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What is Rumination in OCD?

Oct 19, 2023 | Anxiety, OCD

Everybody has found themselves, at one point or another, stuck in a loop of overthinking about past events, conversations, or important decisions. While most of these thoughts are temporary, for some, this repetitive thinking can become overwhelming and unrelenting, affecting their daily lives. These ruminating thoughts are common for those with obsessive-compulsive disorder (OCD).

Rumination in OCD refers to a pattern of repetitive, often distressing thoughts that an individual feels compelled to think about, even when they don’t want to. Unlike casual reflections or daydreams, these ruminative thoughts are unproductive and typically centered on themes of doubt, fear, or perceived mistakes. They can lead to heightened anxiety, fueling the cycle of further rumination and creating a seemingly endless loop.

Understanding rumination in OCD is the first step to breaking this cycle. This article will delve into what OCD is, the underlying mechanisms of ruminating thoughts, and ways to address OCD ruminations.

Understanding Obsessive Compulsive Disorder

Obsessive-compulsive disorder is characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions). The obsessions and compulsions significantly interfere with an individual’s daily activities and quality of life.

OCD may refer to individuals with either obsessive or compulsive traits, not necessarily both. In individuals with both, the obsessive and compulsive urges work together to create a vicious cycle, preventing the individual from living their fullest life.

For individuals with either obsession or compulsion (but not both), the disorder’s symptoms still significantly impact their ability to carry out daily tasks. Obsessions and compulsions create undue anxiety and are time-consuming due to their everyday symptoms.

Common Symptoms of OCD

OCD is characterized by two main components: obsessions and compulsions. While the manifestation of OCD symptoms varies widely, they generally have the same root causes and are responses to underlying anxieties, fears, or perceived threats.

OCD Obsessions

For individuals with OCD, obsessions are intrusive thoughts, images, or urges that cause anxiety and stress. These obsessions typically take the form of fears or forbidden thoughts but can also include a desire for order or maintaining perfection.

Common obsessions include the following:

  • Fears of Contamination: Concern about getting dirty, infected, or contracting germs.
  • Fears of Harm or Violence: Worry about causing harm to oneself or others.
  • Moral Fears: Excessive concern about right or wrong; or fears of committing a perceived sin.
  • Sexual Obsessions: Distressing thoughts about taboo subjects.
  • Perfection Obsessions: A constant need to perform tasks correctly, to know or remember certain things, or a fear of mistakes.

OCD Compulsions

Compulsions are direct acts that individuals feel a need to perform in response to their obsessions, or according to rigid rules. In general, compulsions are strategies to relieve the stress of their obsessions, prevent a feared event, or maintain order in their lives.

Common compulsions include the following:

  • Checking: Repeatedly checking things to ensure they’re in the correct order or place.
  • Counting: Counting or listing objects repeatedly.
  • Ordering: Making sure objects are placed in a precise arrangement.
  • Cleaning: Excessive hand-washing, showering, or cleaning household items.
  • Hoarding: Collecting or keeping things that one doesn’t need, stemming from a fear of something bad happening if they’re thrown away.

Contextualizing OCD Symptoms

Obsessive-compulsive disorder is often misunderstood in popular culture, where the symptoms may be downplayed or misrepresented as mere quirks or preferences. However, the severity of OCD symptoms can be profound, and contextualizing the symptoms is crucial to dispel misunderstandings about this condition.

While many OCD symptoms are common occurrences on their own, their severity for individuals with OCD is significant enough to disrupt their quality of life. For example, most individuals will have a moderate fear of germs and wash their hands to stay clean. Individuals with OCD who excessively fear germs will repeatedly wash their hands, sometimes to the point of rawness.

One of the most significant impacts of OCD is that it involves rituals that make simple tasks enormously time-consuming or mental obsessions that prevent adequately carrying out everyday activities.

Additionally, the severity of the stress can be intensely distressing. The fears or needs of individuals with OCD are not simply worries but overwhelming fears that lead to anxiety and hopelessness.

Unlike general fear or anxiety, where actions performed relieve stress and make an individual more content, the actions of individuals with OCD do not improve an individual’s quality of life.

Further, the thoughts and actions symptomatic of OCD are repetitive and seemingly endless. While individual preferences come and go, OCD symptoms, such as ruminating thoughts, continue to distress the individual until they break the cycle or get proper treatment.

What is Rumination?

Rumination refers to continuously thinking about the same thought or issue, especially those related to negative experiences. It involves constantly focusing on distress, its causes, and its consequences rather than its solutions.

In other words, rumination involves problem-dwelling thinking in response to distress rather than problem-solving. Rumination often becomes cyclical because the more someone dwells on distress, the worse they feel and the more likely they are to further think about the issue.

