Do you often ask this innocent question? Watch out – you may be at risk for depression, anxiety, and other disorders.

Photo by: Jonathan Singer / Unsplash

Photo by: Jonathan Singer / Unsplash

Why may it be unhealthy to ask Why all the time?

Do you frequently ask yourself:

-       Why did this happen to me?

-       Why do those things always happen to me?

-       What’s wrong with me?

-       Why couldn’t I have handled things better?

-       Why do I always react this way?

-       What does this mean about me?

Questions, such as, “Why me?” or “What’s wrong with me?” and replaying the problem or a situation over and over in your head, may be a sign that you have a tendency to ruminate. 

What is rumination?

Rumination is repetitive “over-thinking” or dwelling on a problem or on a negative feeling. We may brood on what might have caused the problem, ponder on our predisposition to encounter obstacles, or obsess about the unfairness of the world.

Rumination is the tendency to replay negative experiences over and over again in our minds.

Rumination actually originates from the Latin word rūminātio - chewing the cud. Yes, that is what the cows do – chew and re-chew and re-chew their cud.

But what is the problem with asking this little innocent question “Why?” over and over again? Isn’t it good to get to the bottom of the issue? Maybe, just maybe, if we ponder on it a little more, we will find a solution. Or maybe we will learn a valuable lesson that will allow us to act differently in the future. Or we will finally understand the root of our problem. Or will figure out something important that we might have missed.

Unfortunately, rumination often masquerades as self-reflection and problem-solving. But no matter how long we continue to ruminate, we will not find the solution. Rumination does not help us to move on. It keeps us stuck. Instead of helping us to have clarity, it just makes us feel worse.

Moreover, when people ruminate while they are in a negative mood, they interpret life situations and events more negatively, remember more negative things that happened to them, and feel more hopeless about their future and more helpless to change it. Rumination leads to passivity, disempowerment, and anger.

As if it’s not bad enough, research shows that excessive rumination is related to and may increase depression, anxiety disorders (especially social anxiety and Generalized anxiety Disorder (GAD)), OCD, illness anxiety, PTSD, eating disorders, and substance abuse.

What is the difference between rumination and problem-solving?

Of course, reflecting on a problem with the purpose of taking active steps toward improving the situation is an important step in achieving our goals.

Rumination, however, means passively dwelling on a problem for too long. It usually focuses on the abstract aspects of the problem, not on the concrete steps toward a solution. If anything, this endless dwelling often stands in the way of finding a solution or making a change. Therefore, while problem-solving may move us closer to our goal, rumination keeps us where we are.

When you approach the problem in a very concrete and specific way and brainstorm the practical steps to improve it or approach a similar situation differently in the future, you are probably problem-solving.

If you think about the same situation in an abstract way, generalize it, and ask a lot of Why? questions – you are ruminating.

Why do people ruminate?

Rumination often feels as if we are resolving a problem. It may, therefore, make us feel productive for a little while. It also makes us feel that if we ruminate enough, we will finally understand what happened and why, we will make sense of everything, and will be able to avoid these mistakes in the future. Or it can actually replace taking an action – thus, bringing short-term relief as we feel we can postpone any action or decision-making.

Rumination often masquerades as self-reflection and problem-solving. But rumination does not help us to move on. It keeps us stuck.

Recent research has focused on conceptualizing rumination as a habit (a pretty unhelpful habit, that is). Seeing it as a habit helps explain why it is so difficult to stop ruminating and also provides strategies to overcoming or diminishing it.

When we tend to ruminate every time we are in a bad mood, we develop a connection between the bad mood and rumination, and in time, we just can’t help it – when our mood worsens, we start ruminating. And when do we tend to have a dampened mood? Usually, it is when for one reason or another we are unable to make progress toward our goals. An example of a goal may be getting a job, developing a closer relationship, succeeding at school, improving our financial situation, etc.

Basically, if each time we feel bad because we don’t progress toward our goal, we turn to rumination, we develop a passive ruminative stance that becomes deeply ingrained in our thinking. It becomes automatic and is very difficult to change.

To summarize:

Sad Mood + Repetitive Abstract Negative Thinking + Reduced Active Coping = Rumination Habit

How to overcome or reduce rumination?

First of all, you need to identify whether it’s a rumination, a self-reflection, or an attempt to problem-solve.

Do you focus on the concrete changeable aspects of the situation or on the abstract questions?

Do you focus on the specific doable steps to remedy the problem or do you dwell on how bad things are?

Second, examine the benefits and costs of rumination. How is rumination helping you? Do you feel that it helps you be more prepared for worst-case scenarios? Does it distract you from starting to take action on difficult things? Does it provide a sense of control over your life? And what has rumination been taking away from you? Are you less present and engaged in your life? Do you waste a lot of time ruminating? Do you live in a permanent state of doom and gloom?

