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Let’s talk about rumination. The “rumination” that refers to repetitive, excessive thought patterns, NOT the kind that refers to how cows eat (why is the English language like this?!)
As a therapist who has dealt with anxiety myself, there are a couple of things that were absolute game-changers for me. Getting control over rumination was one of those things. But it took me a long time to realize and accept that rumination was something I was doing, not something that was happening to me. And if I was in control, that means I could choose to stop.
The American Psychological Association defines rumination as “obsessional thinking involving excessive, repetitive thoughts or themes that interfere with other forms of mental activity.”
It’s what you are doing when you can’t stop thinking about how and why your ex broke up with you 6 months ago. Or it’s what you are doing when you are lying in bed anxiously anticipating everything you have to do the next day. It’s what you are doing in the shower when you can’t stop crafting the perfect comeback to the condescending comment your mother-in-law made last weekend.
By definition, rumination is an internal action, meaning you can be doing it anytime and anywhere. But I also see people ruminate aloud with their friends, family, and therapists. It can manifest as conversation about the same problems or worries that loops around and around without ever coming to a conclusion. Occasionally you feel like you had a meaningful breakthrough or settled on a solution, but it won’t last for long. Before you know it, you are facetiming your best friend, your mom, or your partner to talk it through just one more time…
Minor rumination can occur as a response to any of the typical life stressors and transitions. For example, temporary rumination can occur before a major change, after a break up or loss, or after getting a scary diagnosis. Teenagers tend to ruminate more when they are going through puberty and coping with the drama of adolescence, while simultaneously trying to be more independent and figure things out for themselves.
But sometimes rumination becomes a significant driver of a larger problem. It can be like throwing fuel on an emotional fire, making it virtually impossible to put out until the rumination is under control. For many people it’s a behavioral symptom associated with a diagnosable mental health condition.
Rumination is associated with:
Major Depression: Major Depressive Disorder refers to a prolonged period of low mood and/or irritability that is often associated with changes in sleep, appetite, energy, and enjoyment of life. When someone is depressed, rumination can look like:
Preoccupation with what you dislike about yourself, your life, and the world
Reviewing the past; particularly regrets, mistakes, or resentments
Harsh, repetitive self-criticism
Excessive focus on slights or criticisms, or frequently thinking about how others are against you
Thinking about the future in a helpless and hopeless way
Rumination keeps people trapped in depressive episodes by fueling feelings of helplessness, hopelessness, and worthlessness. It is also exhausting, which gets in the way of taking helpful action. Rumination can end up replacing other more enjoyable activities, which are crucial for recovering from a depressive episode.
Generalized Anxiety Disorder (GAD): GAD is characterized by excessive and uncontrollable worry on a variety of topics, and is often associated with an inability to relax, avoidance, and anxiety that shows up in the body as a racing heart, restlessness, GI concerns, muscle tension, etc. The “worrying” that occurs with GAD is another form of rumination, and it looks like:
Trying to anticipate and solve every possible bad outcome
Excessive planning, reviewing, and checking
Worrying about how you behaved, responded or interacted
Obsessive-Compulsive Disorder: Rumination in OCD is a very common (and commonly overlooked) mental compulsion. OCD has historically been known by it’s overt, physical compulsions such as cleaning, re-arranging, checking, and counting. OCD also involves compulsions that occur entirely in one’s mind, and for many sufferers, this is the only type of compulsion that they are experiencing! Rumination in OCD can look similar to that of GAD, and it can also include:
Trying to “figure it out” or come to a conclusion that resolves the anxiety
An internal back and forth between an anxious voice saying “What if” and a logical voice that responds with reassurance…over and over again
Mentally rehearsing how you will respond to a future event
Mentally reviewing past events to look for a mistake or assess how other people were responding
What’s so wrong with rumination?
If you are struggling with rumination, it may be very clear why it is a problem! At the height of my anxiety, I was ruminating so much I felt like words could fall out of my ears. My head genuinely felt more full due to the sheer amount of thinking that was happening.
