https://pixabay.com/users/colin00b-346653/
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Attention, Memory, Intrusive Thoughts, and Acceptance in PTSD: An Update on the Empirical Literature for Clinicians:
Jillian C. Shipherd and Kristalyn Salters-Pedneault
Excerpt:
“Additionally, intrusive thoughts tend to be experienced with a sense of “now-ness” (although the individual usually does not lose awareness of other aspects of the present moment, as in a flashback), and are regarded as separate from intrusive ruminatory or evaluative thoughts about the trauma (Hackmann et al., 2004).
In fact, the “now-ness” of intrusive thoughts is more intense in trauma survivors with PTSD as compared to those without (Schonfeld & Ehlers, 2006). As discussed previously, this is hypothesized to be related to the poorly elaborated memory and disjointed way that trauma memories are stored (see Ehlers, Hackmann, & Michael, 2004).
Although intrusive thoughts are an expected and normative part of trauma recovery, trauma survivors often report that the thoughts are disturbing, and are an indication that they are “going crazy” (Shipherd, Beck, Hamblen, & Freeman, 2000).
When an intrusive thought occurs, it can be associated with emotional distress, physiological arousal, and interference with concentration or task completion, lasting anywhere from minutes to hours.
It is understandable that survivors would want to avoid this experience (e.g., Lazarus, 1983).”
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My two cents: Psychological définitions do not describe my intrusive thoughts.
They are prolific in volume, but hold little fear, mostly unworthiness and shame mixed with anger.
The emotions of harm feel real. My intrusive thoughts are accurate, public sexual humiliation came from a real betrayal.
I can not reframe that in to anything good, after a childhood of abuse, this trauma destroyed trust.
Realize at 69 the damage between childhood and this betrayal is massive, I am still haunted, suffering to this day.
I have accepted it and surrendered to it, but that storyline continues.
I have done the work with therapists and this intrusive thought lives on.
Now, they say avoidance or trying to squash these intrusive thoughts does more harm.
So what does someone do, whose intrusive thoughts run constantly like mine at times?
How would you like the worst day of your life to play over and over and over and over and over and over and over and over and over and over and over and over?
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PTSD - A Way Out.com 
Posted by Don't Lose Hope on March 26, 2021 at 1:12 pm
That’s so true. And they also feel so insistent and attention-grabbing.
Posted by Marty on March 26, 2021 at 1:13 pm
I did not think I was the only one who experiences these kind of intrusive thoughts
It’s like a machine gun but instead of bullets trauma thoughts are fired
Posted by Marty on March 26, 2021 at 2:38 pm
More of this article
Intrusive Thoughts
It is generally common for all people to experience unwanted intrusive thoughts (Rachman & de Silva, 1978; Salkovskis & Harrison, 1984). Intrusive thoughts are even more likely following traumatic events and are a hallmark and troublesome feature of PTSD. These thoughts are typically short sensory flashes (most commonly visual) of discrete aspects of the trauma (e.g., Ehlers & Steil, 1995; Hackmann, Ehlers, Speckens, & Clark, 2004). Additionally, intrusive thoughts tend to be experienced with a sense of “now-ness” (although the individual usually does not lose awareness of other aspects of the present moment, as in a flashback), and
are regarded as separate from intrusive ruminatory or evaluative thoughts about the trauma (Hackmann et al., 2004). In fact, the “now-ness” of intrusive thoughts is more intense in trauma survivors with PTSD as compared to those without (Schonfeld & Ehlers, 2006). As discussed previously, this is hypothesized to be related to the poorly elaborated memory and disjointed way that trauma memories are stored (see Ehlers, Hackmann, & Michael, 2004).
Although intrusive thoughts are an expected and normative part of trauma recovery, trauma survivors often report that the thoughts are disturbing, and are an indication that they are “going crazy” (Shipherd, Beck, Hamblen, & Freeman, 2000). When an intrusive thought occurs, it can be associated with emotional distress, physiological arousal, and interference with concentra- tion or task completion, lasting anywhere from minutes to hours. It is understandable that survivors would want to avoid this experience (e.g., Lazarus, 1983). Unfortu- nately, avoidance is central to the psychopathology of PTSD and turning off intrusive thoughts can undermine recovery. Indeed, the use of suppression as a coping strategy following trauma has been found to predict psychological distress in survey studies involving both adults and children (Aaron, Zaglul, & Emery, 1999; Amir et al., 1997; Ehlers et al., 1998; Morgan, Matthews, & Winton, 1995). These findings support the theoretical notion that survivors who attempt to avoid aversive memories by suppressing intrusive thoughts may, ironi- cally, be facilitating the maintenance of these symptoms, a supposition that has been discussed by several authors (Amir et al., 1997; Amir, Cashman, & Foa, 1997; Ehlers et al., 2004; Gold & Wegner, 1995; Purdon, 1999; Purdon & Clark, 2000; Steil & Ehlers, 2000; Trinder & Salkovskis, 1994).
