How Rumination Reinforces OCD Symptoms—And Makes Them Worse

Rumination is a word that’s used somewhat often, and most of the time it has nothing to do with a mental health condition. It’s the act of repeatedly dwelling on a thought, situation, or experience, analyzing it in an attempt to solve a perceived problem. 

By definition, rumination is repetitive or persistent, and it’s considered a pattern of “overthinking.” It can include reviewing past events, replaying conversations, and a whole host of other manifestations. Though rumination is often used as a way of neutralizing distress and anxiety, it can actually make them worse—even for people who don’t suffer from any mental health problems.

For people with obsessive-compulsive disorder (OCD), however, ruminating can be much more impactful. It’s considered a compulsion (the “C” in OCD), and it maintains the vicious cycle of OCD symptoms. What’s more, it can even make them worse over time—here’s how.

How rumination reinforces the OCD cycle

Mental compulsions—among which rumination is just one of many—are often overlooked because they are internal and therefore unseen. They can be extremely sneaky, and people with OCD often overlook them entirely. Though it can be tough to recognize, rumination serves to fuel the cycle of obsessive thoughts and compulsions, just like any other compulsion. 

Many times, one’s constant engagement in rumination only reinforces the idea that their intrusive thoughts, images, or urges are important, or even dangerous. In reality, they’re not dangerous at all, and compulsions do nothing to prevent them from returning again and again. Rather, compulsions like rumination train the brain to mistakenly recognize uncomfortable thoughts as a threat, and they become more and more distressing over time.

People suffering from OCD often also report feelings of hyper-responsibility. They spend a great deal of time trying to circumvent bad things from happening. They often believe that through rumination, they can stave off negative outcomes. Unfortunately, this serves to only strengthen the sense of over-responsibility that they already feel. In an effort to maintain a sense of control, this cycle is perpetuated time and time again.

Rumination prevents habituation

Engaging in rumination functions to keep the intrusive obsessions at the forefront of one’s mind, rather than dismissing them as unimportant. In a sense, it keeps them alive. Unfortunately, this prevents an important process called habituation, by which people can become accustomed to uncomfortable feelings by allowing them to pass on their own.

Habituation is often crucial in the treatment of OCD with exposure and response prevention (ERP) therapy. Through gradual and consistent exposure to obsessions, people with OCD can learn to tolerate the distress they feel when faced with similar scenarios in the future. It is through this process that OCD sufferers can learn that their obsessions are not actually threatening or dangerous, and that they are capable of tolerating discomfort without resorting to compulsions. 

When helping people understand how OCD works, I find it helpful to explain the “fight, flight, or freeze” response. Imagine you’re standing face to face with a mama bear in the middle of the woods. In that scenario, there is a very real threat. You could be attacked and left for dead. That is a terrifying scenario. Our brains are developed so that hopefully, when presented with such a danger, we can respond effectively and survive. 

When someone’s obsessions are triggered, their brain wants to respond in the same way—except this time, there is no real danger, and they don’t need to do anything in order to remain safe. They are already safe—their brain is sounding a false alarm. A thought, no matter how scary or how awful it may feel, is not, in and of itself, dangerous. 

ERP can teach you how to stop ruminating

If you are struggling with ruminating on intrusive thoughts, ERP therapy can teach you how to stop engaging with these thoughts and prolonging the OCD cycle. You will learn how to sit with uncomfortable feelings and resist the urge to do compulsions, including rumination. Like any other feeling, you will see that anxiety eventually passes, and you don’t have to do anything to make this happen. 

The best way to practice ERP and manage intrusive thoughts and mental compulsions is to work with a trained therapist. At NOCD, our therapists specialize in OCD and ERP, and they will provide you with a personalized treatment plan designed to meet your unique needs. Your therapist will teach you the skills needed to begin your OCD recovery journey and will support you every step of the way. They will guide you in taking small steps to reach your goals.

Our team of therapists at NOCD are passionate about the treatment of this debilitating disorder and are trained by world-renowned experts. To learn more about working with a NOCD therapist, schedule a free call with our care team.