Suggestion | Overthinking at night? 6 strategies for better sleep.

Suggestion |  Overthinking at night?  6 strategies for better sleep.

Overthinking at night — about insomnia and other things — is a common problem for many of my sleep-disturbed patients. It interferes with falling asleep or returning to sleep, and prevents peaceful rest when they still can’t sleep.

Overthinking usually refers to thought processes such as racing thoughts or persistence. Content — such as worries or demands of the next day — may also be maladaptive. It may be triggered by a diagnosed condition such as depression, generalized anxiety disorder, obsessive compulsive disorder (OCD), attention deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), or hypomania. It can also be stimulated by intense experiences such as stress, exciting plans, perfectionism, insecurities, caffeine use or painful or worrisome life events.

There are many psychological tools to help overcome overthinking, but two people with comparable struggles may not benefit from or prefer the same tools. We insomnia specialists try to provide a large and diverse set of tools that address causes or manifestations without sacrificing specificity.

Regardless of the tool, there are some general principles that can help overcome overthinking:

  • Suppressing unwanted thoughts can make them more determined, and they can come back. Good technique allows us to coexist peacefully with our thoughts.
  • At night, it is best to use simple, calming techniques that don’t dwell on the content of our worries.
  • Issues that fuel overthinking — such as overwork, too little support, isolation, guilt, mental health issues, and inadequate exercise — are important. Why are you overthinking? What do you need more or less in your life? These questions are best addressed in the afternoon or evening.
  • Engaging in negative thinking or excessive anxiety can condition unwanted thought habits. Buddhist teacher Thich Nhat Hanh warns us to be careful which plants we repeatedly water in our minds. These are plants that will grow big and strong and, in turn, require a lot more care and feeding.

One of my patients is a caring spouse, mother and friend, and successful in a meaningful and demanding career. He has a child with mental health defiant and will wake up at night worried, questioning his own actions and playing out possible scenarios.

These thoughts are not constructive and interfere with rest and sleep. Talking through her feelings of helplessness and fear is important. I also offered him some helpful strategies. Here are some of them:

Use a calming distractor

During periods of insomnia, turn to more relaxing thoughts to compete with your innate thoughts. The human mind cannot entertain two narratives simultaneously.

Listen to a peaceful audiobook, a podcast or talk radio program, or read a relaxing story or book (in very low, blue-blocked light). Whenever an unwanted thought arises, don’t push it away. Let them recede into the background and gently return your attention to your relaxing distraction.

If interior techniques like visualization stick around long enough for you (they don’t for many), explore calming and fun memories like a vacation or a room at your grandmother’s house. Don’t choose a distractor that will keep you awake, and don’t focus on sleep as a goal when using it.

This is, at most, a 30-minute technique that should be used in the afternoon, after the stressful part of the day but hours before bed if there is any residual stress or worry.

By confronting problems constructively, they tend to bother us at night. This technique also teaches us to tolerate inaction or reflection when the time has not come.

Make a list of all your worries and stressors. For each question, ask yourself: Is there anything I can do about this in the next two weeks (even if I can’t completely solve this problem)? If so, what can you do and when exactly will you do it? Action steps should mitigate the problem itself, such as setting up a payment plan for overdue bills, or emotional problems effects, such as reminding yourself that more income-generating jobs are coming.

Update the list nightly and continue with the action steps until you no longer need the technique.

Give yourself an optional few minutes each night to think any way you want about the items on the list. The rest of the day and night, when the thought arises, say, “Not now; I will contact you during the scheduled worry time. If you’ve decided that there’s nothing to be done about a particular problem, when the thought of that problem comes up, remind yourself that there’s nothing to be done.

Try exposure therapy for thoughts

This is a daylight technique. Variant is used for thoughts that can accompany OCD, but I teach it for preoccupied thoughts more generally.

  • Take a few days to list your recurring negative and anxious thoughts.
  • Record into the audio recorder on your phone or computer three times in one long recording.
  • The first time, speak the thought in the tone that naturally comes into your head.
  • The second time, exaggerating the tone.
  • The third time, make the tone nonsensical.
  • Listen to the recording repeatedly for an hour a day while you are doing something else like playing a computer game that doesn’t involve words or sounds, or cleaning.

You may feel a little worse at first (and you can always ignore this technique if necessary). However, after a few days, the recording will become so boring and the background noise so repetitive that when thoughts pop up in the privacy of your head, they easily move into the background.

Examine the feeling of being ignored

This is a technique for getting in touch with buried feelings. I recommend it especially to those who are preternaturally competent and stoic, rarely allowing themselves to feel vulnerable. Those feelings may overtake them at night in the form of distress and overthinking.

Mornings are a pleasant and calm time to get in touch with feelings that are being overlooked. This is a listening task, not a thinking task.

Encourage yourself with half sentences like: “What I’m afraid of is” or “What makes me sad is” or “What I’m disappointed about is” or “What I’m ashamed of is” or “What I regret is” or “What makes me I am traumatized is.” Pick a few half sentences per sitting Commit to seriously addressing what comes up at a later time (not in the evening).

Cognitive therapy techniques invite us to bring rational thinking – for example, evidence for and against, and correction of cognitive distortions – to support our assumptions.

It can be an excellent tool during the day to reassess our worries and other upsetting thoughts. For example, if you are worried about something, ask yourself what the worst, best, and most likely outcome would be, in that order.

Beneath the rational veneer, there may be a part of us that is very fearful. Children do not ask their parents to prove their soothing statements or ask what qualifies them to make such statements; they bask in a soothing place.

Develop more soothing language and a kinder tone to yourself (day and night), and try to believe in yourself. There are lots of other strategies for calming down too.

I’ve written before about repeatedly observing a person’s overthinking to cultivate self-awareness and establish habits of competing thoughts. There are many other useful techniques—from meditation to journaling to rest periods to relaxation techniques like breathing to slow your thoughts and Yoga Nidra to keeping a piece of paper by your bed (to use sparingly) to jot down the things you desire. remember tomorrow to worry about exposure.

I hope that some of the techniques I’ve suggested got you off to a good start and help you reduce or eliminate overthinking and get a good night’s sleep.

Lisa Strauss, PhD, is a clinical psychologist in private practice in the Boston area. He specializes in sleep disorders.

We welcome your comments in this column at OnYourMind@washpost.com.

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