Rumination in OCD: What is it and how to stop it?

Rumination is a core feature of OCD that causes the sufferer to spend excessive time and effort trying to figure out, analyze, fix, clarify, or gain control over a particular obsession or theme.

Rumination is not a subtype of OCD in and of itself.

It is a compulsion that occurs within all OCD subtypes and is a key contributing factor to maintaining the OCD cycle.

If you are living with obsessive-compulsive disorder you likely find yourself trapped in a loop of relentless ‘problem-solving’ thoughts. In the hope to mitigate the fear of potentially negative outcomes, you become stuck in the search for answers.

This degree of rumination is exhausting.

Your brain feels like it is in constant ‘ON MODE’ and so even if you are physically resting, your mind is still going. It can be truly draining.

In this article, we will discuss the ins and outs of rumination; understand exactly why you ruminate and how you can break this mental habit and find long-term relief over short-term fixes.

 

The definition of rumination

Rumination is a cognitive behavior. It is the repetitive and relentless thinking about the potential causes and consequences of one’s thoughts or actions.

In the context of OCD, rumination becomes a compulsion done to reduce our uncertainty and ‘solve’ our fear.

If you suffer from OCD, you experience obsessions in the form of unwanted thoughts, images, urges sensations, or feelings.

You begin trying to ‘figure out’ what those obsessions might mean about you, why they are there, and how you can avoid any potential negative consequences.

This attempt to find certainty within uncertainty can find you stuck in the rumination trap.

Rumination can commonly become a mental habit that you feel you do not have control over.

Rumination in all aspects of life, but especially within OCD, can feel like our brain doesn’t have an off button.

People with OCD find themselves ruminating for inordinately prolonged periods of time. Whilst this may not appear like much of an inconvenience, it causes the sufferer an immense amount of stress. It is also exhausting to have your brain continuously running at 100 miles an hour.

What causes rumination in OCD?

Within the context of OCD, rumination is a mental compulsion.

Compulsions of any kind are performed to offer temporary relief from the anxiety, uncertainty, and distress caused by OCD. Compulsions can present themselves in many ways, depending on the individual and their OCD theme.

When we have obsessions it is natural to want to reduce or remove the uncertainty that we feel.

When we feel uncertain or out of control, we feel like the only way to gain that control is to rationally try and solve it in our mind which causes us to do ruminative behaviors.

This is a very valid and normal response but for people with OCD, particularly when the obsession is something that is unsolvable, they then get stuck in a cycle of rumination that doesn’t result in anything positive.

Common OCD compulsions may include:

• Checking to see if the doors are locked
• Mentally repeating a prayer or song
• Excessive cleaning
• Excessive hand washing
• Avoiding certain people, places, or things
• Checking if your child is still breathing
• Removing sharp objects from your home
• Watching certain pornography to check your sexual preferences

Rumination as a compulsion often presents as a form of checking and fixating on a particular obsession as a form of mental solving. We do this in the hope that it will allow us to gain some sort of control and in some instances, avoid a worrisome outcome.

For example, you may suffer from harm OCD and fear that you are going to hurt your partner.

This is the obsession that overwhelms you with anxiety and uncertainty. So that you can feel reassured that you haven’t actually hurt your partner, you might feel the urge to consistently check on them to make sure they are okay.

This is the compulsion. By checking on your partner you see that they are okay and for a moment, you experience a reduction in anxiety and uncertainty.

In this scenario, rumination may show up as repeatedly thinking about the obsession.

You may ruminate on thoughts such as:

Why would I want to harm my partner?

Don’t I love them?

What does that mean about me?

Am I dangerous?

Will I worry about this forever?

And this can also encompass the compulsion:

Did I check?

Were they okay?

Should I check again, just in case?

What if I’m wrong and they aren’t okay?

Am I anxious right now?

Will I always be anxious?

How this becomes a mental compulsion in and of itself is as follows (particularly in the case of specific subtypes that challenge the OCD sufferer’s morality and self-concept):

1. Rumination offers a small sense of control. The sufferer may believe that if they keep their attention on those obsessions and try to ‘figure them out’ then they are being responsible by ‘being on top of them’.

2. Rumination can act as self-punishment. You may wonder how that offers relief from those feelings of distress, anxiety, or uncertainty. Surely self-punishment doesn’t make us feel good? But with many OCD subtypes comes a great deal of guilt and shame. A sense that we ‘shouldn’t’ be having these thoughts and it makes us a ‘bad’ person for having them. Rumination on those obsessions in the form of self-critical thoughts can give the sufferer a sense of ‘i’m getting what I deserve’ as though they aren’t allowing themselves to ‘get away with it’. And this can offer relief.

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Is rumination the same as intrusive thoughts?

This neatly follows our answer to the above question.

Where OCD is concerned, rumination is the mental behavior of thinking about the same thoughts or feelings over and over again, far more than is necessary or helpful. 

