How do I handle racing thoughts?

Step by Step plan to manage thoughts that won't stop

First Step: Transition your body into a relaxed muscle state. This is a way to "manually override" the fight/flight response. When you have racing thoughts, you are in fight/flight. A tried and true way to relax your body is to complete a progressive muscle relaxation (PMR). It's easiest done lying down, but if you can't lie down then you can do this wherever you are. Take a few good deep belly breaths to bring your attention to your body, and beginning at your feet gently tell your body parts one at a time to relax. Specifically "Feet: relax, legs: relax, hips: relax" etc. Start at your feet and move up to the top of your head, and then go back down so that you have addressed each body part twice.

While moving through the Progressive Relaxation exercise your brain is distracted from the racing thoughts. When you are finished, your body has turned off that fight/flight mode which causes the racing thoughts. 

However if you find that not to be the case, many people find a mantra helpful. What we are trying to do is allow your brain to have something else to think. Helpful mantras include "I am safe," "I am valuable," "I can figure things out," "I can finish things."

Second Step: After you have finished your PMR, if you hear those distress causing thoughts come back up, pick a mantra and repeat it for one or two full minutes. 

What you're hearing here is that we are replacing the racing thoughts with an alternative focus. We are tasking your brain with focusing on relaxing and NOT the potential threats. All your brain is trying to do with racing thoughts is find potential threats and solve for them. It's very good for when there are problems that need an immediate solve, and really tough for when you're trying to solve for potential situations that haven't happened yet.

Third Step: If the above do not give you relief, then you start in on cognitive challenging work. But this cannot be done well unless your body is in a relaxed muscle state. You do not have your full cognitive resources when your thoughts are racing. That might not feel true because your experience is that the thoughts won't stop. The rational thoughts are what we are trying to access and you cannot get to them when you are in the fight/flight mode. After some attempts at bringing your body into relaxation, and after you do some mantra work, if your brain is very persistent at bringing your attention to a possible problem, use the Socratic Method (Clark, Egan 2015) to gently question the rationality of a specific thought.

A few of the Socratic Method questions: 

1. What is the evidence for this thought? What is the evidence against it?

2. Am I basing this thought on facts, or feelings?

3. Is this thought black and white, when reality is more complicated?

While this combination of exercises can be done wherever you find yourself, it does take a minimum of 5-10 minutes. 

Fourth Step: For a more specific plan, book in here and we'll discuss what else you might need to alleviate the distress caused by racing thoughts.

Source: 1. Clark, G. I., & Egan, S. J. (2015). The Socratic method in cognitive behavioural therapy: A narrative review. Cognitive Therapy and Research, 39(6), 863-879. 

Additional Socratic Method Questions can be found here: https://www.therapistaid.com/therapy-worksheet/socratic-questioning