Zulkayda Mamat has always been interested in the interplay between memory and trauma. Ethnically Uyghur, Mamat left China when she was 12 years old, becoming part of the diaspora community. She has borne witness to the mass trauma experienced by the Uyghurs, at least a million of whom, by many estimates, have been detained in internment camps
“Anxiety and paranoia surged as everyone became hypervigilant of their actions so as to not exacerbate the conditions of their loved ones inside or even outside of the concentration camps,” Mamat recalls. “Many fell into depression as they became separated from their families and alienated from any meaningful contact, and many developed PTSD symptoms as they heard stories of the camps or remembered their previous experiences of abuse, and so on.”
Those experiences have driven Mamat, a cognitive neuroscientist who just received her PhD in at the University of Cambridge, to explore effective interventions to alleviate mental distress. “Being able to control our thoughts, especially ones that debilitate or hinder us from thriving and positively contributing to the world around us, can be incredibly empowering,” she says. “Indeed, when I observed some of the people who have ventured on the journey of healing for quite some time, I noticed that the most content individuals had a powerful grip on their intrusive thoughts.”
Working with her graduate school advisor Michael Anderson when the COVID-19 pandemic hit, Mamat undertook a study of how individuals might train themselves to suppress unwanted thoughts. The pandemic, she says, further exposed the need for new tools to improve mental health, and their study was conducted remotely via Zoom with 125 adults from 16 countries. Contrary to conventional wisdom that suppressing thoughts causes harm, the researchers found that the training lowered anxiety surrounding those thoughts.
I spoke with Mamat about the study, which was published in Science Advances, and its implications, as well as next steps.
CNS: What new insight were you seeking with this study?
Mamat: Broadly, this project was designed to serve two major goals: (1) to conduct the first causal test attempted to evaluate theoretical predictions central to the now-popularized idea that suppressing thoughts causes them to come back even stronger; and (2) to translate our science in a way that benefitted urgent mental health needs of the world, especially with the backdrop of the COVID-19 pandemic. We are hoping our research would encourage the general public, as well as clinical scientists, to re-evaluate the practice of direct suppression as an effective intervention that can complement existing therapeutic techniques in alleviating the adverse effects of many intrusive and upsetting thoughts that disturb our minds and hearts.
CNS: How does targeted thought suppression work?
Mamat: Firstly, it is important to mention that what we are calling “direct suppression” is not avoidance, nor is it distraction. We are actually precisely asking people to not distract themselves because that tends to be the default: When we don’t want to think of something, we tend to want to think of something else, often something positive. We are asking people to completely block out all thoughts, to keep a blank mind. Essentially, it is learning to focus your attention intensely, rather than diverting your attention to something else. This takes practice, hence the training, and each person has a way of figuring out what works best for them.
The specific strategy for blanking one’s mind differs person to person. In fact, this is why I don’t give explicit instructions for exactly how to suppress cognitively during the training. The general idea, however, is to first acknowledge a thought that comes to your mind as an intrusive one that you would want to get rid of.
CNS: Can you give an example of this?
Mamat: Yes, for example, it could be a fear of being laid off and unable to pay for your bills. So, when this thought comes, for the next few seconds, try your best to block any images or thoughts of any associated details of that event out of mind and to keep it out of mind. It is important to not replace the unwanted thoughts with something else, like another thought or image, and to instead remain focused and try to be present in keeping your mind blank. This will likely be very difficult to do at the beginning as images tend to pop back in quite frequently, but eventually and hopefully with repeated practice, you will develop a strategy of your own and can employ it whenever an intrusive thought comes to mind. And don’t do it for longer than a minute at a time, as at that point, you are likely imagining some form of thought rather than suppressing.
CNS: What were you most excited to find?
Mamat: Challenging the idea that “suppression is bad for you”, we show that repeated practice at suppressing fearful thoughts never worsened mental illness; rather, it improved mental health, and significantly decreased vividness and anxiety-inducing effects of those fears. Most striking of all was that suppression training had the biggest mental health benefits for those in greatest need—those with likely PTSD, anxiety, and depression. We were very excited to see these benefits persisting for 3 months after the training for these vulnerable populations. Beyond our expectation, over 80% of our participants spontaneously used the suppression technique over those 3 months without instructions to do so.
CNS: Were there any novel techniques/approaches in your study that you would like to highlight?
Mamat: Actually, we are not inventing or discovering a new technique, because this is something that is inherently possible within every individual. Controlling seemingly uncontrollable thoughts is a very intuitive idea. Therefore, if anything, the “novelty” of this work is to remove some of those veils that have prevented many people from harnessing this natural cognitive ability in themselves.
CNS: What do you most want people to understand about this work?
Mamat: The key takeaway is that it is possible to blank your mind by recruiting your attention and suppressing intrusive thoughts as they arise. Though brief as it may be, with practice, those few seconds of suppression could loosen the grip those intrusive thoughts have on your well-being.
Clinical neuroscientists seeking to understand and treat mental health disorders can hopefully appreciate and consider suppression as a potential complementary, non-drug therapeutic approach. With more research and replication, this line of research can potentially also influence international guidelines for the treatment of various psychiatric disorders with intrusive thoughts as an underlying symptom.
CNS: What’s next for this line of work? And how best can these findings be applied to future studies?
Mamat: The next step is to replicate this work in a clinical population that struggles from symptoms of intrusive thinking, such as those suffering from PTSD, obsessive-compulsive disorder, and major depression. Delineating how patients can learn this can facilitate a path towards actively implementing such a training in clinical spaces for those who need it the most.
-Lisa M.P. Munoz