Can suppressing unwanted thoughts be good for your mental health?

Sep 26

Trigger warning: if you are a therapist you had better sit down before reading further, because a new research paper has just come out with the disturbing news that you can improve someone’s mental health by training them to suppress unwanted thoughts.

When I came across this paper my reaction was ‘Ok. This must be research by some wild-eyed undergraduates high on TikTok influencers and Pro Plus’. However it turns out to be from experienced neuroscientists from the University of Cambridge, published in the respected journal Science Advances.

This study is controversial because it challenges the received wisdom that although suppression of disturbing thoughts might help in the short term, it can rebound, resulting in even greater disturbance. It’s a complex and detailed paper – and some commentators seem to have dismissed it too quickly – but to cut a long story short, the researchers trained 120 participants to suppress thoughts that were personally distressing to them. The results were that “suppression reduced memory for suppressed fears and rendered them less vivid and anxiety provoking. After training, participants reported less anxiety, negative affect, and depression with the latter benefit persisting at 3 months”. This training was more effective when suppressing negative thoughts than when suppressing emotionally neutral thoughts or positive thoughts.

“These findings will be surprising – even unacceptable - to many therapists, but apparently there is already evidence from neurobiological research that suppressing thoughts helps maintain mental health.”

Those reporting higher trait anxiety and post traumatic stress benefitted the most from suppressing their distressing thoughts. In fact the 11 participants who could be provisionally diagnosed with PTSD based on their Impact of Events Scale scores “showed significant mental health benefits 3 months after suppressing fears”, in terms of improved depression, negative affect, and anxiety, and wellbeing.

It is important to note what is meant here by thought suppression in this study. In contrast to being asked ‘Don’t think about a white elephant’, and then finding it almost impossible to not think of a white elephant, the task was for participants in this study to “persistently confront reminders that reactivate their fearful thoughts […] and then suppress awareness of the associated memory” without substituting the feared thought for another thought.

***Image: Man playing Whac-a-mole. (**Photo*** ***by Unknown Author, licensed under*** ***CC BY-SA-NC***).

The task in this study then is an example of retrieval suppression, which is said to be less likely to lead to the ‘ironic rebound’ of increased negative thoughts and feelings. (For a more complete description of the retrieval suppression task in this study, see paragraph 5 of the Procedure section here)

These findings will be surprising – even unacceptable - to many therapists, but apparently there is already evidence from neurobiological research that suppressing thoughts helps maintain mental health. “For example, engaging the right lateral prefrontal cortex to suppress intrusive thoughts is associated with greater resilience to developing post traumatic stress disorder (PTSD) after violent trauma”.

Are there any obvious errors in the methodology of this new study? Experimental psychology is not my field, but as far as I can see there are no obvious problems. The characteristics of the participants don’t really explain much; the 120 participants were recruited from the MRC Cognition and Brain Sciences Unit participant panels, supplemented by a few more from social media and word of mouth, which suggests that they might not be all that different to people in the general population. Participants were excluded if they were not fluent in English, or if they had a history of Attention Deficit Hyperactivity Disorder (ADHD). They were from 16 different countries and received the training via Zoom. The research design seems sound e.g. there was a three-month follow-up, and the presentation of negative, neutral or pleasant events involved randomization. The sample size might be considered slightly small, but then again they found a significant effect of the training, which suggest that the sample size was sufficient at least to detect the effect of training in suppression on mental health.

“…blaming men’s wellbeing on not talking about their feelings is missing the point that they may tend to deal with feelings in other ways”.

It is always salutary to have one’s beliefs challenged by good research, and can be a valuable learning experience. So what can we learn from this study that is relevant to male psychology? Well, it has become popular to say that men’s mental health problems are due to masculinity. Part of the problem, it is said, is that when men (men in general, not all men) have problems they don’t talk about their feelings because that’s a sign of unmasculine weakness. However there is evidence that men – by and large - process distressing feelings differently than women do, with men more likely to want to take part in activities whereas women are more likely to prefer to talk about their feelings. So blaming men’s wellbeing on not talking about their feelings is missing the point that they may tend to deal with feelings in other ways. It is also true that stoicism – which doesn’t require talking about one’s feelings so might look like ‘bottling up’ feelings to the casual observer – is a cornerstone of Rational Emotion Behaviour Therapy (REBT), which research has shown to be an effective therapy. However if your coping style is to grimly squash down feelings that are threatening to gush out everywhere, then unless you are in a ‘life or death’ situation, such as a military action, this is not the best approach to dealing with everyday life, and most therapists would probably agree with that.

So can suppressing thoughts be good for your mental health? The answer according to this new research is yes, as long as you use retrieval suppression. Can it be used as a therapy? The authors of the paper conclude that “the substantial and durable mental health benefits, safety, high endorsement, spontaneous use, and accessible delivery make suppression training a promising and scalable intervention on its own” or as a complement to other therapies.

We should wait for replication of these remarkable findings before rewriting the textbooks on therapy, but in the meantime we might agree that although it’s good to talk to someone you can trust, we might respect the coping style of the strong silent type a bit more too.

Scroll down to join the discussion

Disclaimer: This article is for information purposes only and is not a substitute for therapy, legal advice, or other professional opinion. Never disregard such advice because of this article or anything else you have read from the Centre for Male Psychology. The views expressed here do not necessarily reflect those of, or are endorsed by, The Centre for Male Psychology, and we cannot be held responsible for these views. Read our full disclaimer here.