Rumination
Rumination is a repetitive negative thinking state that is triggered by pervasive negative beliefs. It is a sticky thinking pattern that shows up habitually when triggered by certain environmental or internal states.
Pervasive negative beliefs and rumination
High anxiety isn’t the consequence of lots and lots of anxiety, but rather an anxiety state plus a secondary interpretation of the state as a threat itself (also called second fear). Similarly, depression isn’t lots and lots of sadness, but rather an uncomfortable feeling (like sadness, guilt, loneliness, anger) plus an interpretation of that feeling that you are hopeless, helpless, or worthless because of it.
As an example, everyone feels lonely sometimes. Loneliness can be a clean or clear emotion if you notice it, and think, everyone feels this way sometimes. It’s painful to feel isolated and disconnected. If you don’t add any more to that, the feeling is likely to peak and pass or to give you information on an action that might be beneficial for you, like reaching out to a friend.
A more common experience of loneliness is that when the feeling of loneliness shows up, you think, what is wrong with me? why do I always feel this way? I’m such a loser for feeling like this… These thoughts are likely to trigger feelings of hopelessness, helplessness, or worthlessness. Specifically,
Helplessness – There’s nothing I can do to make this better.
Hopelessness – Things will always be this way.
Worthlessness – This is because of me. I am worthless and unlovable.
Behavioral activation is the main intervention for these types of thoughts and feelings because I want to give your body and mind the opposite experience. I want you to experience: Things in my life change. My life can change based on my actions. People like me and I feel connected to them when I take effective action.
That said, I am aware that worthlessness often feels like a blanket. If you are starting to or have lost interest in activities you usually find pleasurable, it is the feeling of worthlessness that is clouding your interest. You often have to act as though you aren’t feeling hopeless, helpless, or worthless over and over until those feelings actually fade (just like doing lots of anxiety exposures).
Rumination is a repetitive negative thinking state that is triggered by pervasive negative beliefs. It is a sticky thinking pattern that shows up habitually when triggered by certain environmental or internal states.
What can we learn about rumination from worry?
Rumination is to the past what worry is to the future. When anxious, you are prone to ask, what if? When hopeless, helpless, or worthless, you are likely prone to ask why? You will have the urge to replay past memories in an attempt to figure out why you feel the way you do, and whether or not you deserve it. This is called rumination.
Worry is a repetitive negative thinking state triggered by anxiety sensitivity and intolerance of uncertainty (and often other mechanisms too). When you perceive a threat, your body experiences fight-or-flight sensations and catastrophic future-oriented thoughts. To overcome worry, you have to predict that it is coming and then be ready to get distance from your catastrophic thoughts. If when a “what-if” thought shows up, you engage it and keep it going, you are going to fall into a worry spiral.
We want to learn to use the same skills with the urge to ruminate. That is, we want to try to predict the triggers that provoke feelings of hopelessness, helplessness, and worthlessness, and then have a plan for redirecting your attention back to the present moment, rather than ruminating about the past.
What’s the difference between rumination and introspection?
Introspection is a chosen thinking state. Like choosing to be in a conversation with a friend and choosing to either discuss a certain topic or change the topic, introspection is a chosen conversation with yourself. You can keep it going or choose to think about something else. You don’t need to figure out whatever you are thinking about at the moment. Reflective introspection starts and stops based on your decision.
Reflective introspection is different than rumination the way that problem solving is different than worrying. During both reflective introspection and problem-solving, you are choosing to bring your attention to the relevant topics and your attitude towards them is one of curiosity and hopefulness. Put differently, attempting to problem-solve or reflect assumes that your action will have positive consequences. It is an assumption of hope.
Overcoming rumination
Here’s the plan for overcoming rumination:
● Self-monitor to figure out what triggers feelings of hopelessness, helplessness, or worthlessness.
● Use behavioral activation to redirect yourself to the present moment when depression zaps your energy.
● Write out the memories that your mind often uses against you when you are ruminating.
● Make a plan to discuss content about which you actually feel hopeless, helpless, or worthless in therapy.
We can’t prevent feelings like sadness, loneliness, guilt, or anger from arising, but we can work on how we respond to those feelings. You are on your way towards overcoming depression if when you feel these feelings, you challenge the urge to ruminate in both your thoughts and your actions.