Learning to Notice Thoughts

Meet Alice. She's a 42-year-old mother of two with a demanding career and a long history of anxiety, depression, shame, and negative self-talk. She's been in therapy for years, yet in many ways, her life has only become more painful. She decides to give therapy one more try and seeks out a new therapist who practices a type of therapy she's never heard of: Acceptance and Commitment Therapy (ACT).

During the first session, the therapist asks standard questions about Alice, her life, and her pain. The therapist also explains what ACT is and how it differs from other approaches. Alice feels a good rapport with the therapist and leaves hopeful. But as she drives home, she begins to feel sad and frustrated. Behind those difficult feelings is the following realization:

I don't think ACT therapy will work for me.

As this thought rings in her mind, Alice feels even sadder and more hopeless. More thoughts follow: "What if nothing works?" and "What's the point of trying again?" As a card-carrying people pleaser, Alice decides not to waste the therapist's time. She cancels her next session and wonders whether she should resign herself to a life of anxiety and depression.

I Think Therefore I Believe

We'll get back to Alice in a moment, but first, let's think about thinking. The 17th-century philosopher René Descartes famously said, “I think, therefore I am.” But when it comes to understanding how thoughts work, I find this variation more helpful: “I think, therefore I believe.” Here are some examples:

I think it’s going to rain = I believe it’s going to rain

I think the Red Sox will win = I believe the Red Sox will win

I think I’m a good person = I believe I’m a good person

I think I’m a failure = I believe I’m a failure

I don’t think ACT will help = I don’t believe ACT will help

I want to clarify one thing: I'm not asking you to believe that ACT will help. ACT doesn't work for everyone. However, more than 3,000 studies have demonstrated its effectiveness in reducing many forms of human suffering, including depression, anxiety, negative thoughts, and suicidality. It's completely OK to believe ACT will help, and it's equally OK not to. But something more important than belief is required here: a willingness to give it a try.

Can you be willing to try, even if you have doubts?

What does your experience tell you about this? Have you ever tried a new food while believing you wouldn't like it, only to find it delicious? Have you ever doubted a new job, partner, or hobby so much that you almost decided not to take the chance, only to find later that things worked out well?

I can't guarantee ACT will work that way for you. But if you've never tried ACT, there's no way to know whether it will help, even if your mind tells you it definitely will—or certainly won't. Belief isn't required, and doubts are completely OK. I only ask for openness to the possibility that ACT may help, along with a willingness to give it a try.

Now, back to Alice. Although I'm using a pseudonym, she was actually my client. I respect every client's right to decide whether to engage in therapy with me or work within the ACT model. However, I also know that doubts can become so strong at the beginning of therapy that the belief “It won't work” becomes a self-fulfilling prophecy. When I saw that Alice had canceled our next session, I called and asked why.

“I’m so sorry,” she said. “You seemed very nice, and I'm sure you're great at your job. But I just don't think ACT is going to work. I feel like I've tried everything. This is just another flavor of the week, and I don't want to waste your time on a hopeless cause.”

I validated Alice's skepticism and reminded her that continuing was completely up to her. Then I asked whether she would be willing to talk for about 10 minutes so we could understand what was happening in her mind.

Alice agreed. I asked her to bring the thought I don't think ACT therapy will work for me into her mind and really buy into it—to believe it and take it as gospel truth. I then asked her to notice what she felt. She reported even more sadness, frustration, and hopelessness.

Next, I asked her to change the thought—not from the negative “It won't work” to the positive “It will work,” because this wasn't an exercise in positive thinking. Instead, I asked her to describe the experience of having the thought more accurately by saying:

"I'm having the thought that ACT therapy won't work for me."

After sitting with this version for a few moments, I asked what she was feeling. Alice said, “I'm still not sure, but this thought doesn't feel like it has to stop me. I guess it's normal to have doubts. I can have this thought without giving up already. I guess I'll come back next week, if you don't mind.” Alice didn't get rid of this thought or change it from negative to positive. Instead, she created a sense of distance from the thought. Just by noticing this thought as a thought, Alice was able to step out of the battle with it. This led to a new sense of openness: "I can have this thought and still give ACT a try."