And so sometimes rumination does get confused with intrusive thoughts. After all, they are both a form of unwanted thought, aren’t they?

An intrusive thought is a type of obsession. They pop up seemingly out of nowhere and are unwanted. The sufferer wants to avoid having these thoughts and can be confused as to why they have them and what they mean about them.

A thought is a thought. Intrusive or not, we cannot control our thoughts.

However, rumination is a behavior. This is why, within the context of OCD, they can become a mental compulsion in and of themselves. With that in mind, rumination is a reaction that can be modified with the correct training. 

We do not have a choice in thinking these intrusive thoughts, whereas rumination is done specifically to offer short-term relief from the anxiety and uncertainty of intrusive thoughts (or any other obsession).

This is not to say that OCD sufferers are actively trying to ruminate.

It can easily become an automatic habit that happens without us even realizing we are doing it. It requires a high level of self-awareness to catch this behavior in its tracks.

OCD is typically known as the ‘doubting’ or ‘uncertainty’ disorder. It is the fear of this uncertainty and the worry surrounding it that feeds the desire to ruminate. Because the OCD sufferer cannot be 100% sure, they ruminate to try and solve the problem and dispel their doubts. Whereas, intrusive thoughts are the source of that fear or doubt.

Does rumination make OCD worse?

Rumination does not necessarily make OCD worse but it is a contributing factor in maintaining the OCD cycle.

As with any compulsion, the act of ruminating solidifies and reinforces our internal alarm system. Each time we perform a compulsion, we signal to the brain that we are not capable of managing uncertainty or anxiety without it.

It also signifies to the brain that the anxious alarm was right to go off in response to our obsessions, teaching the brain that the obsession is a source of real danger, fear, or worry.

Rumination is not solely experienced by OCD sufferers. Everyone with a human brain engages in rumination at some point or other. However, it is a very common behavior found in those who experience generalized anxiety disorder, panic disorder, health anxiety, and even depression.

We all have worries, doubts, and fears in life that we may spend an unwarranted amount of time thinking about in the hope to avoid an outcome or solve a problem.

The difficulty with rumination in OCD is that there is no actual danger or threat, we simply perceive our obsessions in this way.

And so rumination as a mental compulsion does not teach our brains to tolerate the uncertainty and anxiety so that we can continue on with our lives without the urge to do compulsions

Signs of rumination

As with all mental compulsions, it is more difficult to effectively explain or show observers just how much they can negatively impact the life of an OCD sufferer.

In truth, when we think of them as ‘recurring and consistent thinking about a particular topic’ it can appear to be somewhat of a nothing-problem.

But the reality is quite different. They are as valid, inconvenient, and distressing as any other compulsion (mental or physical).

In fact, some people report them as being the most painful part of OCD.

Oftentimes people with OCD aren’t even aware they are ruminating – it can feel like more of a daydream or thoughtful inquiry. But that is what makes rumination something to be cautious of, it can become an unhelpful habit you don’t even realize you are doing.

Here are some potential signs that you may be ruminating:

 

• Thoughts are focused on your specific fear or type of OCD

If your thoughts are consistently focused on your particular theme of OCD, with the recurring pattern of trying to understand it, analyze, stop it, avoid it, or apply meaning to it… this could be a sign of rumination.

• Thoughts offer reassurance

• Yes, you definitely turned the oven off.
• It wouldn’t hurt to check in on them one more time.
• You’re not a bad person.

• Thoughts keep you awake at night

A sure telltale sign that you’re trapped in a cycle of rumination is if your brain struggles to switch off at night. If that’s when those worrisome thoughts pop up that you feel inclined to resolve or ‘figure out’… it could be a symptom of rumination.

• Thoughts seem like an exaggeration

If you step back and look at your thoughts logically but notice they actually appear quite illogical, or make things seem much bigger or worse than they are, this could be a sign of rumination.

For example, you went to a party and someone said ‘You look nice today’. Except you begin ruminating on whether the reference to today means that you don’t look nice any other day and continue trying to understand what they must have meant by that comment, rather than taking it as a compliment.

• Thoughts are designed to gain clarity and control over an obsession

If you’re involved in a mental thinking loop of trying to dissect a particular obsession, over-analyze, or seek greater certainty around the context of an obsession… this could be a sign of rumination.

• Thoughts feel like they help you solve a problem in relation to an obsession

• What if I am with my partner and I don’t feel anything toward them?
• What if I am driving my car and I lose control and hit someone?
• What if I have a harm thought while I’m cutting chicken?
• What would I do If I went to the park and had an intrusive thought that I don’t want?
• What if I date someone of the opposite sex to prove to myself I am straight?

Rumination outside of OCD

Rumination isn’t solely confined to those with OCD. It is born out of a source of worry, doubt, uncertainty, or fear. And we all experience these things throughout life.

