How do I know I’m ruminating about an obsession relating to my OCD, and not just worrying, generally?
While worrying could be said that you are made to feel anxious about something verifiable that has already happened or could happen in the future; ruminating, on the other hand, is to compulsively mull or think something over at great length, usually about the obsessive-compulsive problem.
What are the solutions for both worrying and ruminating?
When addressing a worry, someone will likely use a combination of intuition while also reasoning with facts, and in which case, a satisfactory solution is usually found. Once the worry is solved, the person moves on. For pervasive concerns linked to generalised anxiety disorder (GAD), it might be a little more complicated. This is especially so when depression is involved, but again, ways to manage a problem can be worked on by generating helpful strategies.
However, when people ruminate, they tend to compulsively search for answers, mentally scrambling around for solutions, albeit unsuccessfully. A person will deliberate about lost opportunities, disappointments, if-only statements and regrets; also “shoulds” and “musts”, such as “I should have done this”, “I must do that” or “if only I hadn’t have done _____”. Sorrow, grief, what to do about this or that, how to protect oneself or others, and fear about the future and what it holds for them add to the problem.
Unfortunately, no matter how many times a person becomes distracted about the things that matter to them, they never seem to settle on any concrete answer that would generally help them move on, and so it goes on.
So what’s the answer?
First, and before you can start to put helpful strategies into place, it’s important to recognise when negative reflection is happening, especially when one’s repetitive thinking is about an obsession in obsessive-compulsive disorder. Therefore, it is particularly crucial to identify that while obsessions and ruminating both take place in the mind not to confuse the latter as an actual obsession.
Should an obsession be present then the ruminating will usually be seen as the corresponding mental compulsion related to it. If the obsessive thoughts are that harm might come to oneself or someone else, then the ruminating will usually be going over the “what-if” scenarios and fearing the worst.
By identifying that you are ruminating, you are, in effect, doing what you would do when you notice yourself doing any other compulsion. Therefore, the answer is to resist ruminating as someone would with any other compulsion, and in terms of starving any obsession. Exercising control once you become aware that you’re doing a mental ritual means you can learn to follow through by “shifting state”.
What is meant by “shifting state”?
This means being in the present, and using your five senses as you move your mind and body to something else or being mindful of what you’re already doing. For example, if you like the outdoors, you might choose to spend time in the garden, or the park, and be mindful of the scents, touch, sounds, and what you see. Having sweets in your pocket is helpful too as you can pop one in your mouth and mindfully direct your attention to the taste. Strong flavours such as mint or humbug are particularly useful.
But isn’t this like blocking obsessional thoughts, won’t ruminating just start up again?
No, because obsessive thoughts are involuntary and cannot be controlled, but behaviours can be controlled, whether mental or physical. And so in this instance, you would be stopping a negative response when you shift state, not trying to stop an obsession. In other words, you would acknowledge the intrusive thoughts are there, accept they’re there, and allow them to come and go while staying in the present with your mindful activity.
Will shifting state increase my anxiety?
It can do, as moving away from any compulsion can increase discomfort, but this is normal because anyone in the grip of anxiety wants to run away from it as quickly as they can. Unfortunately, avoidance is not a long-term solution. The goal, therefore, is to rest with raised anxiety while being supported with your mindfulness attention on what you’re doing presently; also, having the confidence that you’re holding yourself up until the symptoms reduce in their own time, so it’s bearing with the distress and building a tolerance to it that counts.
How can I make sure I don’t go back to ruminating?
One useful tip is to convince yourself that any further ruminating will be given attention to in one hour and for a strict amount of time, let’s say 10 minutes only for mental review. It might be that when an hour passes you’ll have forgotten to come back and address the issue, or let it go. However, if after an hour has passed and you are hard-pressed to fall back into ruminating, then ask yourself where it will lead, and then persuade yourself to come back in another hour. The way out of this spiral is to be stubborn in training yourself to resist becoming preoccupied and, instead, becoming more in control of rationally prioritising your thoughts to help you find workable solutions.
I worry endlessly about being gay and mentally go over what-ifs, repeatedly. Is this ruminating?
Yes, the ruminating happens when you deliberate at length about the problem. This circular thinking usually involves self-questioning. For example, “How do I know if I’m gay?”, “When I looked at pictures of people of the same sex to prove or disprove my sexual orientation, I experienced a groinal sensation, what if this shows I am gay? When all questions have been exhausted, they start over again.
So would I shift state? Or would I do an exposure?
You can shift state and also do an exposure. Doing an exposure would usually be to gradually introduce yourself to same-sex people and allowing yourself to ride through associated anxiety. You might start by looking at pictures of people of the same sex in underwear, next watching movies about sexual orientation, and then moving to real experiences, for example, by going to a swimming pool and observing attractive same-sex persons or going into gay bars and getting to know people. Both techniques effectively reduce obsessive-compulsive symptoms (you become less sensitised to your fear), and with practice leads to remission (fear habituation).
Solutions can usually be found for usual worries; also, problems that fit with a generalised anxiety disorder. The solution for ruminating differs in that obsessions are involuntary as opposed to ruminating, which is a voluntary behaviour to search one’s mind for answers that cannot be found in the mind. Since ruminating is a choice, when spotted, it can be resisted. Shifting state can help a person mindfully distract where intrusive thoughts are acknowledged, accepted and allowed to come and go while leaning into raised anxiety until it reduces naturally. Also, to reach remission or dramatically reduce the symptoms of OCD, a person would practise confronting their fears and resist doing their usual corresponding rituals to reduce anxiety. This is known as exposure response prevention, the gold standard evidence-based treatment for obsessive-compulsive disorder.
By Carol Edwards © 2018 Updated 2019.
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