I work on a pretty unique college campus. There is a relatively stringent Honor Code that outlines appropriate standards of conduct for students. Among other things, the Honor Code limits sexual intimacy for students who aren’t married. As you might imagine, a portion of the 18 to 25 year olds who abstain from sexual expression experience some anxiety around the topic.
I’ve met with quite a few young people in therapy who have trouble with this area. Thoughts and behaviors that are sexual in nature can produce quite a bit of guilt and confusion for these students, especially if they occur over and over again. What I’ve found with a segment of students that I work with is that their guilt often isn’t sufficient to get them to stop thinking about sex.
One young man who I worked with was particularly distraught about this issue. He described having to hum songs and keep his eyes down as he walked around, so as not to have sexual thoughts triggered by seeing attractive women around campus. He expressed having a running dialog in his mind during moments of anxiety, which he believed kept his thoughts focused on things other than sexual topics. It went something like this:
“OK, I’m walking to class… not really thinking too much about sex or anything. Just gotta keep looking down as I walk – I won’t see anything that will make me think about sex… Oops, I just looked up and saw the girl walking in front of me. I looked at her body – now I’m thinking about sex… I’ll hum a song in my mind so I don’t think about sex. Don’t think about sex… don’t think about sex…”
Ironically, this guy’s anxiety about not thinking about sex was so significant that it occupied his mind constantly. So much of what he did – who he interacted with, how he walked, what he thought about, how he would spend his time – these things were influenced by anxiety and guilt about keeping his thoughts “clean.” And thus the idea of “sex,” instead of becoming a smaller influence in his life (what he intended), gained increasing power over him on a daily basis.
Historically, cognitive-behavioral strategies in psychotherapy have emphasized learning to “control” our thoughts, in order to favor thought processes that optimize healthy social and emotional functioning. It’s a nice idea, isn’t it? I can think about what I want to think about. This belief gives us a sense of control in our lives, like we are “the master” of our mind, rather than subject to its whims. The alternatives are unsettling. I can sometimes think about what I want to think about? I can’t control what I think about?
I’ll sometimes do an activity with my class to demonstrate that not all of our thoughts are consciously controlled. I’ll show them four words, and ask them to complete the sentence. The four words are “Mary had a little…” Technically, we could theoretically use any ending to complete this sentence. “Mary had a little apprehension about her spelling test.” “Mary had a little gambling problem.” However, the vast majority of people complete this sentence (as you might have) by saying “Mary had a little lamb.” The brain wants to end the sentence with “lamb,” because that’s what it’s wired to do, at least for those of us who grew up with that nursery rhyme. It’s the most automatic response, and alternative responses take more effort.
Now imagine that instead of the phrase, “Mary had a little” being the trigger, it’s a visual stimulus, like seeing someone who you could be physically attracted to. And instead of the word “lamb” being the response, it’s a sexual thought. In a very similar way to how we’ve made an association between the words “Mary had a little,” and “lamb,” this young man who I worked with had an association between seeing a pretty girl and having a sexual thought. That was, perhaps, one problem he was dealing with. The bigger problem, however, had become the fact that he was opposing this thought process, and thus opposing his own brain – fighting a battle that was inherently unwinnable.
Newer cognitive behavioral therapy models, such as Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT) emphasize acceptance of thoughts, rather than opposition. This seems counter-intuitive at first glance. Accepting a thought you don’t want to have is like giving in, capitulating, throwing in the towel, isn’t it? It’s weak, and ensures that the thought will never go away. What we find, however, is that this actually isn’t the case.
My client was stuck in a pattern of thoughts about sex and experiencing shame and anxiety as a result. His fears about having a sexual thought made him try to control his thoughts, and every unsuccessful attempt made him try to clamp down harder on his thoughts. He eventually reached a point where he was so anxious that he became less able to cope with his thoughts. If, instead of attempting to oppose his thoughts, he could begin to accept that they happen, he would become much more able to work through them.
For this young man, acceptance could involve saying something like, “Oh, I noticed an attractive woman, and I had a sexual thought as well…” What doesn’t then happen is the attempt to control the thought. Instead, he accepts that it happened, accepts that it’s OK for it to happen sometimes, and then moves on. “What should I have for dinner tonight…”
At its heart, acceptance is a very zen concept. It recognizes the limits of our ability to control our lives, and suggests that directing our efforts toward working effectively with what we’re given leads to greater inner peace than trying to oppose it. What I have noticed is that as my therapy clients sacrifice their need to control their lives in order to practice acceptance, their anxiety (even chronic, long-term anxieties they have had) begins to loosen its grip over them.
Ironically, as we let go of needing to be liked by others, people will like us more. As we let go of needing to get the grades, the job, or the money, whatever cognitive resources were occupied by anxiety about these things become free for us to use to obtain them more effectively. We can let go some of the things we think we need, in order to live with the kind of peace that enables greater success.