Do you often find yourself caught in a whirlwind of obsessive thoughts that seem impossible to escape? Maybe you seem to reassure yourself temporarily, but then that nagging doubt creeps back in asking “but what if…?” If so, I’ve written this blog for you to help you to understand more about this common OCD compulsion.
Obsessive compulsive disorder (OCD) is an anxiety disorder that many people struggle with. It is typically characterised by becoming preoccupied with intrusive thoughts/images/urges/doubts and engaging repetitive behaviours called compulsions in an attempt to reduce the distress caused by intrusions.
Rumination is a common “covert” compulsion; in other words, it’s a safety seeking behaviour that we can’t necessarily see you doing. You do it because it feels like it helps you in some way, that it provides some sort of relief from the distress you feel from the intrusions. The trouble is that the relief you get from ruminating is only temporary, and it keeps you stuck in the long term.
What is OCD rumination?
Let’s clarify what we mean by OCD rumination. Rumination is a deliberate, analytical thought process. This is different to intrusive thoughts, which are uncontrollable, unwanted and involuntary. Rumination however, is a deliberate attempt to try and reassure, solve, figure out and be absolutely sure about a certain fear that you have.
It can feel a bit like being stuck on a mental treadmill where the same thoughts and doubts replay over and over again. It can feel like a never-ending, negative thought process that seems to continuously loop in your mind without coming to an end or a conclusion. It tends to lead to further doubts and “what if?” questions, which increases your preoccupation and keeps you stuck in OCD.
A clinical example
Here’s an example to put things into context.
Jane is coming home from work and waiting for the train. Out of nowhere, she experiences a violent intrusive image of pushing the stranger in front of her into the oncoming train. Instead of thinking “woah that was rather unpleasant and strange” and brushing it off as just one of many weird thoughts that everyone’s brains come up with, she takes it to mean something important that can’t be ignored. So, she starts to ruminate on it. The content of her rumination may sound a little like this;
“Oh my god, that was awful. I am so weird for having this thought! What does it mean? Does it mean that I actually WANT to push this stranger into the train? Oh my god, if I want to push a stranger into an oncoming train then I must have a deep, dark, murderous side to me. Maybe I won’t be able to control myself and I’ll actually act on this thought!”
She then might engage in some “mental argument” with herself which is another form of rumination. Psychologists Sally Winston and Martin Seif describe this as a conversation between different “voices of the mind,” such as the false comfort voice and the worried voice:
False comfort voice: “Come on, I’m sure you don’t want to actually do that. You’re a nice person! You’ve never hurt anyone before in your life”.
Worried voice: “But there was that one time I pushed my sister over in an argument when I was 10 and she hurt herself. What if I’ve been suppressing this side of me for my whole life??”
False comfort: “Oh don’t be silly, everyone argues with their siblings. Besides, you were only 10 years old then! Kids don’t know any better”
Worried voice: “But I’ve watched true crime documentaries about psychopaths and they always show psychopathic tendencies from a young age, maybe that’s me!”
And it can go on and on and on. Trying to be certain, trying to figure out, trying to solve.
How I can help you
Like any behaviour, rumination is something that you have learnt in order to try and deal with your anxiety. The good news is, just as we learn behaviours, we can UNLEARN them too with the right help and support.
When you work with me, we’ll use Cognitive Behavioural Therapy (CBT) to understand more about your unique rumination patterns and how they are keeping you stuck in a vicious cycle. Then, using evidence-based tools and techniques, I will show how to press stop on the rumination process and disengage. Eventually, rather than trying to be more sure (which is an impossible task!), you will feel more comfortable with uncertainty and confident in your ability to sit with the discomfort of not knowing for certain.
I’ve successfully treated many clients who are stuck on the mental treadmill of rumination. If you need support with rumination and OCD, get in touch here to arrange your first session and reclaim your life from anxiety.
References
Seif, M. N., & Winston, S. M. (2019). Needing to know for sure: A CBT-based guide to overcoming compulsive checking and reassurance seeking. New Harbinger Publications.
