1. Dr. Nic Hooper

2. Don’t think of a white bear!

3. What is thought suppression ? According to Daniel Wegner ‘attempting to banish ones unwanted thoughts’ In everyday terms It is the attempted removal of unwanted thoughts from the mind. A natural reaction Rachman and Da Silva (1978) 80% of people will attempt to suppress an unwanted thought

4. Why is thought suppression important? Smoking cessation (Toll, Sobell, Sobell & Wagner, 2000) Worrying (Mathews & Milroy, 1993) Stress (Roehrich & Goldman, 1995) Sleep impairment (Ree et al, 2004 ) ASD (Harvey & Bryant, 1998), OCD (Freeston & Ladouceur, 1997), GAD (Beckner et al 1988 ), PTSD (Foa, Steketee & Rothbaum, 1989; Ehlers & Steil, 1995), Specific Phobias (Thorpe & Salkovskis, 1997) Depression (Wegner, 1994)

5. Research outline Why is it that we cannot suppress our thoughts? What are the possible effects of thought suppression on behaviour? What are the alternatives to thought suppression in the management of unwanted thoughts?

6. Why is thought suppression futile?

7. Taught Untaught

8. Procedure 1. Screening measures 2. Equivalence training and testing 3. Five minute suppression phase 4. Induction of cognitive load 5. Avoidance program

9. Hooper, Saunders and McHugh (2010)

10. BEAR BOCEEM GEDEER

11. Opposition Relations and TS Opposition relations seem particularly interesting in this context When a person is trying to suppress a thought then one strategy may be to think of something that is very different or opposite along some dimension E.g., if I am trying not to think of something sad or depressing then I may think of something happy or uplifting However, doing so may eventually fail for the same reason that any other distracter fails – because the association between the stimuli is strengthened

12. Relational Network Target (‘BEAR’) Derived same Taught same Derived Opposite Derived Opposite Control

13. Procedure 1. Screening measures 2. Same opposite training and testing 3. Five minute suppression phase 4. Induction of cognitive load 5. Avoidance program

14. Stewart, Hooper and McHugh (under review)

15. But so what….. According to our results it is likely that thought suppression is difficult due to environmental reminders However, from an ACT perspective, we are not really concerned with whether we can suppress out thoughts per se Instead we are interested in valued living It is therefore more important to us to determine if thought suppression narrows our behavioral repertoire causing us to lose contact with our values

16. Thought suppression and behavioural avoidance

17. Procedure Screening measures Equivalence training and testing Five minute suppression phase Induction of cognitive load – (6-digit number) Preference program

22. Hooper, Stewart & McHugh (under review) Bear

23. Hooper, Stewart & McHugh (under review) Trained/Derived items

24. What can we do instead?! According to Relational Frame Theory (RFT) control based strategies like suppression only serve to enhance the relational network associated with an unwanted thought. In order to avoid the unwanted thoughts, one will also have to avoid all thoughts in the relational network as a transformation of suppression functions will occur. (Hooper, Saunders & McHugh, 2010)

25. Recent Alternatives Acceptance based strategies disrupt the transformation of stimulus functions I.e. they alter the aversive functions of the stimuli in a relational network Specifically, acceptance based strategies encourage the client to experience the unwanted thoughts without attempts at altering their form or frequency Defusion Defusion encourages people to distance themselves from their thoughts Mindfulness Mindfulness encourages present moment living, enabling people to come into contact with unwanted thoughts in a non judgemental manner

26. Intervention based research Defusion intervention study – learned helplessness Step one – screening questionnaires Step two – instruction; thought suppression, defusion, no instruction Step three - learned helplessness has been used in previous research to induce a depressed like state by exposing participants to an insolvable task. Step four – the dependent measure; maze task

27. (Hooper & McHugh, in press)

28. Intervention based research Defusion intervention study – food cravings Step one – Participants told they are to refrain from eating chocolate for 6 days Step two – Instruction; thought suppression, defusion, no instruction Step three –Participants had to record the amount of times they ate chocolate across a five day period, they also recorded the amount of cravings they experienced. Step four – Participants returned to the lab to complete a taste test, where rebound was measured.

29. Hooper, Sandoz, Ashton, Clarke and McHugh (2012) Defusion TS Control Cravings 13.25 9.29 11.71 Chocolate eaten 5.88 7.29 9.64 Minstrels eaten 3.31 14.59 10.93

30. Intervention based research Mindfulness based study – Spider fear Step 1 – screening questionnaires Step 2 – thought suppression/mindfulness inductions Step 3 – Behavioural Approach Test (BAT) Step 4 – anxiety measure

31. Behavioural Approach Test (BAT) 1. Move 1 metre to the table 2. Move 1 more metre to the table 3. Approach the table 4. Touch the jar for more than 10 seconds 5. Lift up the jar 6. Open the jar 7. Touch the spider with a pencil for more than 10 seconds 8. Remove the spider from the jar 9. Touch it with a finger for more than 10 seconds 10. Put the spider on their hand

32. Hooper, Davies, Davies and McHugh (2011) BAT data

33. Results – STAI data

34. Intervention based research Mindfulness based study – Stereotype threat (female math stereotype) Step 1 – Maths test 1 Step 2 – Mindfulness versus no mindfulness exercise Step 3 – Induction of stereotype threat Step 4 – Maths test 2

35. Weger, Hooper, Meier and Hopthrow (2012)

36. Future Directions Language and Behavioural Avoidance Inclusion of appetitive stimulus – up the valence Manipulation of values Intervention Based Research The development of different behavioural measures of the effectiveness of ACT component based techniques Public speaking Sports performance Studying behaviour Pain

37. Thank you