A Case Presentation: Coping With Intrusive Thoughts

    When we are stressed, we tend to suffer from intrusive thoughts. As a result, we have difficulties concentrating and sleeping. Since most people tend to have intrusive thoughts while being stressed, it may be assumed that it is a genetic trait that helped our ancestors to survive. When our ancestors had a negative experience, they probably suffered from intrusive thoughts for a long period of time, until they came up with a plan how to cope better, in case the negative experience should reoccur. When they had catastrophic expectations, they probably suffered from intrusive thoughts for a long period, until they came up with a contingency plan. Unfortunately, most modern humans, when they have a negative experience or catastrophic expectations, instead of using the experience or expectation to enrich their life experiences, they just suffer from intrusive thoughts.

A Case Presentation:

    Jack works as technician in a factory. He is married and has two children. Jack loves his job but, due to the recent economic crisis, he anticipates being laid off in the near future. During the last month, he has hardly slept more then a few hours each night. Intrusive thoughts about being unable to get another job bother him day and night.
    In order to understand Jack's catastrophic expectations, I asked him, "How do you see the future, in case you will be laid off?"
His answer was very quick: "I am afraid to think about it. If it happens, I would feel awful. It will be disastrous for my family."
    I asked Jack, "If your fears would actualize, would you get crazy and be hospitalized? Or, would you commit suicide?"
    Jack answered very quickly: "No way, I would never commit suicide, and I am not going to get crazy. My family needs me. They would not survive without my help."
     "So what would you do?" I asked.
    "I told you. I am afraid even to think about it," he answered with tears in his eyes.

    I told Jack about Lucy's Legacy (For more details review chapter: "Evolutionary Psychology'") and how she survived in her harsh environment. I also mentioned how people survived during the Holocaust and world wars. I explained to Jack the contribution of intrusive thoughts to the survival of Lucy and her contemporaries. "When Lucy heard that a new predator invaded their territory, she became vey scared and suffered from intrusive thoughts and probably she did not sleep at nights like you. However, the important difference between the two of you is that she made a contingency plan such as: If the predator attacks from the left side, I'll climb a tree and if it attacks from the right side, I'll jump to the lake. The problem with your approach is that you just keep thinking about the problem and not how to cope with it."

    While Jack's eyes were closed, I guided him to imagine the future. "Imagine that the economical crises would intensify and you were laid off. Although you do your best to find a job as a technician, there is none. You don't have enough food in the house. What are you going to do? How would you and your family survive?"
    "I know a few upper middle class families who live in my home town. I'll offer myself as a handy man. I can take good care of the yard, fix broken appliances, paint a house etc. I'll ask for minimum wage. We'll eat only basic food, no desserts, no sodas, purschase no new clothes, attend no movies. We will just survive."
    "Would your wife and your children go along with your plan? Would they be disappointed in you?"
    "No, they'll be proud of me. We will survive as Lucy survived in her harsh environment. Am I not her close relative?" He said in assertive voice.
    Jack opened his eyes, looked straight at me, and said, "Thank you very much for forcing me to look at the future. We'll make it. We will survive."

    I suggested that Jack share with his wife our discussion and ask her to join us in the next session. Jack's wife was very supportive of him during our next meeting. She told Jack that she was aware of the fact that he is worried about being laid off from his job, but she did not realize how much he was afraid of the future. Jack told her that he did not share with her his feelings because he did not want to worry her. She stated, that if worse-comes-to-worse, she his willing to look for any type of work, such as working as a nanny or even cleaning houses. She turned to Jack and said, "I'll be like Lucy and you'll be like Lucy's boyfriend. We are going to survive and teach our children how to survive without complaining."

    Jack is still working in the same place and he is still worried about being laid off, but he is less anxious and he sleeps better at nights.