Rumination

Mentally 'chewing over' negative thoughts

Many depressed individuals often have times where they sit alone and begin to consider how bad everything is. An important term to understand here is the term ‘rumination’. Rumination is a term used to describe a behaviour that involves ‘chewing over’ something in our minds, over and over again. If we begin to consider a problem or a difficult situation, and we are alone with no distractions, there may be little to take our mind off the problem and we may begin to ruminate over this problem. Depressed individuals sometimes feel that the best way to alleviate worry is to think over a problem over and over in their minds. Unfortunately this may simply mean mentally going round in circles and continuing to focus on the problem until it appears overarching and overwhelming.

Of course many problems need to be addressed and tackled in a practical manner. But one needs to take clear goal oriented action rather than just chew the problem over and over in one’s mind.

Rumination and Obsessive Compulsive Disorder

Rumination is also a central feature of Obsessive Compulsive Disorder. Even if you don’t know what this disorder is, you may have seen movies where someone obsessively washes their hands over and over again or has little rituals they do in order to try and be sure they have done something such as checking they have locked the door three or four times in a row. They may also be superstitious, believing they can’t step on the gaps between paving slabs on a path, or they may feel the need to do things a certain number of times, perhaps check everything 5 times before they can feel confident they have actually done something. Around 70% of the population tend to indulge in various such rituals – albeit often not as severe. This demonstrates that often behaviours that are maladaptive are behaviours we all do and that those who suffer from severe personality disorders simply do these things a lot more than the rest of us.

Rumination, when applied to emotions, usually involves the belief that, somehow, if we think about something enough, if we try and mentally understand the emotions under consideration, we might somehow be able to control those emotions. So for example, if we are angry with someone, we might think that if we sit and think about all the aspects of the scenario – why we are angry, what we could have done differently, why the person did what she did, whether or not they were being vindictive or not etc etc, basically ‘chew over’ and try to over think our emotion, we might somehow be able to control it and thereby extinguish it. In reality, just as is the case for the person with Obsessive Compulsive Disorder, overly focusing on the negative emotion may well actually increase the potency of that emotion.

Of course negative emotions are actually often pointing to a difficult situation that needs to be addressed. Ignoring the situation might be the opposite extreme of ruminating and may also not be a good option. One may actually need to take concrete practical steps in order to attempt to resolve the problem. Often, however, depressed individuals don’t use the best strategies to try to resolve conflicts and learning good strategies for achieving goals will be one of the focuses of the 'Organisation' section of this website. For now we will focus on the ‘not ruminating’ aspect of the problem.

Cognitive approach for treating OCD

The Cognitive approach for dealing with Obsessive Compulsive Disorder (OCD) involves learning to stop ruminating. Prognosis for recovery from Obsessive Compulsive Disorder is, I am afraid to say, not good. However, it is possible to recover from this condition and I personally know someone who had full-blown Obsessive Compulsive Disorder who now barely even has any symptoms. But reconditioning in this manner probably took her around 10 years in total. The important thing to bear in mind is that full recovery can occur, so don’t focus on those who don’t recover, focus on the fact that some do recover.

I will now mention the Cognitive approach to treating symptoms of OCD. After presenting this approach I will then discuss this approach as it relates to rumination. At some point, the person with OCD, in the Cognitive model for recovery, has to begin to ignore the overwhelming urge to keep checking things, and force himself not to do this. The checking behaviours do actually provide some alleviation from the anxiety and fear that the individual has concerning the possibility that she may forget, for example, to lock her front door properly. Due to the fact that this checking does alleviate anxiety a little, for the person with OCD, the trauma induced by not checking is immense and overwhelming. She feels that she is losing the little control over her anxiety that she has. But the OCD patient has to force herself to go through this process. It is pretty much like going through the detoxification process for an alcoholic. The aim, however, is for the OCD patient to experience that after not checking, the world did not end, no terrible calamity occurred and nobody died. These are the kinds of underlying fears that plague the OCD patient and deep down she believes that if he doesn’t check then these calamities may occur. Once the patient has forced himself to not check so much, the patient is then encouraged to reflect on the fact that nothing terrible has occurred as a result of not checking. This is facing her demons as it were. Eventually the OCD patient will hopefully begin to realise that the checking behaviours are actually unnecessary. They can actually survive without them, and terrible things seldom happen as a result.

The Cognitive approach and rumination

I could provide a far more in-depth explanation of this process, but I am simply using it as an example of how rumination operates. Emotional rumination, ‘chewing over’ negative emotions that is, is often a potent behaviour for the depressed individual. And the depressed individual needs to undergo a similar process to the OCD individual in order to learn not to sit and ‘chew over’ negative emotions for extended periods. It is actually a kind of OCD behaviour and causes similar levels of stress. At some point the depressed individual will need to learn to

Consider the best steps that she can think of to try to resolve the difficult situation that she is ruminating over.
Take the practical steps she has decided on.
Then stop thinking about the situation, and do something practical to take her mind off it.

How does rumination contribute to depression?

Depressed individuals tend to have moments in their lives where they sit alone and reflect on how there is no hope and nothing to live for. This is also similar to, or perhaps a form of rumination. One of the key elements of recovering from depression, from my perspective, is having strategies in place already prepared in advance, which can immediately be applied when one of these ‘doom spirals’ occurs. I call these situations ‘doom spirals’ because the moment one sits alone and begins to think in this manner, its like a rolling snowball, the thoughts intensify fast and the felling of ‘depression’ begin to get deeper and deeper and within minutes there appears to be no reason to live any more. One of my aims is to help depressed individuals to learn to have practical activities and strategies ready so that as soon as the individual feels that she is moving into one of these ‘doom spirals’ she can stop thinking along these lines and occupy her mind with other practical activities. Typical activities that can be useful in order to divert one's time away from potetial isolating 'doom spirals' include:-

Building a social support network and some friendships so that one can make sure she is not spending time alone, since it is often when the individual is alone that these ‘doom spirals’ occur
Self-pampering activities – this means learning what it is that you enjoy doing the most and what activities make you feel relaxed and happy. These activities might include doing some exercise, or watching a movie.

Often, however, depressed individuals find these activities difficult, and this may in itself be a depression contributing factor within the complex web of behaviours associated with depression.

Click on the links below in order to be taken to related pages

Treatment for depression

Cognitive Therapy

Organisation skills - how do they relate to anxiety?

Introduction and contents pages for this section of website