Elsevier

Clinical Psychology Review

Volume 20, Issue 8, November 2000, Pages 973-995
Clinical Psychology Review

Paradoxical and less paradoxical effects of thought suppression: A critical review

https://doi.org/10.1016/S0272-7358(99)00019-7Get rights and content

Abstract

The process of consciously trying to avoid certain thoughts is referred to as thought suppression. Experimental research has documented that thought suppression may have paradoxical effects in that it leads to an increased frequency of the to-be-suppressed thought intruding consciousness. It has also been claimed that suppression has disruptive effects on episodic memory (i.e., a less paradoxical effect). The present article critically evaluates studies on the paradoxical and less paradoxical effects of thought suppression. More specifically, the issue of whether thought suppression plays a causative role in the development of various psychopathological symptoms is addressed. While laboratory studies have come up with highly consistent findings about the paradoxical effects of thought suppression, there is, as yet, little reason to believe that such effects are implicated in the etiology of obsessions, phobias, or other psychopathological conditions. Relatively little work has been done on the alleged memory effects of thought suppression. The studies that have examined this issue have found mixed results. Accordingly, the case for the amnestic power of thought suppression is weak. Alternative explanations and competing theories are discussed, and it is concluded that research concerned with the psychopathological consequences of thought suppression would benefit from development of better taxonomies of intrusive thinking and cognitive avoidance strategies.

Section snippets

The Basic Phenomena

Systematic research on thought suppression only started after Wegner and colleagues (1987) published their by now classic “white bear” experiments. The general outline of their critical experiment was as follows. Normal subjects were assigned to one of two groups. The first group was an “initial suppression” group in which subjects were instructed to suppress the thought of a white bear for a 5-minute period. Following this, subjects were given expression instructions: That is, they were asked

Individual Differences in Thought Suppression Tendencies

Results obtained by Merckelbach, Muris, Van den Hout, and De Jong (1991) indicate that people differ in how successful they are at thought suppressing. These authors found a positive relationship (r = .59, n = 35, p < .001) between the number of intrusions during suppression and the frequency of intrusions during control periods (see also Rutledge, Hollenberg, & Hancock, 1993). That is, subjects who reported a high frequency of intrusions when they tried to suppress a certain thought, also

Thought suppression and memory

It is widely believed that adults who have experienced traumatic childhood events may cope with these experiences by engaging in selective suppression of traumatic memories (e.g., Brett & Ostroff 1985, Terr 1991, Terr 1993). By this view, selective “forgetting” or thought suppressing would underlie psychogenic, or in DSM-IV terms dissociative, amnesia, that is, “an inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be

Implications for therapy

Wegner (1989) is clear about the lessons for treatment to be learned from thought suppression studies: “in many cases of unwanted thought, it may be best to stop suppressing” (p. 174). According to Wegner, thought suppression experiments provide a straightforward rationale for habituation- or exposure-oriented treatments. In clinical literature, some good examples can be found that seem to underline Wegner's position. Thought stopping is a case in point. In thought stopping treatment, the

Concluding remarks

The pioneering work of Wegner and colleagues (1987) on the paradoxical effects of thought suppression has stimulated a vast amount of research (see, for a review, Clark & Purdon, 1993). To date, more than 30 studies have documented immediate enhancement and/or rebound effects of thought suppression. Thus, it is safe to conclude that the paradoxical consequences of thought suppression represent robust phenomena. In contrast, the memory-out-of-order effect that is also ascribed to thought

References (118)

  • B.A. Esterling et al.

    Empirical foundations for writing in prevention and psychotherapyMental and physical health outcomes

    Clinical Psychology Review

    (1999)
  • M.H. Freeston et al.

    Cognitive intrusions in a non-clinical population.1. Response style, subjective experience, and appraisal

    Behaviour Research and Therapy

    (1991)
  • A.G. Harvey et al.

    The role of valence in attempted thought suppression

    Behaviour Research and Therapy

    (1998)
  • A.G. Harvey et al.

    The effect of attempted thought suppression in acute stress disorder

    Behaviour Research and Therapy

    (1998)
  • J. Kirk

    Behavioural treatment of obsessional-compulsive patients in routine clinical practice

    Behaviour Research and Therapy

    (1983)
  • W. Kuyken et al.

    Intrusive memories of childhood abuse during depressive episodes

    Behaviour Research and Therapy

    (1994)
  • J.W. Lawrence et al.

    Early avoidance of traumatic stimuli predicts chronicity of intrusive thoughts following burn injury

    Behaviour Research and Therapy

    (1996)
  • J. Littrell

    Is the reexperience of painful emotion therapeutic?

    Clinical Psychology Review

    (1998)
  • R.J. McNally et al.

    Autobiographical memory disturbance in combat-related posttraumatic stress disorder

    Behaviour Research and Therapy

    (1995)
  • T.P. Melchert et al.

    Different forms of childhood abuse and memory

    Child Abuse & Neglect

    (1997)
  • P. Muris et al.

    Suppression and dissociation

    Personality and Individual Differences

    (1997)
  • P. Muris et al.

    Verbalization and environmental cueing in thought suppression

    Behaviour Research and Therapy

    (1993)
  • P. Muris et al.

    Abnormal and normal compulsions

    Behaviour Research and Therapy

    (1997)
  • P. Muris et al.

