tape,
o have the person listen for one hour per day.
o Also when the bad thoughts come, they should listen to the tape
until the thoughts stop.
o They must resist distracting themselves or comforting themselves
with reassuring self statements during this time.
o When the tape becomes boring it is a good sign that treatment is
working.
o The thoughts will not disappear completely. But the person can
remind himself/herself that they are just thoughts and let them
pass without anxiety.
See page 86 for examples of In Vivo Therapy for thoughts.
Cognitive Therapy
o Cognitive errors can be confronted and changed.
Common cognitive errors
Attributing too much importance to having particular thought
Thinking they need to be able to completely control their thoughts
Thinking a situation is more dangerous than it really is
Intolerance of uncertainty
Perfectionism
Excessive responsibility

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The Imp of the Mind: Exploring the Silent Epidemic of Obsessive Bad Thoughts

By Lee Baer, Ph.D.

The Imp of the Perverse, as Poe described it.

Visits everyone from time to time with one of two outcomes:

1. We give little attention to the thoughts and move on.

This urge is universal and historical

o The thought to suppression effect.

Why this works: Habituation

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