Here are the two versions of the thought. The first appeared automatically in Alice's mind after our first session. The second is the slight revision I asked her to hold during our follow-up call. Do these phrases mean the same thing? Read them again:

I don't think ACT therapy will work for me.

I'm having the thought that ACT therapy won't work for me.

What's the difference? For one thing, one is a judgment, and the other is a fact. Can you tell which is which? If you noticed that the second phrase—“I'm having the thought that ACT therapy won't work for me”—is a fact, good job. It is a fact that Alice had this thought, while the thought itself is a judgment.

Remember, I'm never going to ask you to simply believe that ACT will help. The only way to know is to experience something new or different while remaining open to the possibility that ACT may help you suffer less.

Practice ACT Skills: Notice a Thought and Unhook

So now it's your turn. Bring to mind a painful thought you've had about yourself, or an anxious “what if,” and hold it in your mind for about 30 seconds while really buying into it. Then rephrase it like this: “I'm having the thought that…” Here are a few examples:

I think I’m a failure = judgment/belief

I’m having the thought that I’m a failure = fact (you are indeed having this thought)

I think it’s going to rain = judgment/belief/prediction

I’m having the thought that it’s going to rain = fact

See if you can get a sense of what this means. If you have the thought “My life is hopeless,” that is a judgment. Even if you don't always believe it, there are probably times when you do. I don't genuinely believe anyone's situation is hopeless, but if I had just met you, I might say, “I don't know whether your life is hopeless. But I do know one thing: you sometimes have the thought ‘My life is hopeless.’ Can we agree on that?” Did you notice any difference between the raw form of the thought (looking from the thought) and the revised version (looking at the thought)? If you didn't, that's OK; please hang in there.

I Am a Kangaroo

Sometimes silly examples help illustrate this point. Close your eyes and bring the thought "I am a kangaroo" into your mind. Hold it there and let yourself buy into it. Let yourself believe it is simply true: I am a kangaroo.

Now, if you're reading these words, I'm going to assume you are not a kangaroo. You probably know that, and you're likely not taking the thought "I am a kangaroo" seriously. It just sounds silly. But if you were able to hold that thought in your mind, then the statement “I'm having the thought that I am a kangaroo” is a fact. It is a fact that you had the thought.

Now what if I said, “I think I know what your problem is. In my expert opinion, you are a kangaroo. And of course, kangaroos pretending to be human can't have a good life. That is my official evaluation, and that will be $120, thank you.”

I am a kangaroo = evaluation

I’m having the thought that I’m a kangaroo = fact

Other examples of evaluations:

I can’t be happy because of my childhood trauma = evaluation

I’m having the thought that I can’t be happy because of my childhood trauma = fact

I’m not the kind of person who does mindfulness = evaluation

I’m having the thought that I’m not the kind of person who does mindfulness = fact

Observations and Evaluations

One goal of ACT is to help you see your thoughts differently rather than trying to think different thoughts. When we encounter unwanted thoughts, our usual strategy is to change or avoid them. Unfortunately, that often leads us deeper into pain. Like struggling in quicksand, struggling with painful thoughts usually gets us mired deeper in the muck.

Instead, we can learn to see thoughts from a different perspective and reduce their impact without changing or eliminating them. One important way to do this is to notice the difference between observations and evaluations.

Your mind gives you two broad categories of thoughts. Some are descriptions of what we see, hear, touch, taste, and smell, or descriptions of objective facts. Others—especially the thoughts we struggle with—are evaluations. Evaluations can take the form of judgments, predictions, assumptions, or any other thought that doesn't describe the world objectively.

Here are a few examples:

My boyfriend hasn't texted me in eight hours = observation

…so he’s probably cheating on me = evaluation

I didn't get the job I applied for = observation

…I’m such a failure = evaluation

Notice that evaluations often come after observations. In fact, giving you judgments and evaluations is one of your mind's most important jobs. Should I eat this, or is it poisonous? Are those people from the other tribe friend or foe? Can I climb this tree to get the honey, or will the bees swarm me?

