How to stop your intrusive thoughts

How to stop your intrusive thoughts

By: Heryani Jamaludin


In 1992 while living in America, I became pregnant with my second child. A few months later my husband was made redundant. At 7 months pregnant I flew half way across the world to have my baby in Singapore. Three weeks after my C section my family and I resettled in the UK. I stayed with my in-laws temporarily and moved house two more times before we could purchase our own home. Meanwhile my father-in-law passed away after a long struggle with cancer. When my husband found work outside the UK I stayed behind to look after my 2 young children in a small village in the south of England.

When my baby was 5 months old I started to have recurring thoughts about a small incident at my father – in – law’s funeral. These unwanted thoughts had such an emotional charge that every time I picture the incident I  get upset . I would cry. Things got worse when I started to cry for no reason. The thoughts were intrusive and interfered with my daily routine. I could not concentrate on the simplest of tasks and it occupied my mind for most of the day. When my 5 year old son asked me why I was crying I started to panic and feared that I was going mad. I felt scared and exhausted . In desperation I went to see my GP. I thought that he was going to be dismissive of me. Instead my GP listened carefully and referred me to a mental health practitioner.

At the first session the MHP took a history. She reflected to me that in one year I lived in 3 countries – experienced redundancy, birth and death and now caring for my young family without my husband. She instructed me to wear a rubber band on my wrist and to snap that rubber band each time I have the thoughts. She helped me put the incident in perspective so that I wouldn’t load it with negative emotions.
Skeptical about the process but desperate to get better, I tried the technique for 2 weeks and guess what? It worked! I saw the MHP for another session and that was it. The rest of the time I did my own internal work. No pills, no long therapies, just a technique and sorting out of thoughts.

Looking back I’m convinced that my intrusive thoughts came from relentless stress that I had generally managed well but never gave myself enough ” me ” time to regroup. I basically took care of everyone but did not see to my own needs.  The incident  itself wasn’t that traumatising. It was at best a little embarrassing.  Now I would just shrug it off or laugh it off. But at that time due to my stress levels I made it into a very big deal – to such an extent that it affected my mental health.  I have learnt many things since that incident in 1992. One would argue that snapping a rubber band and causing pain – thus associating pain with unwanted thoughts is a mild form of self harm.  For me it wasn’t. The pain if you can call it that was rather mild . As it was self inflicted you can  control how hard you snap that rubber band.  More importantly it worked for me. For those who do not wish to have the rubber band you can snap your fingers or clap your hands to literally snap out of the intrusive thoughts.  But I thought the rubber band technique was the most discreet and would attract little attention if you are in a public place. Please share if you’ve experience something similar.

#thought stopping # mental health practitioner #stress#association

High expressed emotions can cause relapse

Recovery from schizophrenia in early 20th century England- treatment options


Recovery from schizophrenia in 20th century England was very much a ‘hit and miss’.  There was very little understanding about the nature of the illness and its treatment.  Society labelled people who suffered from schizophrenia as “lunatics”.  Wealthy people locked away their mad relatives in an attic room away from  others. Doctors treated patients with insulin or performed frontal lobotomies. This was a procedure that involved a sharp, long needle inserted through the eye to get to the brain.


The origin of expressed emotion – a study by Brown et al

In the 1950’s doctors began prescribing chlorpromazine. Patients became stable and went back to their homes.  It wasn’t  long before these patients relapsed and  returned to hospital. To understand the reasons for these relapses a psychiatrist called George Brown studied over 229 discharged men.  He found that those who lived with their parents and wives were more likely to relapse. Those who lived with other relatives or in lodgings fared better. He found a connection between the carers’ behaviour towards the person with mental illness and the relapses. He termed this as expressed emotion.

Definition of expressed emotion


High expressed emotion or ‘HEE’  are words, actions and attitudes that  carers demonstrate toward the person with mental illness.  An example of a critical comment is a remark on his apparent lack of comiment.  Hostility are words that are harsh or critical; blaming the person for being sick or lazy, spoken in a loud and aggressive manner.

Emotional over involvement is when the carer or relative blames himself for the illness and showing regret and remorse.  In his study, Brown found that patients who returned to their wives or parents soon relapsed and were readmitted. Those who lived with siblings and informal carers did better


Low expressed emotions denoted by ‘LEE’ is emotion that is conveyed by a compassionate, empathetic attitude towards the sufferer. Exercising patience , giving the sufferer plenty of space, speaking in soft tones. Talking to and trying to understand the person suffering from schizophrenia- his hallucinations, delusions and exploring coping strategies so that the sufferer may have fulfilling life play a major role in relapse prevention. A general positive regard by those around him is key to remaining well.


What can you do as a health professional?


Recovery is more effective when you involve carers or family members. You should inform them of the nature of the illness , how the medication works and the importance of compliance. Some families of newly diagnosed people are emotional. They are frightened because they do not understand the illness. Your role of counseling them about positive regard and low expressed emotion requires a good balance of empathy and assertiveness. Invite your client to talk about his voices or his delusion – being careful not to agree or argue with the latter. Find out how these symptoms affect his life and how he copes. Help him with exploring new strategies and setting his own  goals.


#expressed emotions#chlorpromazine#psycho-education#causes of relapse

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