Obsessive Thinking, Worry, Rumination - Cognitive Behavior Therapy (CBT)

Obsessive thinking is an inability to gain control over recurrent, distressing thoughts and images. The process may be mildly distracting, or utterly absorbing. Obsessive thoughts and images are embedded in a complex network of feelings, sensations, and often, behavioral routines. Brain imaging studies indicate that obsessive thinking is associated with a neurological dysfunction of unknown cause that forces thoughts into repetitive loops. While some people find themselves obsessing for the first time, others may have had multiple episodes, the specific content changing over time. Obsessive thinking can be like a hamster wheel, as one hamster gets off, another takes its place, and the wheel keeps spinning.

Obsessive thinking can be adaptive, when it is directed toward healthy goals and real problems with achievable solutions. But for many people, this process breaks down. We’re here to talk about the dark side of obsessive thinking: worry, rumination, obsession:

Worry. Worry is the anxious preoccupation with anticipated events.  Healthy worry alerts us to potential problems and motivates problem solving. Once problem solving is underway, the worry will subside. If it’s concluded that there is no clear solution, that direct change over the unwanted situation is not possible, acceptance is achieved.

But often the adaptive process breaks down. Our minds become trapped in an endless process of “figuring it out.” We become plagued by thoughts and images of disastrous outcomes that may never occur. Worriers are particularly challenged by problems that have no clear solution. Instead of accepting and managing these difficult realities, they are viewed as evidence of the futility of even trying to work things out.

 Rumination. Rumination is focused on past events. It is a preoccupation with perceived mistakes, losses, slights, actions taken or not taken, opportunities forever lost. The feelings associated with obsessive rumination are guilt, regret, anger and envyRumination is often accompanied by harsh judgments, criticism, grudges, toward both self and others, and the overwhelming belief that if things had only been different then existing and future misery could have been avoided.

The Damage Done. Obsessive thinking can intensify and prolong distressing emotional states, encourage damaging behavioral routines, communication. Worry reinforces anxious feelings – you literally scare yourself – which, in turn, only leads to more worry. The process can extend into anxious periods lasting hours, days, weeks, even years, at times spiraling into panic attacks and emotional "spikes" of anger, guilt and shame. Rumination reinforces feelings of sadness, hopelessness and anger, and if left unchecked, can sink into depression and withdrawal, or escalate to damaging displays of anger and rage. Obsessions associated with OCD range from distracting to debilitating. And compulsive harmful routines can slowly tear away at lifestyle and wellbeing, or altogether take you out of the game.    


Shouting “STOP” Doesn’t Help

Of course if you could simply will yourself to stop thinking certain thoughts, shout “STOP”, snap a rubber band, trigger a shock, then you wouldn’t be here. There’s no easy “off” switch for obsessive thinking. Saying “stop” is the most intuitive response to obsessive thinking. But psychologists have discovered that the attempt to block some thoughts from awareness leads to an equal and opposite reaction in which the very thoughts you’re trying to suppress come swinging back with a vengeance. Telling yourself to stop thinking obsessively is like pushing a beach ball under the water. The harder you press, the higher it pops, when you can no longer hold onto it!


How to Overcome Obsessive Thinking

Well take heart! You can overcome obsessive thinking, reduce emotional reactivity to the thoughts, get out of your head, and courageously face avoided areas of life! Cognitive-Behavior Therapy is an evidence-based, practical approach for obsessive thinking, worry and rumination. CBT is as an action-focused form of psychotherapy that seeks to reduce the intensity and emotional impact of destructive thought patterns like worry and rumination. CBT works by 1) changing beliefs and assumptions underlying obsessive content, including beliefs about obsessing, 2) practice accepting, distancing, and redirecting attention to other content, 3) courageously committing to the hard work of changing your behavior where it is needed.