Even if it is just ONE thought that is causing you difficulty you can still create a fear hierarchy of small steps that enable you to face the thought.
Write down a list of steps you could take. Even if it is just one word at a time
For example – let’s say the thought is
“I am going crazy and may cause harm to myself or others”.
How distressing would you imagine it would be if you allowed yourself to repeat this thought just once?
What about twice? – three times? twenty times? etc
or could you only bear to first of all repeat the word ‘crazy’ or ‘harm’?
Could you write the thought down – how many times?
Work out the various levels of anxiety you imagine you might experience
You don’t need to be overly brave – GRADUAL exposure is actually MUCH more effective. You learn much more from gentle experimentation than from ‘gung-ho’ John Wayne tactics.