Rumination is a common symptom of OCD. It involves persistently mentally engaging with intrusive thoughts, worries, or doubts in an effort to analyze them, find solutions, or make sense of them. This mental compulsion is used to alleviate anxiety and uncertainty, but it only provides temporary relief and perpetuates the cycle of OCD.
Have you ever had a stressful or uncomfortable thought or worry that you just couldn’t shake? Maybe you find yourself analyzing it over and over, trying to find a solution, but no matter how hard you try, your mind won’t let go. The thoughts keep circling, even long after you want them to stop.
This pattern of thinking is known as rumination. Many people experience it, but it can feel especially urgent and important when you have obsessive-compulsive disorder (OCD), a chronic mental health condition characterized by obsessions and compulsions. It’s one of many mental compulsions involved in OCD, like mental checking or seeking reassurance, that are often triggered by intrusive thoughts, worries, and doubts.
The answer to stopping rumination seems obvious—just tell your brain to “let it go” and move on to something else—right? In reality, learning to stop ruminating can be incredibly challenging. The more you try to push away the thoughts, the longer they stay in your mind, creating a cycle that’s difficult to break.
The good news is that with practice, you can learn to accept uncertainty and distress without needing to resolve or analyze every intrusive thought. Read on to learn more about rumination, what causes it, how it can impact your daily life, and how you can learn to manage it.
What is rumination?
Rumination is a constant and repetitive cycle of negative thoughts, and it shouldn’t be confused with problem-solving. “Rumination is basically just over-thinking,” says licensed therapist Tracie Ibrahim, MA, LMFT, CST. “Most people do it. People with OCD do it obsessively with an urgency of trying to ‘solve’ something or ‘figure something out.’”
If you have a long and overwhelming list of things to do, you may mentally run through it to prioritize your tasks and figure out logistics. This can take time and mental energy, but you’re working toward a practical solution. Unlike this kind of problem-solving, rumination dwells on doubts and worries that cannot actually be resolved.
For people with OCD, rumination is a compulsion. These are behaviors done to cope with distress caused by obsessions, which are recurrent and intrusive thoughts, sensations, images, feelings, or urges.
If you’re having trouble determining whether your thought patterns are rumination or healthy problem-solving, it’s important to recognize that rumination keeps you mentally stuck, focusing on the same issue over and over without reaching any helpful conclusion. If your thoughts feel like they’re circling without an end, causing anxiety or increasing doubt, this may be a sign of rumination.
Because rumination is a mental compulsion, it is often overlooked because it is invisible from the outside. Often, people with OCD themselves struggle to notice mental compulsions. But make no mistake, mental compulsions do what any other compulsion does: they reinforce the idea that an intrusive thought or worry is a problem to be solved, and deceive your brain into believing that you can control the outcome of intrusive thoughts and doubts.
Examples of OCD rumination
As mentioned, rumination is a mental compulsion that people with OCD often engage in to try to alleviate anxiety or find a solution to intrusive thoughts. Here are some examples of different forms of rumination:
- Replaying a conversation: Continuously thinking about something you said or did, wondering if it was the right thing, or worrying about how the other person perceived it.
- Revisiting past mistakes: Going over past decisions or actions, and trying to figure out what you could have done differently.
- Overthinking future events: Constantly imagining possible outcomes of a future situation, like a meeting, test, or social event, and imagining every possible scenario.
- Moral or ethical doubts: Repeatedly questioning your moral choices or wondering if you’ve done something wrong.
- Relationship concerns: Obsessively thinking about whether you truly love your partner, questioning if you are with the right person, or doubting your feelings.
- Checking health worries: Constantly thinking about a potential illness or health issue, or revisiting the same symptoms over and over again in your head for self-reassurance.
Community discussions
How to stop ruminating
Exposure and response prevention (ERP) therapy
If you’re ruminating on intrusive thoughts, exposure and response prevention (ERP) therapy can teach you how to stop engaging with the thoughts causing your distress and accept uncertainty. It’s a specialized form of cognitive behavioral therapy (CBT) that was developed specifically to treat OCD.
For example, if you can’t stop ruminating, one of your goals can be to intentionally allow yourself to experience an intrusive thought without analyzing or trying to solve it. You’ll work collaboratively with your therapist, starting with less distressing thoughts and gradually working up to more intense ones. Over time, this helps you accept anxiety from intrusive thoughts and sit with uncertainty without feeling the need to ruminate.
“Generally, you have to recognize that rumination is happening and use non-engagement responses to stop as quickly as possible,” Ibrahim says. Non-engagement responses (NERs) might involve saying “Maybe, maybe not” to yourself, or even strategically agreeing with your worries and letting them pass. You can say something like: “I’m feeling anxious about this, and that’s okay,” or “Maybe. Anything is possible.”
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Medication
Medication can help reduce the intensity of rumination and other OCD symptoms, particularly when combined with ERP therapy. Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants are two commonly prescribed types of medication that can help alleviate OCD symptoms and allow people to fully engage with therapy.
The bottom line
Ruminating can be exhausting and frustrating, keeping your mind stuck in an unproductive, vicious cycle. This constant overthinking can drain your time and energy, make it hard to focus on other tasks, and heighten feelings of anxiety and worry. Fortunately, ERP therapy can help you resist compulsive rumination, helping you build tolerance to discomfort and uncertainty. With practice, you can learn to break free from the cycle of rumination.
Key takeaways
- Rumination is a repetitive mental compulsion in OCD, characterized by repeatedly, persistently thinking about and trying to “solve” intrusive thoughts, doubts, or worries.
- Unlike problem-solving, rumination offers no resolution and actually reinforces your distress and anxiety.
- Exposure and response prevention (ERP) therapy can help you stop ruminating by confronting intrusive thoughts and worries while learning to accept uncertainty and doubt.