We often ask clients to consider many aspects of difficult events and how they respond. But we have probably all seen rumination, when clients continually and detrimentally consider so many aspects of their stressors.
Rumination is that continual focus on the causes and/or consequences of one’s actions or of difficult situations. This process is found to contribute to number of mental health and medical disorders. These include depression, generalized anxiety, other anxiety disorders, PTSD, OCD, prolonged grief disorder, substance misuse, eating disorders, chronic pain, among others.
So why does rumination affect mental health? Don’t we want clients to examine things that contribute to their difficulties? The problem is that constant rumination is typically very passive. It lacks active engagement or problem-solving to directly address or change factors that contribute to one’s difficulties. It only keeps one focused on negative and difficult events.
There are many reasons people ruminate. For some, ruminating functions to help an individual believe they are “figuring it out”. But if any of us know from professional, or even personal experience, we never figure anything out from it. We just keep “spinning our wheels”.
Rumination also contributes to missed opportunities to actually affect the circumstances that contribute to psychological difficulties (e.g., relationships, family difficulties, unmet goals, etc). It also prevents chances to gain a sense of efficacy in attempting to resolve situations (e.g., asserting one’s needs). So it also may function to reinforce avoidance. This avoidance effect is shown to be an aspect of ruminative worry in GAD.
CBT, behavioral activation, and targeted mindfulness all have some initial support as effective approaches to rumination. CBT appears to target beliefs about the effectiveness of rumination. Behavioral activation may provide concrete positive and meaningful activities on which to focus. And targeted mindfulness may help build skills to shift attention to present focus. Either way, helpful options are promising!
Research on rumination shines a helpful light on how we respond to difficulties. Active problem-solving is more effective than simply mulling over problems. But intentional coping tools (e.g., active reappraisal) help put those difficulties “to rest” when problem-solving cannot influence them.
