Once when I was feeling overwhelmed and was obsessing about something and also not sleeping (I was also manic at the time so had WAY too much energy) he told me that I would sleep better if I moved my bed across the room. This of course meant I had to move all the furniture in my bedroom which was a huge amount of effort and it wore me out, distracted me, and later made me laugh when I realized I'd been tricked into doing something different than obsessing. It did work though.

Do your therapist and pdoc communicate about you?