Remember how we said earlier that the habit of rumination develops when you routinely turn to rumination each time you feel bad? Conversely, if you use other strategies (such as active problem-solving, fun activities, or other distractions) as a response to your negative mood, - you are effectively replacing your rumination habit with other (more productive) habits. Even though rumination seems involuntary, it’s actually a cognitive process that we are able to change by practicing doing something else instead of ruminating.

Specific steps to change the rumination habit

1.    Become a detective.

If rumination has become a habit, it has also become a pretty automatic response to a bad mood. It may seem that it is coming out of nowhere. But it isn’t.

You need to start monitoring very closely and to identify the situations and conditions that tend to trigger your rumination:

- Maybe it's a particular place in your home or at work, a time of the day (for example, first thing in the morning, or before bed).

- Does it happen after a social interaction?

- What are the first physical signs of an emotion that lead to rumination (could it be the feeling of the tears coming up, or increased heart rate, or tightening in your chest?)

- Or are there specific thoughts that usually precede your rumination?

Each time you catch yourself ruminating, stop and ask: what had happened right before I started ruminating? Where was I? What was I thinking? What was I feeling? What were the sensations in my body?

2.    Practice non-engagement.

This is not just passively doing nothing. Non-engagement means actively making a choice to not engage in ruminating. You practice consciously shifting your attention to another topic or activity even though you are still aware of the problem.

3. Come up with alternative strategies that will replace the rumination.

Those strategies have to be incompatible with rumination, and they also need to be rewarding.

Some examples of the strategies are:

When we tend to ruminate every time we are in a bad mood, we develop a connection between the bad mood and rumination, and in time, we just can’t help it – when our mood worsens, we start ruminating.

-       Active problem solving (thinking of concrete steps to take; developing a plan)

-       Physical exercise

-       Listening to upbeat music

-       Going for a walk

-       Dancing

-       Calling a friend (and not talking about the problem)

-       Relaxation

-       When you catch yourself asking “Why” questions, try to modify those questions into a more practical “How?” How exactly did it happen? How can I make it better?

4.    Start working on breaking the connection between the triggering situations or conditions and the ruminative response

This is done by replacing rumination with the strategies that you identified as helpful and incompatible with rumination.

It goes like this: you plan ahead and have a list of alternative strategies ready for the situations where you usually ruminate. When you find yourself in one of those situations (or feel a negative emotion), you immediately implement at least one alternative strategy.

Remember: you are working on breaking a bad habit. It is very important that you consistently practice the strategies that you have chosen as a response to your negative mood or to the situations that you recognize as leading to rumination.

5.    The goal is to form a new habit.

As you consistently respond to the identified triggers with the newly chosen activity, - you eventually start doing it automatically.

6.    Practice, practice, practice.

Be on a constant lookout for your cues/triggers. Use every opportunity and every cue to practice the newly chosen activities as a new response. Your goal is to do it as many times a day as possible. Remember - rumination is a habit and habits are difficult to break; therefore, you need to practice a lot!

7.    As an advanced bonus strategy, when you progress, try re-creating the cues for rumination on purpose so that you can practice immediately connecting them to the new activity.

You can re-create a sad or angry mood by recalling a sad or aggravating event, playing sad music, or purposefully putting yourself in a situation/place that you know will lead to a negative emotional state.  I know it sounds counterintuitive but think of it as a wonderful opportunity to regain control of your reaction to those situations (that is, not ruminate).

8.    Don’t give up!

You know it takes time to change a habit. But it is well worth the effort to finally start actively addressing the problems instead of passively dwelling on them.

Have a list of alternative strategies ready for the situations where you usually ruminate. When you find yourself in one of those situations (or feel a negative emotion), immediately implement at least one alternative strategy.

89.    Seek professional help.

Long-standing habits are very hard to break. If you feel that rumination is interfering with your life or if you are feeling anxious and/or depressed, it may be time to seek psychotherapy.

There are various strategies that your therapist may be using to help you overcome rumination. A therapist specializing in Cognitive Behavioral Therapy (CBT) will conduct a functional analysis of ruminative instances, identifying antecedents, behavior, and consequences that are involved in keeping the habit going. She will then help you find responses that are incompatible with rumination and incorporate them into your daily life.


References:

Harvey, A. G., Watkins, E., Mansell, W., & Shafran, R. (2004). Cognitive behavioral processes across psychological disorders. Oxford, UK: Oxford University Press.

Treynor, W., Gonzalez, R. & Nolen-Hoeksema, S. Cognitive Therapy and Research (2003) 27: 247. Ruminative Responses Scale.

Watkins ER, Nolen-Hoeksema S. A habit-goal framework of depressive rumination. J Abnorm Psychol 2014;123:24-34.

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Anna Prudovski is a Psychologist and the Clinical Director of Turning Point Psychological Services. She has a special interest in treating anxiety disorders and OCD, as well as working with parents.

Anna lives with her husband and children in Vaughan, Ontario. When she is not treating patients, supervising clinicians, teaching CBT, and attending professional workshops, Anna enjoys practicing yoga, going on hikes with her family, traveling, studying Ayurveda, and spending time with friends. Her favorite pastime is reading.

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