How to respond to an unwanted intrusive thought: The ills of suppression and the gains of some alternatives

Suppression is one of various mental control techniques that people may use to manage unwanted thoughts. Evidence suggests that it is at best unsustainable and at worst counterproductive. This leads to the question: If suppression is a futile way to respond to unwanted, intrusive, thoughts, what is a more effective alternative? In two studies (non-clinical OCD), I evaluated the relative effectiveness of suppression and three alternative mental control techniques---focused distraction, creating associates, and mindful-acceptance---on the frequency of intrusions, distress associated with them, and selective attention to the unwanted material. Results support the claim that suppression is a counterproductive technique for dealing with unwanted, intrusive thoughts. In the non-clinical sample, adverse effects of suppression were reflected both in the frequency of intrusions and distress associated with them. In the OCD sample, the harmfulness of suppression was reflected primarily in the magnitude of distress and not in thought frequency. Additionally, results suggest that focused distraction and the technique of creating associates have potentially salutary effects for the management of non-clinical, intrusive thoughts. Focused distraction was also the most effective technique for managing clinically significant intrusive thoughts in OCD. However, in individuals with OCD, the second most effective technique was mindful-acceptance, whereas creating associates actually produced adverse effects in this group. Thus, it appears that the effectiveness of specific mental control tactics differs in normal experience and in OCD. Furthermore, correlational analyses of baseline measures reveals that individual differences such as preexisting metacognitive beliefs may influence the effectiveness of mental control both in normal experience and in OCD.