A new study challenges the common belief that consciously suppressing negative thoughts is bad for mental health, finding that people who suppress negative thoughts have lower levels of post-traumatic stress and anxiety and have less vivid intrusive thoughts. The findings suggest it is a promising alternative approach to treating mental illness.
Just like our actions, our thoughts and emotions often need to be controlled, especially when we are reminded of unpleasant events. Repression is a psychological defense mechanism in which people deal with traumatic events by consciously pushing disturbing thoughts and experiences out of their minds.
The traditional view in psychology, originating from Freud, is that repressed content can be controlled by the body and produce a series of negative downstream effects, such as depression, anxiety, stress-related illnesses and substance abuse. However, a new study from researchers at the University of Cambridge in the UK finds that conventional thinking may be wrong and suppressing negative thoughts may actually be good for our mental health.
Michael Anderson, one of the study's two authors, said: "We are all familiar with Freud's idea that if we suppress our feelings or thoughts, then these thoughts will remain in our unconscious and have harmful effects on our behavior and health. The whole point of psychotherapy is to awaken these thoughts so that people can process them and remove their power. In recent years, we've been told that suppressing thoughts is inherently ineffective and actually causes people to think about them more—the classic idea of 'don't think about the pink elephant.'"
The researchers considered the brain's inhibitory control mechanism, the ability to override our reflexive responses, and how this might be applied to memory retrieval, particularly the retrieval of negative thoughts. They recruited 120 people in 16 countries to test whether suppressing negative thoughts works and, if so, whether it is beneficial. They assessed the mental health of the participants, which included many suffering from severe depression, anxiety and post-traumatic stress related to the COVID-19 pandemic.
Each participant was asked to think about various situations that might occur in their lives over the next two years: 20 negative "fears and worries," 20 positive "hopes and dreams," and 36 "routine and mundane" neutral events. The fear must be a concern that is currently recurring in their mind.
Participants provided a cue word and a key detail for each scenario. For example, a negative scenario might be "Visiting parents with COVID-19 in the hospital," the prompt word is "hospital," and the key detail is "breathing." The positive scenario might be "Watching my sister get married", the prompt word is "Wedding", and the detail is "Dress".
The researchers gave each participant a three-day, 20-minute-a-day online training session that included 12 "no imagine" and 12 "imagine" repetitions. In "no imagine" trials, participants were shown a negative or neutral situational cue word and asked to mentally imagine the event. Then, while staring at the cue word, they were asked to stop thinking about the event by blocking out the image or thought evoked by the cue word. In "imagine" trials, participants were shown a positive or neutral situational cue word and asked to imagine the event as vividly as possible. For ethical reasons, participants were not asked to vividly imagine negative scenarios.
Before the study began, at the end of the third day, and three months later, participants were asked to rate each event's vividness, likelihood of occurrence, future distance, anxiety or joy about the event, frequency of thoughts, current level of worry, long-term impact, and emotional intensity. They also filled out questionnaires to assess changes in depression, anxiety, worry, mood and well-being.
After the training and three months later, participants reported that the repressed events were less vivid and less frightening. They also reported thinking less about the events.
Zulkayda Mamat, another author of the study, said: "It was clear that the events that participants practiced suppressing were less vivid and less emotionally anxiety-provoking than other events, and overall, participants' mental health improved." But we found that the greatest effects were among participants who practiced suppressing fearful rather than neutral thoughts. "
Participants with higher levels of anxiety and post-traumatic stress benefited most from suppressing painful thoughts. Among the post-traumatic stress participants who suppressed negative thoughts, their negative mental health scores dropped by an average of 16%, while those who suppressed neutral events saw only a 5% drop in their scores.
Three months later, participants who had received fear-suppression training continued to experience less depression and a downward trend in negative emotions. Those who were trained to suppress neutral events did not show these effects.
Importantly, suppressing negative thoughts did not lead to "rebound," in which the event is recalled more vividly. Of the 120 participants, only one showed improved detailed recall of the suppressed items after training, while six of the 61 participants who suppressed their fear reported increased vividness of the "unimagined" events.
"Our findings run counter to accepted wisdom," Anderson said. "While more work is needed to confirm these findings, it appears that actively suppressing fearful thoughts is possible and may even be beneficial."
The research was published in the journal Science Advances.