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OCD Rumination | How to get help?

OCD Rumination | How to get help?



In obsessive compulsive disorder or OCD, obsessions are the intrusive and repetitive images and thoughts that are extremely distressing to the individual. While compulsions are the actions the individual ritualistically performs to reduce the distress, asa direct result of the obsession.

The common manifestations of OCD such as contamination type, aggressive type, checking type or the symmetry/ordering type can be easily detected. They all have an obvious compulsive behaviour that the individual often engages in.

But there is a type of OCD that is very hard to notice, commonly known as “pure-O” or pure obsessions. Here the individual only tends to have obsessions.

Many times in pure-O, the individual may believe for years that they do not have any obvious compulsive behaviour and in some cases, it can be true. But in most cases, the individual does have a compulsion – mental compulsion acts.

In such mental acts, the individual pays serious attention to the obsessive thought or image and starts questioning them over and over to find possible solutions.

This mental act of going over the obsessive thought over and over again is known as rumination. OCD and rumination go hand in hand. Rumination is one of the core characteristics of OCD that causes a person to spend an inordinate amount of time worrying, figuring out, trying to understand, analysing or clarifying thought or theme. Individuals tend to ruminate on certain topics:

  • Philosophy
  • Metaphysical
  • Questions of life and death
  • Religion
  • Origin of universe
  • Nature of morality

Rumination occurs in all forms and subtypes of OCD, a state of mind where a person indulges in long periods of time lingering on to the topic of their obsessions, such as fear of losing things, contamination, or mental checking. Many assume rumination to be the intrusive thoughts and images that occur in OCD, which can be  misleading. Rumination is a mental act that the individual engages in to reduce the distress caused by obsessive thoughts.

Individuals may go on a rumination on one obsessive thought, questing and trying to find answers, for hours and even days. They may be normal but the individuals themselves know how distressing it is.

The individual may go on for years, assuming they only have obsessions and no compulsions for it. Rumination OCD is very hard to detect but once detected, the individual can get help to reduce and eventually stop.

Symptoms of Rumination OCD

There is a very subtle distinction between obsession and rumination. Obsession and rumination both stem from similar types of ‘concerns about control and uncertainty’.

Common Obsessions and Compulsions of Rumination OCD

  • Obsessive thoughts regarding hygiene or cleanliness
  • Fear of feeling dirty, catching a disease, or infecting others unintentionally
  • Disturbing thoughts or fear of harming someone
  • Avoiding certain places or people to prevent being triggered
  • Spending long periods of time reviewing past events and memories
  • Feelings of inappropriate sexual activities
  • Constant worry or fear about environmental contaminants, like toxins, lead or radioactivity
  • Fear that something terrible might happen to you or a loved one
  • Fear or worry that something is not good or things will always go wrong if you don’t take a specific action or do something perfectly
  • Thoughts or images in powerful conflict with your ideals or religious beliefs
  • A long period of time spent pondering existential topics
  • A nagging need for order or symmetry
  • Existential, religious or philosophical obsessions, such as a need to know your place in the universe

Top three techniques to help reduce ruminating-

intrusive thoughts

Rumination can be a major psychological burden. If you suffer from a negative overthinking cycle, then you have to know that it is possible  to put a stop or reduce the flow of unproductive and exhaustive thoughts.

Many techniques can be used as rumination OCD treatment to help you come out of the negative thought pattern which has manifested into a habit.

Here are the three techniques that will help reduce anxiety and increase happiness:

Mindfulness training-

Psychologists have developed cognitive therapies that help patients dealing with rumination intrusive thoughts by practising mindfulness.

This is quite effective because mindfulness makes us think about how we think, instead of having a downward spiral with our thoughts.

Mindfulness brings a sense of awareness into your thought patterns and helps you identify the triggers and realise where the negative thoughts come from.

Mindfulness therapy will include educational sessions and psychological interventions, along with breathing techniques and yoga.

The main goal of these sessions is to help the patient gain insights on how their brain functions, and encourage individuals to focus on their present state. These exercises also stop the patient from obsessing over the past.

Problem-solving techniques-

OCD rumination can be described as “problem-solving gone haywire”. Hence, it makes sense that one of the key techniques to problem-solving is addressing and reversing the numbing and paralysing effect of ruminations.

The first step would be to ask the right questions. For instance, choose action-focused questions like “what can I do about it?” instead of “why did that happen?”. Once you get your questions sorted you move on to the basic steps of problem-solving-

  • Identifying the problem
  • Deciding on the objective
  • Listing resources that will help tackle the goals
  • Tracing a step-by-step action plan
  • Putting the plan into writing if needed

Distractions

This technique involves not giving your mind time to brood or engage in any negative thoughts that will lead to a downward spiral. You can keep your mind occupied with something that you find motivating or interesting. This could be volunteering, exercising, or singing.

An important thing to note is one should choose a constructive distraction, instead of depending on toxic distractions like overeating and substance abuse with drugs or alcohol. Of course, the idea of a constructive distraction sounds good in theory but using it in real life can be challenging.

This is where you need to go for professional help. Therapists and counsellors will teach you to replace your thought patterns and help you get better with mindfulness practice.

Another recommendation would be to allow yourself to ruminate for a brief period, set a time limit, and come out of the thought process to go on for a short period.

Overthinking or ruminating is a vicious cycle that is hard to quit, people who are engaged in negative thinking are on a never-ending quest for insight.

Patients who break away from this toxic pattern can look forward to achieving mental peace and achieving a sharper understanding of themselves.

Most treatment options for OCD ruminations operate on the basis that engaging in compulsions strengthens the obsession. Thus they focus on preventing the individual from engaging in the compulsive behaviour.

Likewise, for ruminations, the individual can engage in other activities when they realise they are ruminating. Individuals can engage in activities like singing a song or focusing on something else in their environment.

Treatment for Rumination and OCD

Generally, a typical treatment of pure OCD rumination includes a combination of psychotherapy (CBT or ERP), Mindfulness-based behavioural therapy (MBBT) and medications or a combination of all for optimal results.

Cognitive Behaviour Therapy (CBT) – CBT is a type of psychotherapy that provides you with tools to think, act, and react to your negative and obsessive thought patterns. Ultimately the goal is to replace any negative thoughts with positive/productive ones. 

Exposure and Response treatment (ERP) – ERP therapy is designed in a way that helps the individual control and tolerate the anxiety associated with obsessive thoughts and simultaneously not allowing them to act on a compulsion to reduce that anxiety. With consistent practice, the anxiety reduces and the individual feels better. This is a type of cognitive treatment, and here you will be exposed to situations that trigger your OCD.

Mindfulness-Based Behavioural Therapy (MBBT) – In an MBBT treatment for rumination in OCD, informal mindfulness training along with exposure and response prevention (ERP) is incorporated with a writing intervention focusing on both behaviour and mindfulness components that contribute to treatment effectiveness.

Gaining Control of Your Thoughts

Even though both types of thoughts – obsessive rumination and rumination of compulsions – are problematic but they are controllable. You might be caught in ruminating thoughts but you can act on them or else they’ll in a way become reality. 

There is a lot of medical help you can get to quiet your mind and live free of obsessions and compulsions. Treatments like Cognitive Behavioural Therapy (CBT) can teach you how to control and master your thoughts and actions, and mindfulness practices can help you learn to coexist with any OCD or rumination symptoms you have difficulty controlling.

When one realises they are not able to stop or control their ruminations, professional help is necessary. Treatment options such as cognitive behaviour therapy, counselling, group therapies and other psychotherapies are available to help the individual cope with their obsessions. For treatment options from our expert team, call us on +91611194949.