If that is your experience, then you are probably desperate to get a handle on this. Rumination to this degree can make it hard to fall asleep, and may even have you waking up in the middle of the night just to jump right back into that obsessive stream of thought. A well-meaning doctor might misdiagnose insomnia and prescribe sleeping medications.
Rumination distracts from other things that you need to be doing such as listening in conversations, paying attention to children, or being fully present during enjoyable and relaxing activities. Also, your job.
If you are ruminating all day, you aren’t attending enough to what you are doing and might find yourself feeling distracted, forgetful, and careless. This is one reason why anxiety disorders can mimic ADHD.
For all these reasons, rumination can cause observable impairment in your day to day life. But that is not the worst part. Rumination impacts us emotionally as well.
Rumination is a behavior that occurs in response to a feeling. Ideally, our feelings ebb and flow, without us getting in the way. Rumination can get in the way by:
Keeping us stuck in painful feelings like anger, guilt, shame, sadness, regret, and embarrassment. It’s emotional quicksand.
Fueling anticipatory anxiety (the anxious feelings that we feel before an event, which are almost always worse than the actual event.)
Creating further doubt about something that is already over. For example, have you ever left a social event feeling good, only to start thinking about everything you said and how everyone responded? Next thing you know, you are convinced that everyone is mad at you and you are preparing an apology text?
Rumination may be an attempt to avoid further anxiety; for example, when you are excessively planning ahead or trying to prepare a response for every possible outcome. But this prevents you from learning that you can handle whatever comes your way. In other words, it gets in the way of learning to trust yourself.
Myths about rumination
Despite all the ways that rumination is painful and disruptive, you may still believe that it is helpful or serves a purpose. That is why the first step in tackling rumination is looking at your beliefs about how rumination is working for you.
Myth: Rumination is protecting me.
Truth: We are not supposed to go through life anticipating every possible problem or conflict, and having a plan for how to address it. Attempting to live like this is making you more anxious, i.e., more likely to feel like the world is a dangerous place and that you are ill-equipped to handle it.
Myth: Rumination is problem-solving. It’s productive.
Truth: Productive problem-solving, whether it is internal or in conversation with others, will eventually come to a reasonable solution. You will find yourself able to move on. When rumination is masking as problem-solving, it will never feel satisfactory or good enough. You will know the difference: one feels good, and the other has everyone in your life feeling exhausted!
Myth: I’m “processing” painful thoughts and experiences and this is necessary for healing, growth, or closure.
Truth: This is a tricky one. It may be challenging to know when you have moved from processing to ruminating, especially when this processing is occurring within a helping or therapeutic relationship (this often occurs in therapy with undiagnosed OCD and was termed “co-compulsion” by Dr. Sally Winston). Remember that rumination is highly repetitive and it does not move you closer to an insight, solution, or sense of satisfaction. More often, it leaves you feeling more confused or distressed. Metaphorically, think of processing as a path you have to walk that ultimately leads to a destination. Rumination is a circle; you log a lot of steps but never really get anywhere.
Myth: Rumination is automatic and out-of-my control.
Truth: Many people believe they cannot control rumination, especially when they have been doing it for a long time and it is associated with intense emotional states. I understand why it feels uncontrollable. In my clinical experience, I’ve found that some people find it easier to stop ruminating than others, and I suspect that there are brain-based reasons why it is more challenging for some people. All that being said, you do have more control over this than you believe you do! The first step is seeing the rumination as a behavior that you are doing, as opposed to something that is happening to you, outside of your control.
How to stop
Prepare yourself: I am about to share a lot of words in order to basically say that to stop ruminating you have to….just stop. However, I do have some tips:
First, become an expert on your rumination patterns:
Identify what you tend to ruminate about: You are not ruminating about anything or everything. What are the re-occurring themes of your rumination?
What is the purpose of the rumination? I’ve mentioned many of the common ones already, like “figuring it out” or trying to better understand a past event.
Are there certain times of day that you are most likely to ruminate? Knowing this will help you be more prepared to catch rumination early.
