The commonly-held belief that attempting to suppress negative thoughts is bad for our mental health could possibly be flawed, a recent study from scientists on the University of Cambridge suggests.

Researchers on the Medical Research Council (MRC) Cognition and Brain Sciences Unit trained 120 volunteers worldwide to suppress thoughts about negative events that frightened them and located that not only did these turn into less vivid, but that the participants’ mental health also improved.

​​​​​​​Study: Improving mental health by training the suppression of unwanted thoughts. ​​​​​​​Image Credit: Fida Olga / Shutterstock

“We’re all acquainted with the Freudian concept that if we suppress our feelings or thoughts, then these thoughts remain in our unconscious, influencing our behaviour and wellbeing perniciously,” said Professor Michael Anderson.

“The entire point of psychotherapy is to dredge up these thoughts so one can take care of them and rob them of their power. In newer years, we have been told that suppressing thoughts is intrinsically ineffective and that it actually causes people to think the thought more – it is the classic idea of ‘Don’t take into consideration a pink elephant.’

Anderson said these ideas have turn into dogma within the clinical treatment realm, with national guidelines talking about thought avoidance as a significant maladaptive coping behavior to be eliminated and overcome in depression, anxiety, and PTSD, for instance.

When COVID-19 appeared in 2020, like many researchers, Professor Anderson desired to see how his research could possibly be used to assist people through the pandemic. His interest lay in a brain mechanism generally known as inhibitory control – the power to override our reflexive responses – and the way it may be applied to memory retrieval, and particularly to stopping the retrieval of negative thoughts when confronted with potent reminders to them.

Dr. Zulkayda Mamat – on the time a Ph.D. student in Professor Anderson’s lab and at Trinity College, Cambridge – believed that inhibitory control was critical in overcoming trauma in experiences occurring to herself and plenty of others she has encountered in life. She had wanted to research whether this was an innate ability or something that was learned – and hence could possibly be taught.

Dr Mamat said: “Due to the pandemic, we were seeing a necessity in the neighborhood to assist people deal with surging anxiety. There was already a mental health crisis, a hidden epidemic of mental health problems, and this was getting worse. So with that backdrop, we decided to see if we could help people cope higher.”

Professor Anderson and Dr Mamat recruited 120 people across 16 countries to check whether it would, in actual fact, be possible – and useful – for people to practice suppressing their fearful thoughts. Their findings are published today in Science Advances.

Within the study, each participant was asked to think about numerous scenarios that may plausibly occur of their lives over the subsequent two years – 20 negative ‘fears and worries’ that they were afraid might occur, 20 positive ‘hopes and dreams,’ and 36 routine and mundane neutral events. The fears needed to be worries of current concern to them which have repeatedly intruded into their thoughts.

Each event needed to be specific to them and something that they had vividly imagined occurring. For every scenario, they were to offer a cue word (an obvious reminder that could possibly be used to evoke the event during training) and a key detail (a single word expressing a central event detail). For instance:

• Negative – visiting one’s parents on the hospital because of COVID-19, with the cue ‘Hospital’ and the detail ‘Respiration.’
• Neutral – a visit to the opticians, with the cue ‘Optician’ and the detail ‘Cambridge.’
• Positive – seeing one’s sister get married, with the cue ‘Wedding’ and the detail ‘Dress.’

Participants were asked to rate each event on numerous points: vividness, likelihood of occurrence, distance in the longer term, level of hysteria concerning the event (or level of joy for positive events), frequency of thought, degree of current concern, long-term impact, and emotional intensity.

Participants also accomplished questionnaires to evaluate their mental health, though nobody was excluded, allowing the researchers to take a look at a broad range of participants, including many with serious depression, anxiety, and pandemic-related post-traumatic stress.

Then, over Zoom, Dr Mamat took each participant through the 20-minute training, which involved 12 ‘No-imagine’ and 12 ‘Imagine’ repetitions for events every day for 3 days.

For No-imagine trials, participants got one among their cue words and asked to first acknowledge the event of their minds. Then, while staring directly on the reminder cue, they were asked to stop serious about the event – they mustn’t try to assume the event itself or use diversionary thoughts to distract themselves, but slightly, attempt to block any images or thoughts that the reminder might evoke. For this a part of the trial, one group of participants was given their negative events to suppress and the opposite given their neutral ones.

For Imagine trials, participants got a cue word and asked to assume the event as vividly as possible, considering what it could be like and imagining how they’d feel on the event. For ethical reasons, no participant was given a negative event to assume, but only positive or neutral ones.

At the tip of the third day and again three months later, participants were once more asked to rate each event on vividness, level of hysteria, emotional intensity, etc., and accomplished questionnaires to evaluate changes in depression, anxiety, worry, affect, and wellbeing, key facets of mental health.

Dr Mamat said: “It was very clear that those events that participants practiced suppressing were less vivid, less emotionally anxiety-inducing, than the opposite events and that overall, participants improved by way of their mental health. But we saw the largest effect amongst those participants who got practice at suppressing fearful, slightly than neutral, thoughts.” 

Following training – each immediately and after three months – participants reported that suppressed events were less vivid and fewer fearful. Additionally they found themselves serious about these events less.

Suppressing thoughts even improved mental health amongst participants with likely post-traumatic stress disorder. Amongst participants with post-traumatic stress who suppressed negative thoughts, their negative mental health indices scores fell on average by 16% (in comparison with a 5% fall for similar participants suppressing neutral events). In contrast, positive mental health indices scores increased by almost 10% (in comparison with a 1% fall within the second group).

Generally, individuals with worse mental health symptoms on the outset of the study improved more after suppression training, but only in the event that they suppressed their fears. This finding directly contradicts the notion that suppression is a maladaptive coping process.

Suppressing negative thoughts didn’t result in a ‘rebound,’ where a participant recalled these events more vividly. Just one person out of 120 showed higher detail recall for suppressed items post-training, and just six of the 61 participants who suppressed fears reported increased vividness for No-Imagine items post-training, but this was consistent with the baseline rate of vividness increases that occurred for events that weren’t suppressed in any respect.

“What we found runs counter to the accepted narrative,” said Professor Anderson. “Although more work shall be needed to substantiate the findings, it looks as if it is feasible and will even be potentially useful to actively suppress our fearful thoughts.”

Although participants weren’t asked to proceed practicing the technique, many selected to achieve this spontaneously. When Dr. Mamat contacted the participants after three months, she found that the advantages, by way of reduced levels of depression and negative emotions, continued for all participants but were most pronounced amongst those participants who continued to make use of the technique of their each day lives.

“The follow up was my favourite time of my entire PhD, because day by day was just joyful,” she said. “I did not have a single participant who told me ‘Oh, I feel bad’ or ‘This was useless’. I didn’t prompt them or ask ‘Did you discover this beneficial?’ They were just routinely telling me how helpful they found it.”

One participant was so impressed by the technique that she taught her daughter and her own mother easy methods to do it. One other reported that she had moved home just before COVID-19 and felt very isolated through the pandemic.

“She said this study had come exactly on the time she needed it because she was having all these negative thoughts, all these worries and anxiety concerning the future, and this really, really helped her,” said Dr Mamat. “My heart literally just melted, I could feel goosebumps throughout me. I said to her ‘If everyone else hated this experiment, I’d not care due to how much this benefited you!’.”

The Medical Research Council of the UK and the Mind Science Foundation funded the research.

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