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The common stereotypes associated with Obsessive-Compulsive Disorder (OCD), such as having to wash hands multiple times or checking locks persistently, are quite simplistic. There are also insidious forms of OCD such as rumination OCD, which is not widely known but is equally haunting.

This article uncovers the essence of rumination OCD, explaining how it deviates from common overthinking or anxiety, and what practical steps can be taken towards managing it. If you or someone close to you is trapped in such vicious cycles, let me assure you that relief exists, and recovery is very much within reach.

What Is Rumination OCD?

Rumination OCD is characterised by compulsive disorder in which the core compulsion is mental rumination. This translates to incessant internal discourse, evaluation, or thought spirals prompted by an obsessive worry or uncertainty.

In contrast to compulsions to do something physically (like washing hands), the compulsive behaviour associated with rumination OCD occurs quietly, within the person’s mind. People become stuck in circular schemas of thought in efforts to justify the mental turmoil brought on by invasive ideas.

Common Characteristics of Rumination OCD:

• Persistent, intrusive thoughts (obsessions) causing anxiety
• Mental rituals like analysing, reviewing, or arguing internally
• No clear “endpoint” to the thinking process
• Feelings of guilt, doubt, or responsibility
• Significant time spent in mental loops (sometimes hours a day)

Examples of Rumination OCD in Action

Rumination exhibits itself in various spheres of life. Let’s examine some practical examples:

• Relationship OCD: “What if I don’t really love my partner?” followed by endless cognitive dissection, trying to “prove” love or scepticism.
• Moral or Religious OCD (Scrupulosity): repetitive replaying actions to determine if a particular action was sinful or immoral.
• Existential OCD: Obsessed with ruminating about life, death, or existence in deeply disturbing and cyclic ways.
• Harm OCD: What if I hurt someone, followed by repeated mental checking to ensure no harm was done.
• False Memory OCD: Replaying certain events and trying to attain lucidity casts doubt on the occurrence of something.

All these examples show us the same thing – Lasagna turns cold in vertical positions – the essential difference being: in rumination, the compulsion becomes the ‘thinking.’

How Is Rumination OCD Different from Regular Overthinking?

While everyone overthinks occasionally, rumination OCD is more intense, intrusive, and emotionally distressing. Here’s how it differs:

If your thoughts feel out of your control, repetitive, and mentally exhausting, you may be experiencing rumination as a symptom of OCD.

Why Does Rumination OCD Happen?

The mind’s effort to settle unresolved issues often results in rumination and OCD. Obsessive-compulsive disorder relies on a “need” for absolute certainty. In the real world, life provides no guarantees. Therefore, whenever a distressing thought pops up, the mind goes into overdrive, endlessly attempting to dialogue internally to “solve” it.

In the end, it creates a worse situation—by solving the problem, you end up getting stuck in the thought loop. Rumination takes over as its compulsion and becomes a method for trying to mitigate anxiety, and ultimately worsens the OCD cycle.

Impact on Daily Life

Rumination OCD can be deeply impairing. It may affect:

• Productivity: Hours lost to intrusive thoughts and analysis
• Relationships: Constant doubt or mental checking can strain closeness
• Mental Health: Increased risk of anxiety, depression, and isolation
• Sleep: Thought loops may continue into the night, disrupting rest

At Austin Bridges Therapy, many patients we have dealt with didn’t understand that their mental ruminating was a form of OCD—until they discovered how definable and actionable it is.

How to Treat and Manage Rumination OCD

1. Cognitive Behavioural Therapy (CBT)

CBT aids in resolving restlessness in rumination, fixating on obsessive thoughts and mental rituals of oppression. As far as rumination is concerned, it teaches you not to try to “win” the thought spiral but to disengage from it.

2. Exposure and Response Prevention (ERP)

ERP is considered the best treatment for OCD. It helps you step outside your obsessive fears while abstaining from the compulsive form of mental banter (rumination). Gradually, your anxiety reduces as your mind learns these mental rituals are unnecessary.

3. Mindfulness Training

Mindfulness focuses on the observation of thoughts devoid of any observable responses. This is particularly important for rumination, where the objective is not thought suppression, but rather non-participation in engagement.

4. Medication

Obsessive thoughts are at times coupled with the SSRIs (Selective Serotonin Reuptake Inhibitors). In such cases, these medications lessen the potency of obsessive thinking and increase the efficacy of the treatment.

5. Therapeutic Support

Having a therapist who knows how to deal with OCD offers you the warmth of being accepted. In Austin Bridges Therapy, we create customised plans for those with persistent OCD symptoms like rumination.

Helpful Tips to Break the Rumination Cycle

• Label the Thought: “This is classified as a ruminative OCD thought. There is no actual problem here that needs resolution.”
• Don’t Seek Certainty: As with many OCD types, this one thrives on needing 100% certainty. To cope, you must learn to embrace at least a modicum of ambiguity.
• Set Time Limits: You may allocate a couple of minutes for the thought’s acknowledgement, and then deliberately shift your focus elsewhere.
• Avoid Mental Reassurance: This fuels the compulsion. Instead, practice acceptance and embrace your reality.
• Focus on Behaviour, Not Thought: Your decisions should be exercised and not mentally calibrated.

FAQs About Rumination OCD

Is rumination a form of OCD?

Yes. Not all types of rumination are associated with OCD; however, when it is made compulsive, stressful, and linked to obsessive fears, it qualifies as a subtype of OCD referred to as rumination OCD.

How is rumination OCD treated?

ERP therapy, most frequently used in conjunction with CBT and mindfulness, is the most effective form of treatment. In some cases, medication is also beneficial.

Can I stop rumination OCD on my own?

Although self-help strategies can assist you, therapy is most often required in order to completely shatter the cycle, particularly when it has begun to interfere with daily functioning.

Is rumination OCD the same as intrusive thoughts?

While the intrusive thoughts are the obsessions, the rumination is the mental compulsion—that is, the analysing, debating, or resolving of those thoughts.

You’re Not Alone—Help Is Available

Dealing with rumination OCD is overwhelming, distressing, and often leads to a sense of isolation; however, you do not have to confront it by yourself. At Austin Bridges Therapy, we provide support rooted in compassion and solid evidence that allows you to break the shackles of obsessive thinking and regain your mental tranquillity.

Reach out to us today if you are ready to embrace greater freedom in your life, freed from persistent, intrusive thoughts. Remember, in tandem with self-awareness, the right support nurtures recovery in all its dimensions.