Once you find yourself ruminating, tell yourself, “I am not going to figure that out right now.” If you want to ease into it, set a timer and give yourself a limited amount of time to think about it and then…
Turn your attention to other things that need to be done. Like a fisherman, your mind is going to toss thoughts out with the intention of hooking you into ruminating. Don't bite!
If you know that your rumination is of the depressed variety- feel free to use some distraction to interrupt rumination. Ideally, distraction that involves engaging with something joyful, humorous, or active. Learn and practice self-compassion as an alternative to beating yourself up.
If your rumination is of the anxious/OCD flavor, then do not replace it with an enjoyable distraction. Sorry, but it’s likely to become another form of avoidance or compulsion. Instead, interrupt rumination by doing whatever else you are supposed to be doing at the moment. If nothing needs tending to, choose a values-based activity and get to it. You can also check out my article “Disengaging With Unhelpful Thoughts” for more strategies.
If you often find yourself in the midst of rumination that involves really overwhelming feelings, you might want to first try out the Dropping Anchor technique that I discuss in How To ‘Drop Anchor’ and Ride Out the Storm. It was not designed for rumination necessarily, but can help interrupt when emotion is really intense.
It is not an exaggeration to say that getting rumination under control can be life-changing. It’s often a key contributor to really painful emotional cycles. But it is not easy and many people need help to troubleshoot their strategy. If you are struggling with rumination, it’s worth seeking out professional help from a licensed clinician.
Here are two resources I often share and each one takes it’s own unique approach to rumination:
Mindfulness for Mental Rumination (with Jon Hershfield) on the Your Anxiety Toolkit podcast
How to Stop Ruminating by Dr. Michael J. Greenberg
Catch me in the comments! I would love to hear your thoughts (haha) on rumination.
What are some ways that rumination has kept you stuck?
Do you believe that this is something you can control?
Any tips you want to share with others?
A reminder: I invite you to read along and join me for a book discussion of “The Full Catastrophe: All I ever wanted, everything I feared” by
.Please go here to register for the book discussion on May 30th at 12pm EST (US). It’s FREE to participate.
I hope you will join us! This will be an informal discussion and Casey has agreed to join us!
To learn more about The Full Catastrophe, I highly recommend checking out the reviews on Casey’s website. You can get a copy for yourself HERE or anywhere else you buy books. The QR code in the book includes a reading guide with discussion questions, which I will use to facilitate our group chat. You can also access additional bonus content here. You can learn more about Casey on her Substack.
If you have been following along, then you are hopefully building a hefty tool-kit for responding to difficult thoughts and feelings! Here’s some you may have missed:
Disclaimer: This article is a reflection of my personal and professional experiences as a licensed clinical psychologist. It reflects my current and best understanding of these issues. It is intended to be educational and informative, but is not medical, clinical, or therapeutic advice. Following this newsletter does not establish a therapeutic relationship with me. Dr. Amber_Writes, and other written communication by Amber Groomes on Substack, is not a substitute for treatment, diagnosis, or consultation with a licensed mental health professional. I assume no liability for any action taken in reliance on my writing here at Dr. Amber_Writes. Any questions about your personal mental health treatment should be directed to your personal medical professional. You can find a therapist at Psychology Today.
It's an issue for me in the context of trauma -- ruminating on the bad memories, which often happens when I have a sensory trigger, but also happens as certain dates approach.
Rumination of all forms for me was way worse before I took hormonal birth control non-stop (no placebo days), as part of PMDD. It was torture.
Another great article Dr. Amber! I am a recovering ruminator. You covered everything here that took me a year to learn. I had a saying that "the over examined life is not worth living." I knew I was ruminating but I didn't know what to do to help myself. It's so emotionally draining and exhausting yet I persisted.
This was years ago when this type of information was not readily available.
Once I reached perimenopause and didn't have the energy for superficial things I finally addressed my ruminating habits. I can tell you I'm so much better for being aware, accepting it, and learning how to manage it. STOP!
I'm also much more social because I don't spend the hour after any social engagement ruminating about what I said and what the other person said to find flaws in myself. I'm just me with nothing to prove without the pressure for perfection.