Why am I having these horrible thoughts? Why you shouldn't listen to everything your brain tells you in pregnancy
Intrusive thoughts, what they mean (and what they don't mean) and how to deal with them when you are pregnant and sick.
So you are pregnant. And sick. And now you can’t stop thinking “dark” thoughts that are making your life miserable.
Why on earth would your mind do this to you?
The truth is my experience of hyperemesis gravidarum and the related mental health nightmare I went through was the one and only time I have ever said to myself “thank God I’m a Clinical Psychologist.”
Depression, anxiety, trauma and thoughts…
Believe it or not, the mind is trying to be helpful here. The mind sends us warnings about danger and possible solutions to problems in the form of thoughts. Sometimes verbal thoughts, sometimes images and sometimes sensory experiences and urges. These thoughts are designed to alert us to possible danger and tell us what to do about it. They come from the primitive and fastest part of the brain and therefore do not pass through a filter of social (or personal) acceptability.
This makes the most sense when we look at a common example. Someone suffering from travel anxiety following a car accident might have the recurring thought “I’m going to crash my car”. The mind has sent her that thought to try and protect her because it believes travelling in the car to be dangerous based on its past experiences. In response to her thought “I’m going to crash my car” the brain detects that she is under threat of harm and helpfully sets up the fight/flight response in the body leading her to feel tense, her heart rate to accelerate etc.
This happens because the oldest part of the brain, the bit that triggers fight/flight does not know the difference between thoughts and reality. It just reacts as fast as it can at the first sign of ANY threat, real or imagined. It has only one goal – to keep you alive.
If she tries to ignore the thought the mind will send her more and more similar thoughts because it thinks it is very important to warn her of the danger. If she tries to push the thought away by telling herself it isn’t true the mind is also likely to up the ante and start sending images to try and convince her of the danger. Both ignoring and trying to push away are therefore exhausting and ineffective.
The result is she is left thinking horrible thoughts and feeling tense and scared every time she gets behind the wheel of her car. Life is exhausting.
When you are pregnant and sick your brain detects the nausea itself as a threat AND it knows you are more vulnerable than usual so it gets very busy trying to protect you from danger. The result is often we feel anxious, worried, sad and depressed. This often makes it hard for us to live the lives we want to live even in the brief moments we are able to get off the sofa or do something other than vomit. For example, there were times in my first pregnancy when I couldn’t even face walking round the block because I was so anxious about being sick in front of strangers, even though the fresh air would probably have been helpful (and who cares if unexpectedly I fertilise someone’s Roses). I’ve worked with many women who have also found it hard to go to their antenatal appointments due to similar anxious thoughts, but of course this then becomes another source of anxiety for the brain to latch on to. Thanks brain!
What can we do about unhelpful thoughts?
Common sense often tells us that if we don’t like something we should try and get rid of it. The problem is that just doesn’t work when what we don’t like is our own thoughts and feelings and you don’t have that energy to waste right now. So, when you get thoughts that are difficult to handle, instead of fighting them it works best if you can learn to distance yourself from your thoughts. Let them float past you like leaves on a stream. If you can do this then the brain stops activating fight or flight as it gets the message that your thought isn’t a REAL threat that needs to be responded to.
But my thoughts ARE true!
Maybe…But are they helping you?
It may well be that your upsetting thoughts have a grounding in reality. The lady who has been in a car accident is, of course, right to note that there is some risk attached to travelling in a car and you might have had some worrying news about your pregnancy. Stepping back from the thought isn’t about saying it isn’t true. It is about giving yourself the freedom to behave in a way that helps you despite what is going on around you.
How to distance yourself from unhelpful thoughts
How on earth do I distance myself from my thoughts? They are in my head!!
There are actually lots of ways to do this. I spend time with my clients working through different exercises until we find one or two that work for them.
Here are a few of my personal favourites:
You could meditate – the aim of mindfulness is to create that distance between you and your thoughts. A meditation might involve focusing on your breath for a while and then imagining attaching your thoughts to leaves that you then send gently down a stream.
You can imagine the thoughts on a screen in front of you. Play with the font, size and spacing of the text. Move the words around on the screen and notice what effect that has on your response to it.
Lemons, lemons, lemons…. You know when you say the same word over and over again it starts to lose its meaning? Well you can do the same thing with a thought that is hard to deal with. Just repeat the most upsetting word over and over (out loud is best) until it starts to sound silly.
Sing it – choose a silly tune that you know well. For me at the moment it is the Mr Tumble theme tune (urgh!) and sing your unhelpful thought to it.
These techniques might sound a bit silly and people sometimes tell me they feel as though these methods are “making fun” of their upsetting thoughts. The thing is we are trying to tell our minds not to take our thoughts so seriously. We are trying to take a step back and give ourselves some space from our thoughts so we can get on with living life. These techniques can help us do that.
Acceptance and Commitment Therapy (ACT)
Separating from our thoughts is one of the most important parts of Acceptance and Commitment Therapy. This is often called a “third wave” Cognitive Behaviour Therapy as it is about the link between thoughts, feelings and behaviour but the focus is on living the life you want to live rather than “getting rid” of symptoms. I like to work in this way with my clients because if we know how we want life to be it is so much easier to be motivated to put in the work to get there. You can read more about ACT in The Happiness Trap by Russ Harris.
Book a therapy session
If you feel like you need a bit of help to live the life you want book in for a free consultation with a psychologist in my team. We can talk about how therapy can help you overcome depression, anxiety or trauma so you can do what matters to you.