It is a very common cognitive behavior that we all perform at some point. However, it becomes a problem when we don’t feel able to identify, catch, and interrupt the behavior. Or it becomes relentless and unforgiving.

Someone who struggles with rumination might say:

• I overthink everything
• I can’t turn my mind off at night
• My thoughts are constantly racing
• I’m constantly worrying and dwelling on things
• I hate my brain

A tendency to ruminate increases the likelihood of anxious and depressive episodes, and is indeed a common component that presents in those who struggle with anxiety and depression.

Outside of OCD, there are arguably certain personality types that may be vulnerable to rumination. The perfectionists, highly competitive types, and overachievers may find themselves ruminating over how they can do better, how they can achieve more, and whether they have done enough.

Likewise, life circumstance plays a part in our propensity to ruminate. 

As it is fuelled by doubt, uncertainty, and stress, there are certain life events that could unsurprisingly increase the likelihood of rumination.

For example, someone experiencing marriage issues may begin to ruminate over how they can ‘fix’ their relationship. They may wonder what they’ve done wrong and what they could have done differently. They may be in constant search of a solution.

Another example could be someone who has lost their job. They may ruminate over why they were let go over someone else. They may think back on the things they’ve said or done which could have caused this situation. And they might fixate on how they’re going to get themselves out of it (and what might happen if they don’t).

But like anything, rumination when used appropriately and effectively can sometimes be helpful.

When not done as a compulsion, reviewing a problem and coming up with solutions can be considered an effective problem-solving behavior. It can deepen relationships when done with a partner or friend, reviewing and reflecting on common worries and doubts.

Yet, if we allow it to become a state of being, it can transpire into consistent venting, complaining, and worrying that ultimately only spirals further into a loop of ongoing negativity or unhelpful thinking.

How to stop ruminating?

So we have clearly identified that ruminating is a) a cognitive behavior and b) a mental compulsion within the context of OCD.

With that, we must tackle rumination the same way we would tackle any kind of habit, and the same way we would tackle any kind of compulsion.

The key to stopping rumination is being aware of your mental behaviors. Being able to catch yourself when your thoughts are spiraling, or when you notice you’ve been thinking about the same thing over and over again for a long period of time.

Awareness is key here.

As we have said above, rumination can happen without us even realizing it. It can disguise itself as daydreaming or helpful problem-solving. And so before we can effectively interrupt that habitual rumination pattern, we must first be aware of when it occurs.

Here are some ways in which you can help yourself catch rumination and slow down your thoughts.

1. Mindfulness
2. Breathing exercises
3. Yoga 
4. Meditation
5. Lifestyle changes

In the absence of a mental health disorder such as OCD, people who struggle with rumination can implement the above practices to help them break the habit.

All of the above are designed to slow us down, bring us back to the present moment, and offer some mental space and clarity.

However, if you struggle with rumination within OCD, more direct support is required.

1. CBT with ERP

What remains the go-to treatment for OCD is CBT (Cognitive Behavioral Therapy) with ERP (Exposure Response Prevention).

The approach with CBT is two-fold: address the unhelpful thinking patterns and change our relationship with them, and address how we respond to them (our behaviors).

As we now know, rumination is a behavior. Whilst it can subtly creep in and trap us in an overthinking cycle without us noticing, it is in fact a habit that can be interrupted. 

ERP requires us to expose ourselves to the source of our anxiety, doubt, or uncertainty, so we can practice resisting the urge to perform compulsions (in this case, rumination).

It can be tricky to understand how we can practice exposure therapy with mental compulsions, yet it works in very much the same way. Exposing ourselves to the obsession, allowing the anxiety and uncertainty to arise, and resisting the urge to find quick relief through rumination.

2. ERP SCHOOL

For those who do not have access to private therapy, online programs are available as an effective guiding light toward recovery.

ERP School has been designed and created by OCD specialist and licensed therapist, Kimberley Quinlan.

A self-paced program that will help you learn the exact tools and techniques that Kimberley uses with her private clients in their OCD recovery, and how to apply them to your specific obsessions and compulsions.

If private therapy isn’t an option for you right now, ERP School can help you take control of your intrusive thoughts and resist the urge to do compulsions so you can drastically increase your quality of life.

You can join ERP School HERE.

3. Private Therapy

Wherever possible, we would always recommend working with a highly qualified mental health professional in a private setting.

Whilst it is entirely possible for you to recover from OCD on your own, working with a specialist will make the journey so much easier. You will always have a supportive person in your corner who can enlighten you about the things you’re missing and point you in the right direction.

If you are based in California or Arizona, we have an elite team of 10 licensed and highly trained professionals who can guide you through Kimberley Quinlan’s OCD treatment plan.

Under Kimberley’s supervision, our team offers the highest level of support. We are a warm, compassionate, and friendly selection of clinicians who are here to help you in your OCD recovery.

If you would like to have an open discussion about how we might be able to help you, complete this submission form here.