These are evaluations, or attempted predictions. Even when they are factually wrong, evaluations are one tool our minds use to keep us alive. But when those evaluations boomerang on us as old, deep, personal, painful thoughts like “failure” or “bad,” our usual way of interacting with them (suppression, reframing, rumination, belief) can amplify the thoughts, and our pain.

Bringing It All Together

One of the most important ACT skills is learning to notice thoughts as thoughts. Put another way, it's the ability to look at a thought rather than from a thought.

Have you ever left your sunglasses on indoors, walked around turning on lights, and wondered why your house was so dark? At 52, this happens to me more than I'd like to admit.

Arrrgh! What’s wrong with these lightbulbs? I can’t see a thing. Maybe I’m going blind! Is there a brownout? It's so dark in here; I hate this!

I stumble around turning on every light and throwing open the curtains. My reality feels very dark. There's very little light; I can't figure out why, and my mind comes up with all sorts of theories, some dire—like maybe I'm going blind.

Then, suddenly, I realize I'm wearing my sunglasses. I take them off, and my house looks brighter again. The lights are working, I'm not losing my sight, and the power grid is fine.

Now imagine taking the glasses off, holding them up, and looking at them rather than through them. When you look through the glasses, everything appears dark. As your mind struggles to understand what's happening, it feels like a crisis. As your mind spins on this problem, even darker thoughts arise, like "maybe I deserve to feel this way" and so on. But when you realize you're wearing the glasses and look at them instead, you may have a new realization:

“Oh, I see what's happening. When I look through the lenses, everything looks dark. But now that I'm looking at the lenses, I can see that they are making things look dark. The darkness isn't an inherent part of my life.”

This is exactly how it works with thoughts.

Think of thoughts as lenses through which you view the world. Sometimes those lenses are like sunglasses so unobtrusive and comfortable that you don't even know you're wearing them.

Consider Alice. When she has the thought “I don't think ACT is going to work for me,” she automatically feels sadder and more hopeless than she did a moment ago. The thought is like a pair of dark glasses that makes her world look dark. It's not that Alice's life is actually bright and sunny all the time. It's just that the lens she's viewing her world through makes everything look downright bleak. In ACT, we call this getting hooked by a thought.

Having the thought isn't the problem, just as holding dark glasses in your hand wouldn't make it hard to see. The problem arises when you put them on your face indoors and forget you're wearing them.

We could throw away a pair of glasses we don't like, but we can't do that with thoughts. Thoughts come and go on their own, and we can't control them except in short bursts and with considerable effort.

But what if we don't have to control them? What if looking at a thought as though it were a pair of dark sunglasses in your hand could take away much of its power to affect your mood and hijack your behavior?

That's what we mean by looking at a thought rather than from a thought. It is the goal of ACT's unhooking exercises.

What if I can't notice my thoughts as thoughts?

No matter how diligently you practice, there will be times when thoughts hook you. It's as if someone sneaks up behind you, puts dark glasses on your face, and you don't even realize it.

With practice, however, you'll get better at noticing when you're looking from a thought. Then you'll be able to use ACT skills to step back and look at the thought instead.

I have had clients who genuinely felt unable to notice their thoughts as thoughts. They experienced them as reality. One sign is when a client says, “It's not just a thought; it's true,” when referring to judgments like failure, bad, or hopeless. Here's the thing about judgments: they are always articles of faith. You can't ever prove them right or wrong. You either believe them, struggle hard not to believe them, or notice them for what they are: sounds in your mind.

Always seeing judgements as true may mean the person is having difficulty looking at a thought—or even noticing it as it arises. It's like a fish that doesn't know it's underwater because being underwater is all it's even known. Here's a brief exercise to help build the skill of noticing thoughts as thoughts, as they arise.

Let Your Mind Finish the Sentence

For this exercise, get comfortable somewhere you won't be distracted.

Read the prompts below and don't speak; just notice what your mind does—listen to your thoughts. This isn't a quiz, so you don't have to answer correctly or write anything down. Just notice what thoughts come to mind.