Attempts to “push away” or suppress thoughts and emotions about the trauma are avoidance symptoms of PTSD, and are endorsed by individuals in survey research (e.g., Bryant & Harvey, 1995; Parkinson & Rachman, 1981; Roemer, Litz, Orsillo, & Wagner, 2001). Unfortunately, suppression or avoidance may lead to the return of (or increase in) intrusive thoughts about the trauma. Indeed, in a prospective study, avoidance-based coping styles (as measured prior to the trauma) were predictive of PTSD symptoms one month post-trauma (Gil, 2005). Conver- sely, approach-based coping has been shown to be helpful (e.g., Tiet et al., 2006) and is an important aspect of empirically supported treatments for PTSD (e.g., Butler et al., 2006).
Thought Suppression and Intrusions
An experimental paradigm called the thought suppres- sion task was developed by Wegner and colleagues (Wegner, Schneider, Carter, & White, 1987) and has
Empirical Studies of PTSD 357
been widely used in the study of thoughts (see also Wegner, 1994; Wegner & Erber, 1992). The thought suppression task is informative for studying the both the intentional and ironic effects of attempts to suppress thoughts about traumatic events. A series of studies have compared the performance of trauma survivors with and without PTSD (Amstadter & Vernon, 2006; Shipherd & Beck, 1999; 2005) to examine the relevance of thought suppression in PTSD psychopathology. While the findings vary somewhat, PTSD patients have most often demon- strated difficulty suppressing thoughts, with an increase in trauma-related thoughts after suppression instructions were lifted (a rebound effect). This effect has been discussed as an analogue for what occurs naturally when trauma survivors try to avoid intrusive trauma-related thoughts. Following suppression, the trauma-related thoughts become more likely to return with greater frequency, and can be subjectively more distressing and interfering. Indeed, distress related to the thoughts appears to be a central component the maintenance of PTSD (e.g., Denson, Marshall, Schell, & Jaycox, 2007), as regardless of PTSD status, all treatment seekers experi- enced a rebound following successful suppression (Beck, Gudmundsdottir, Palyo, Miller, & Grant, 2006). Indeed, a larger literature on “repressors” (a term for individuals who tend to suppress thoughts), indicates that repressors have more intrusive thoughts than people without this tendency (e.g., Geraerts, Merckelbach, Jelicic, & Smeets, 2006). Thus, the empirical literature supports the theoretical notion that attempts to avoid trauma-related thoughts will lead to an increase in intrusion. In sum, short-term relief from the thought is followed by long- term distress.
Deconstructing Thought Suppression
Given that intrusive thoughts are common following trauma, and that both avoidance and approach-based reactions to the thoughts are possible, it is important to consider specific thought suppression strategies more closely (e.g., Cioffi & Holloway, 1993; Lin & Wicker, 2007; Salkovskis & Campbell, 1994; Salkovskis & Reynolds, 1994). Recently, authors have begun to contemplate that thought suppression can occur via many different strategies and that there may be both adaptive and maladaptive strategies. The authors of the Thought Control Questionnaire (Wells & Davies, 1994) consider five different types of thought control, tapping both approach (social control, reappraisal) and avoidance- based strategies (distraction, worry, self-punishment). Sample items from this measure include: I ask my friends if they have similar thoughts (social control); I try a different way of thinking about it (reappraisal); I keep myself busy (distraction); I worry about more minor things instead (worry);
I tell myself not to be so stupid (self-punishment). Interest- ingly, distraction (an avoidance-based strategy) is asso- ciated with increases in thoughts both when trying to suppress trauma-related thoughts (immediate enhance- ment) and following suppression (rebound effect), even after controlling for PTSD symptoms (Shipherd, Tanner, & Beck, 2007). In contrast, social control was associated with successful suppression and an absence of rebound effect (Shipherd et al., 2007). Further, reappraisal of intrusive thoughts was not associated with performance when trying to suppress, but was associated with the rebound effect, even after controlling for level of PTSD symptoms (Shipherd et al., 2007). Indeed, negative self- appraisals in the week following a traumatic event are related to PTSD symptom development over time (O’Donnell, Elliott, Wolfgang, & Creamer, 2007), and rumination over “what if” and “why” a trauma occurred is associated with poor outcomes (Michael, Halligan, Clark, & Ehlers, 2007). Together, these findings suggest that it is not the presence of symptoms that is abnormal, but responses and reactions to the presence of symptoms that is central to recovery.