Metacognition
The ability to think about our thinking - to monitor and observe our internal state - is an extremely useful and versatile skill, which is probably why it pops up in some form in so many of the psychotherapy approaches in use today. It involves being able to pause and take notice of your internal state (thoughts, emotions, memories, urges) and then objectively name what you find ("I'm ruminating about that interaction" or "I'm having an intrusive thought" or "I'm having the thought that I am unlovable"). It's a specific flavor of #mindfulness - observing your internal experience in the moment and recognizing the thoughts and feelings for what they are, with no judgment or agenda.
It's noticing that you've been in the same thought loop for hours or that you've been swept away into a flashback. It's noticing that you're noticing - becoming aware of an observing part within all of us that recognizes what our mind is doing as it is happening. We cannot always control our thoughts, and we rarely can dictate our feelings, but by developing and strengthening this internal observing part, we gain the ability to decide if and how we respond to them.
In neurobiological terms, by noticing our internal state and describing it objectively, we're utilizing core parts of our prefrontal cortex (PFC), which means we activate the circuitry of our brain responsible for regulating emotions and inhibiting urges in the service of a broader goal. This is where change can happen. When the #PFC is online, it can inhibit habitual and automatic ways of responding (including thinking styles) and instead promote deliberate action. In other words, activation of the PFC allows things like values and new learning to impact our thoughts and behavior.
Metacognition is so powerful because it can bring a habitual or automatic process into conscious awareness, which is typically a necessary step in changing it. This makes it a very useful tool in treating mental health problems that involve entrenched unhelpful thinking patterns (which is kind of a lot of them).
It's the crux of Dr. Jeffrey Schwartz's four-step daily practice to manage #OCD, described in his book The Mind and the Brain, which Dr. Gabor Mate later expanded upon in his book, The Myth of Normal, as a way to change any repetitive thought pattern, including the negative core beliefs that can hold us back from living a truly authentic life. The process goes like this:
Relabel. First, recognize the negative or obsessive thought for what it is. Just a thought, not necessarily the truth, and label it as such (e.g., "I'm having the thought that I'm unloveable" or "I'm having an urge to seek reassurance" or "I seem to believe that I'm responsible for everyone's feelings"). Learning how to recognize maladaptive thought patterns can take time. Therapy and journaling can both be useful for identifying these limiting beliefs. Extreme language (e.g., always, never, worst, perfect), imperatives (e.g., should, must), and child-like thinking are all tell-tale signs.
Reattribute. Once you've identified the limiting belief or obsessive thought, the next step is to reattribute it - meaning recognizing that it is an outdated and unhelpful belief or an irrational thought or compulsion. This might mean identifying the historical origins of the negative core belief (e.g., as a childhood defensive strategy) or recognizing that the obsessive thought or compulsive urge feels intense and urgent because of a biochemical quirk in your brain, not because it is true or important.
Refocus. Next comes refocusing - which involves deliberately shifting your attention to some other task (ideally one that you've decided on in advance). You are not trying to suppress your thought or urge, but you are trying to go about your day despite it. You are purposefully lowering the value your brain places on those words. Any constructive, pleasant behavior will do. Hobbies? Walk? Listen to music? Dance? Call a friend? You do you. According to Dr. Schwartz, you want to try to stick with whatever you do for 15 minutes (this can be tougher than you think - you may need to work up to it). Basically, you are teaching your brain that this thought or urge is not worth your attention.
Revalue. If you do steps one through three consistently for at least a month, you'll arrive at the fourth step - which is revaluing. With repetition, your brain begins to get the message that the negative or obsessive thoughts aren't worth its time, and stops bringing them to your conscious attention at all. Taking an honest look at the objective costs the limiting beliefs or obsessive thoughts have had on your life can help to further reduce their power. (This also is a good task for therapy or journaling.)
Recreate. Dr. Mate adds a fifth step - recreate - to encourage people to use the freedom gained from releasing old limiting beliefs (and/or quieting obsessive thought patterns) to actively create the life they really want. When you are no longer buried beneath your defensive adaptations, you can construct a life that feels more authentic and aligned with your values.
This is a very top-down, cognitive-based approach to changing negative and limiting beliefs and thought patterns. It relies on repetition and the principles of neuroplasticity (i.e., "nerves that fire together wire together") to shift the value our brain ascribes to these beliefs or urges. Unfortunately, stress hormones are quite good at shifting our brain back into old habitual (or even innate) patterns of thinking and behaving during times of high stress, so the steps outlined above are no silver bullet. But regardless, the ability to think about our thinking - to honestly observe our mental patterns - is a crucial first step towards growth and change, making metacognition an essential tool in any mental health toolbox.