THE WASHINGTON POST – Overthinking at night 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 may also be maladaptive. It may be fuelled by a diagnosable condition such as depression, generalised 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. 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 co-exist 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 matter. Why are you overthinking? What do you need more or less of in your life? These questions are best addressed early.
– Engaging in abundant negative or anxious thinking can condition unwanted habits of mind.
One of my patients was a caring 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 interfered with rest and sleep.
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 programmes, 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 visualisations 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. 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.
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.
– Take a few days to list your recurrent negative and anxious thoughts.
– Record them into the audio recorder three times in a singular long recording then 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 that doesn’t involve words or sound.
You may feel a bit worse at first. After several days, though, the recording should become boring and repetitive that when the thoughts arise in the privacy of your head, they are easily relegated to the background.
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 under attended 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 traumatised 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.
SELF-SOOTHE
Underneath the rational layer, there can be a primarily 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. – Lisa Strauss
