How does ruminating about an obsession in OCD differ from worrying, generally?
It could be said that worrying makes you feel anxious about something verifiable that has already happened or could happen in the future. Ruminating, on the other hand, is to compulsively dwell on the obsession, whatever that might be. This type of mental review increases anxiety and doubts about what has or will happen.
When addressing a worry, someone will likely use a combination of intuition while also reasoning with facts. In this case, a satisfactory solution is usually found. Once the worry is solved, the person moves on. For pervasive concerns, such as those linked with generalised anxiety disorder (GAD), it might be a little more complicated. This is especially so when depression is involved, but again, ways to manage problems can be worked on by generating helpful strategies.
However, when people ruminate about an obsession, they tend to search for answers, repeatedly. By mentally scrambling around for solutions, albeit unsuccessfully, they worsen the problem. A person will deliberate about lost opportunities, disappointments, if-only statements and regrets. Also “shoulds” and “musts” come into ruminations, such as ‘I should have prayed harder’, ‘I must double-check my work is hundred percent’ or ‘If only I didn’t have OCD, I would be a better person’. Sorrow, grief, what to do about this or that, how to protect oneself or others, and fear about the future and what it holds, all add to the person’s problem.
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. 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. Consider ruminating as a thinking behaviour. It is the corresponding mental compulsion related to the obsession. For example, if the obsessive thoughts are that harm might come to oneself or someone else, then the thinking behaviour 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 the thinking behaviour as you would with any other compulsion, and in terms of starving any obsession.
By exercising control, you become more aware of mental rituals, which means you can learn to “shift state” more readily. 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. There, you would be mindful of the scents, what you can touch, the sounds, and what you can see. Having a packet of strongly flavoured sweets in your pocket can be good since you can pop one in your mouth and mindfully direct your attention to the taste.
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. Leaning into raised anxiety while practising mindfulness is important. This type of attention is beneficial because it teaches you that you can hold yourself up until anxiety reduces in its own time. By bearing with associated distress, you build a tolerance to it, and this is what leads to habituation.
How can I make sure I don’t go back to ruminating?
One useful tip is to persuade yourself that any further ruminating will be given attention to in one hour. You would allow yourself 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. However, if after an hour passes and you’re hard-pressed to fall back into ruminating, then ask yourself where it will lead? Next, 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 with the negative thinking behaviour. Instead, becoming more in control of rationally prioritising your thoughts can help you find workable solutions.
In sum, ruminating happens when you deliberate at length about the problem. This circular thinking usually involves self-questioning. For example, with an obsession about homosexuality, the questions might be ‘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.
In this case, the “shifting state” method can enhance exposure-response prevention. The exposure would be to gradually introduce yourself to same-sex people and allowing yourself to ride through associated anxiety. Later, if you fall into ruminations and the what-if scenarios about your exposures (e.g., ‘What if when I went to the gay bar, I really did fancy that guy/girl’), you can then bring in the “shifting state” strategy.
Intuition and rational thinking can help provide solutions for general worries; also, helpful strategies for people who have generalised anxiety disorder can also be worked on. Obsessions are involuntary as opposed to ruminating, which is a purposeful behaviour to search for answers that cannot be found in the mind. Since ruminating is a choice, it can be resisted. Shifting state is a helpful solution for this negative thinking behaviour since it is a strategy that helps you mindfully distract. Intrusive thoughts are acknowledged, accepted and allowed to come and go during mindful exposure; also, leaning into raised anxiety and allowing the symptoms to reduce naturally is important when using this method.
By Carol Edwards © 2018 Updated 2019.