Obsessive compulsive disorder - OCD treatment and therapy from NOCD

The Rumination Trap: How you can learn to stop ruminating

7 min read
Stacy Quick, LPC

One of the questions I get asked most by people starting obsessive-compulsive disorder (OCD) treatment is “How do I stop ruminating?” The answer seems straightforward enough: you can make a choice to stop. In reality, learning to stop ruminating can seem like one of the most difficult things a person with OCD could do. It’s one thing to know something must be done and another to do something.

What is rumination?

Rumination occurs when you have constant and repetitive thoughts about something; it may involve making repeated attempts to solve a perceived problem you’re having. When you ruminate, you are directing a lot of your attention to a particular thought. It’s the difference between having a thought which can go away as quickly as it appeared, and being actively focused on a thought that you’re fixated on and that may be interfering with daily functioning

Rumination is a mental compulsion. For people struggling with OCD, rumination can look like engaging with an intrusive thought in an effort to figure it out. It can involve searching for an answer—specifically, needing to feel certain about it. You attempt to make sense of the intrusive thought or try to rationalize it. It may even look like trying to reverse the thought or move on from it with a feeling of assurance or peace. I would describe it as going down a rabbit hole, or being caught up in an endless loop. 

Mental compulsions are often overlooked because they are internal and unseen. They can be sneaky, and often the person with OCD doesn’t even realize that what they’re doing is a compulsion. Yet mental compulsions do what any other compulsion does: they reinforce the idea that an intrusive thought is dangerous, and deceive your brain into believing that it controls the outcome of the thought. 

One member I worked with would have the repeated intrusive thought that his partner would become ill if he didn’t properly prepare their food. In an effort to feel less anxious about this and to convince himself that his partner would not become ill, he would replay in his mind every step he had taken to prepare the food. He would picture the process in his mind and walk through it repeatedly. He would do this several times until he felt convinced that he had taken the proper precautions. Some days, this could take hours, but he could not move forward with his day until he felt that this had been resolved. 

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Why do people with OCD ruminate?

OCD is called the “doubting disorder” for many reasons: people with this illness often doubt their memories, the meaning of their thoughts, their values, etc. OCD distorts how they see things and the experiences they have. OCD often leaves them feeling unsure and forces them to seek comfort or reassurance. 

The nature of OCD makes it easy for a person to ruminate and to focus on justifying what they’re doing. After all, many people ruminate on problems they think they’re having in an attempt to solve them. The issue here is that with OCD, there is not necessarily any real problem or danger. Choosing to ruminate only strengthens the false alarm system OCD creates. 

As with any compulsion, the more you do it, the more the alarm continues to go off. You are inadvertently teaching your brain that in order to feel less anxious and uncomfortable, you need to take action. The truth is that you do not need to do anything to feel less anxious. Eventually anxiety fades.

Even more pleasant emotions, such as joy, fade on their own. There’s nothing you have to do to stop feeling those emotions; the feeling simply moves on after a while. When something is funny, you don’t laugh forever—eventually you stop, without having to do anything.

But when feelings of discomfort occur for people with OCD, the brain can send off a signal that there is a danger when there is not. This signal tends to create a high level of intolerance for feeling uncomfortable, or distress intolerance, and causes people with OCD to try to avoid this feeling as much as possible. In order to overcome this, your brain must relearn the signals, which can occur through habituation.

What is habituation?

Habituation occurs when a person stops responding or paying attention to a stimulus—such as a thought, object, place, person or action—with repeated exposure to that stimulus. This essentially means getting used to something that you don’t like or that doesn’t feel comfortable. 

A personal example of habituation involves the train track I had in my backyard growing up. The train would always go over the tracks around 1 AM each day and shake the entire house, that’s how close it was. Though I was acutely aware of it at first, after living there for a few weeks, I no longer paid attention to it. It didn’t wake me up in the middle of the night or cause me to get scared. I habituated and adjusted to it. I no longer noticed it or was bothered by it. The more I experienced it and saw that it was not dangerous, and that nothing bad happened, the less I even thought about it. I eventually stopped thinking about it altogether. 

The same is true for feared stimuli: the more someone is exposed to them, the more comfortable they become with them, and the less of a response they have to them. They began to build a tolerance to the thing that was once very distressing.  

Addressing rumination, since it’s a mental compulsion, works in the same manner. Once you stop ruminating or engaging with the thought, the “false alarm” goes off less and less. The more you do this, the more it becomes habitual. Initially you may find yourself starting to ruminate and catch it. It’s important in these moments that you give yourself compassion and try again. It requires dedication and practice. Guidance from a specialty-trained professional can also help.

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Learn to stop ruminating

If you are struggling with ruminating on intrusive thoughts, exposure and response prevention (ERP) therapy can teach you how to stop engaging with the thoughts causing your distress. In ERP, you will learn how to sit with uncomfortable feelings and resist the urge to do compulsions. You will see that anxiety, like any other feeling, 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 therapist trained in ERP.

At NOCD, all therapists specialize in OCD and receive ERP-specific training from some of the top OCD experts and researchers in the world. They’ll use their expertise to design a treatment plan for the OCD themes you’re experiencing and provide non-judgmental support every step of the way. To prevent cost from being a barrier to accessing treatment, at NOCD, we offer affordable options and partner with many insurance plans.

NOCD Therapists specialize in treating OCD

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Ilyas Patanam

Ilyas Patanam

MBA

I’m a licensed therapist with specialized training in treating OCD using Exposure and Response Prevention (ERP) therapy, the gold standard of treatments. ERP treats all types of intrusive thoughts, including violent and taboo, so that you can overcome OCD.

Ilyas+1 Patnam

Ilyas+1 Patnam

LCSW, LCSW-2

I’m a licensed therapist with specialized training in treating OCD using Exposure and Response Prevention (ERP) therapy, the gold standard of treatments. ERP treats all types of intrusive thoughts, including violent and taboo, so that you can overcome OCD.

Ray Li

Ray Li

LCSW, LCSW-2

I’m a licensed therapist with specialized training in treating OCD using Exposure and Response Prevention (ERP) therapy, the gold standard of treatments. ERP treats all types of intrusive thoughts, including violent and taboo, so that you can overcome OCD.

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