    Individual differences in thought suppression. The white bear suppression inventoryFactor structure, reliability, validity and correlates

    Behaviour Research and Therapy

    (1996)
  • P. Muris et al.

    Thought suppression in spider phobia

    Behaviour Research and Therapy

    (1997)
  • P. Muris et al.

    Suppression of emotional and neutral material

    Behaviour Research and Therapy

    (1992)
  • T.P. Palfai et al.

    Effects of suppressing the urge to drink on the accessibility of alcohol outcome expectancies

    Behaviour Research and Therapy

    (1997)
  • J.W. Pennebaker

    Putting stress into wordsHealth, linguistic and therapeutic implications

    Behaviour Research and Therapy

    (1993)
  • S.J. Rachman

    Unwanted intrusive cognitions

    Advances in Behaviour Research and Therapy

    (1981)
  • S. Rachman

    Obsessions, responsibility and guilt

    Behaviour Research and Therapy

    (1993)
  • S. Rachman

    A cognitive theory of obsessions

    Behaviour Research and Therapy

    (1997)
  • S. Rachman

    A cognitive theory of obsessionsElaborations

    Behaviour Research and Therapy

    (1998)
  • S. Rachman et al.

    Abnormal and normal obsessions

    Behaviour Research and Therapy

    (1978)
  • E. Rassin et al.

    Effects of thought suppression on episodic memory

    Behaviour Research and Therapy

    (1997)
  • E. Rassin et al.

    Thought-action fusion as a causal factor in the development of intrusions

    Behaviour Research and Therapy

    (1999)
  • M. Reynolds et al.

    Intrusive cognitions, coping strategies and emotional responses in depression, post-traumatic stress disorder and a non-clinical population

    Behaviour Research and Therapy

    (1998)
  • M. Reynolds et al.

    Comparison of positive and negative intrusive thoughts and experimental investigation of the differential effects of mood

    Behaviour Research and Therapy

    (1992)
  • P.M. Salkovskis et al.

    Abnormal and normal obsessionsA replication

    Behaviour Research and Therapy

    (1984)
  • P.M. Salkovskis et al.

    Thought suppression and smoking cessation

    Behaviour Research and Therapy

    (1994)
  • P.M. Salkovskis et al.

    Behaviour therapy and obsessional ruminationsCan failure be turned into success?

    Behaviour Research and Therapy

    (1989)
  • R. Shafran et al.

    Thought-action fusion in Obsessive Compulsive Disorder

    Journal of Anxiety Disorders

    (1996)
  • J.C. Shipherd et al.

    The effects of suppressing trauma-related thoughts on women with rape-related posttraumatic stress disorder

    Behaviour Research and Therapy

    (1999)
  • J. Smári et al.

    Obsessive-compulsive symptoms and suppression of personally relevant unwanted thoughts

    Personality and Individual Differences

    (1995)
  • F. Tallis et al.

    Worry and obsessional symptomsA correlational analysis

    Behaviour Research and Therapy

    (1992)
  • H. Trinder et al.

    Personally relevant intrusions outside the laboratoryLong-term suppression increases intrusion

    Behaviour Research and Therapy

    (1994)
  • American Psychiatric Association (APA). (1994). Diagnostic and statistical manual for mental disorders, fourth edition...
  • R.A. Bjork

    Retrieval inhibition as an adaptive mechanism in human memory

  • M.J. Borkovec et al.

    The nature of worry in generalized anxiety disorderA predominance of thought activity

    Behaviour Research and Therapy

    (1990)
  • K.S. Bowers et al.

    Hypnotic amnesia and the paradox of intentional forgetting

    Journal of Abnormal Psychology

    (1996)
  • E.A. Brett et al.

    Imagery and Post Traumatic Stress DisorderAn overview

    American Journal of Psychiatry

    (1985)
  • Cited by (113)

    • Caudate hyperactivation during the processing of happy faces in borderline personality disorder

      2021, Neuropsychologia
      Citation Excerpt :

      In a conceptual context, the suppression of the processing of emotional stimuli and the suppression of emotions can be understood as the opposite of emotion acceptance (Hofmann and Asmundson, 2008; Campbell-Sills et al., 2006). It is known that attempts to suppress affective processing lead to increased negative and decreased positive emotions in the long term (Rassin et al., 2000). In addition, emotion suppression contributes to the persistence of BPD symptoms (Stepp et al., 2014).

    • Replacing intrusive thoughts: Investigating thought control in relation to OCD symptoms

      2014, Journal of Behavior Therapy and Experimental Psychiatry
    • Self-report may underestimate trauma intrusions

      2014, Consciousness and Cognition
    • Consistency of reporting sexual and physical abuse during psychological treatment of personality disorder: An explorative study

      2012, Journal of Behavior Therapy and Experimental Psychiatry
      Citation Excerpt :

      Autobiographical memory in the context of inconsistency of trauma reporting has remained largely unexplored as a putative underlying mechanism of inconsistent memory reports. It has been suggested that a less specific retrieval style may underlie the subjective experience of amnesia typically reported by people who recover memories of child sexual abuse (CSA) (e.g., Dalenberg, 1996; Rassin, Merckelbach, & Muris, 2000). An overgeneral retrieval style means that someone experiences difficulties in retrieving specific autobiographical memories, i.e., memories of personally experienced events happening at a particular place and lasting less than a day (Williams & Broadbent, 1986).

    View all citing articles on Scopus
    View full text