Mary had a little… (notice any thoughts that come up)

Twinkle, twinkle, little…

Row, row, row the…

Once upon a…

I'm not good, I’m…

I'm not bad, I’m…

What did you notice? There are no right answers, but in my experience, many people notice these thoughts: lamb, star, boat, time, bad, and good.

These aren't the “right” answers, but they are by far the most common. Think about this: I put a bunch of symbols on this page; your mind turned these symbols into sounds (thoughts), and predictably, certain other sounds (thoughts) automatically appeared in your mind. Isn't this actually pretty strange? At the same time, it's so normal we hardly notice when it's happening. It's like that fish: being underwater is so normal it doesn't know it's underwater.

If you noticed the thought lamb after the first prompt, why? Is it because the thought is true? Was Mary a real person who actually had a little lamb? Probably not. You thought lamb because you learned that association at some point in your life.

Why do some people tend to think “I'm good,” while others are more likely to think “I'm bad”? Is it because it's true: the first person is literally all good and the second literally all bad? Very unlikely. Bad isn't necessarily any more "true" than lamb, but it popped up in your mind for exactly the same reason: somewhere along the way, your mind created an association between "me" and "bad," just like it did with "Mary" and "lamb" and "twinkle" and "star." And here's the kicker: it will never not be lamb. Even if the word lamb suddenly became the most taboo and shameful thought in the world, if you hear the sounds "Mary had a little..." your mind will hand you the sound "lamb." Forever. You could dedicate every waking moment to trying to erase this connection, and barring a brain injury or disease, lamb will always be first on the list. Does this mean "bad" could always be your mind's automatic response to hearing "I'm not good, I'm..."? The answer is yes. However, when you learn to drop the struggle with painful thoughts and unhook instead, the thought "bad" and the thought "lamb" will feel like sounds in your mind, not the gospel truth. Remember, holding dark glasses in your hand doesn't make your world look dark.

As with the nursery rhymes, negative thoughts are a product of your learning history, not a reflection of universal truth. Maybe you were told you were bad (or good), or your mind arrived at that label based on circumstances. Either way, you learned lamb and you learned bad, and those thoughts can keep popping up automatically, with little connection to whether they are literally true or false.

Do you have to eliminate painful thoughts to be OK—to live your life your way?

Imagine you're in a swimming pool on a beautiful summer day. Several beach balls of different sizes, designs, and colors float on the surface. Some are pleasing, and some are ugly. Some have "Alice is good" printed on them, and some say "Alice is bad."

You might decide that the only way to enjoy yourself is to get rid of the ugly balls and keep the pretty ones. Throwing them out of the pool or deflating them isn't an option. You've tried, and it hasn't worked.

So you try to hold the ugly beach balls under the water, out of sight. This might seem like a solution:

If I can just (ugh...this is hard) hold these big, ugly beach balls below the water (my arms are tired!), I won't have to see them (because I can't!), and my day will be wonderful.

But what would this really be like? Imagine how much effort, focus, and concentration it would require. Then imagine what happens when one of those beach balls inevitably pops back to the surface and floats toward you. You'd feel as if you were back at square one.

In fact, your inability to do the impossible—keep the "Alice is bad" ball submerged—seems to reinforce the belief that you are bad, that the thoughts is "true". If this sounds like a game you can't win, give yourself a pat on the back. You're right.

What if, instead, you allowed all the beach balls to float around the pool, regardless of what they looked like or said? Sometimes the ugly ones would float toward you, and you might not like that. But what if you simply gave up on controlling the beach balls, let them float near or far, while also being present with your friends, the warm water, the refreshing breeze, and the sunshine? Which option might lead to a more relaxing day at the pool?

This is our goal with thoughts. What if any thought—any string of sounds—could arise in your mind, even when it carried a painful history or meaning, while you continued to live fully and meaningfully without investing time and effort in changing or eliminating it?

This is possible and powerful. It requires a willingness to keep moving forward with ACT therapy while practicing these strange skills.