Everyone ruminates to some degree throughout their lives. In many cases, it’s a normal response to significant problems we don’t want to deal with. Continuously thinking about a problem in some ways is safe because it prevents the need to take action.

However, for individuals with mental health issues, rumination becomes a roadblock to emotional well-being and effective coping strategies for the root cause. While it’s most common for individuals with depression or anxiety, it’s also a significant symptom for those with OCD.

How Does Rumination Affect OCD?

At their core, OCD obsessions are characterized by intrusive and unwanted thoughts. When an individual with OCD ruminates, they repeatedly and passively focus on these obsessions, magnifying their distress.

Instead of offering relief of a path toward resolution, rumination often keeps the individual stuck in a cycle of obsessive thought without making the transition into problem-solving.

Moreover, while the compulsions in OCD are typically performed to alleviate the distress of obsessions, ruminating on these obsessions can make the compulsions more frequent or intense. This behavior can lead to an entrenched pattern of obsessive-compulsive behavior.

For example, a person might continually ruminate on whether they locked their door, leading to repeated checking despite it staying locked. The root distress may be a fear of safety and security. However, the ruminating thoughts focus on the fear while the actions fail to alleviate that fear.

In the context of OCD, ruminations can often act as a compulsion in response to an obsession. While not all ruminations in the general sense are compulsions, they often serve as a compulsive action to help alleviate the obsession despite their inability to provide a solution.

Are Ruminations the Same as Intrusive Thoughts?

Ruminations and intrusive thoughts appear very similarly on the surface but are distinct in mental health.

Intrusive thoughts are involuntary thoughts that enter one’s mind spontaneously. They are typically distressing and perceived as inappropriate or out of character for an individual. Almost everyone experiences intrusive thoughts at some point, but they become problematic when persistent.

Ruminations are not spontaneous and involve repetitively dwelling on past events, current feelings, or future problems. They involve continually thinking about issues rather than trying to solve them.

In the context of OCD, an intrusive thought may trigger a rumination. For example, an individual might have an intrusive thought about a loved one getting hurt and then ruminate on this thought, pondering its meaning, implications, or why they had the thought in the first place.

Table depicting the difference between intrusive thoughts and ruminations

While intrusive thoughts and ruminations are central to obsessive-compulsive disorder, they are distinct in their nature, onset, and thought patterns.

For those dealing with OCD, these symptoms can significantly disrupt quality of life and make it difficult to engage in constructive thinking. However, with the right treatment and coping strategies, individuals can address their OCD and lead fulfilling, balanced lives.

What Are Ways to Address OCD Ruminations?

Addressing OCD ruminations typically involves a combined approach of therapy, mindfulness, and, in some cases, medication. Overall, cognitive-behavioral therapy has proven the most effective in helping individuals recognize and alter negative thought patterns and behaviors.

With any of these practices, the best results occur when consulting with a licensed professional. Therapists, especially those trained in cognitive-behavioral therapy, can work with you individually to offer a tailored approach to OCD ruminations.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) involves changing how we think and react to thoughts. It is particularly helpful for behavior change and addressing intrusive or ruminating thoughts in OCD.

While everyone follows their own trajectory, CBT generally involves addressing the cycle of rumination and restructuring the patients’ perspective about their beliefs and the actions that lead from those beliefs.

Exposure and Response Prevention

A specialized form of cognitive therapy, exposure and response prevention (ERP), involves exposure to anxiety-inducing thoughts and consciously preventing the associated compulsion.

When done correctly with a licensed therapist, this process allows the individual to experience and process their thoughts without resorting to coping mechanisms.

Mindfulness and Meditation Techniques

Mindfulness and meditation teach individuals to be present and observe their thoughts without judgment or reaction. For those with OCD, mindfulness and meditation can help break the cycle of ruminative thinking by fostering a non-reactive relationship with intrusive thoughts, reducing their power and influence.

Consultations with a therapist specialized in mindfulness offer strategies and mental tools to be more present in the moment, be more content overall, and feel more comfortable with the anxiety that leads to ruminating thoughts.

Learn How To Address OCD Ruminations Today With Start My Wellness

Everyone has intrusive or ruminating thoughts, but those with OCD experience these thoughts in a time-consuming manner and, in some cases, debilitating. OCD ruminations affect these individuals’ quality of life and can make everyday tasks difficult.

However, with appropriate therapy focused on addressing how we think and react to thoughts can teach you how to live with OCD and be free of the confines of ruminating thoughts.

At Start My Wellness, we offer counseling for OCD from 20 therapists across our locations specializing in cognitive behavioral therapy. With years of experience, our therapists know the intricacies of OCD and strategies to break the cycle of ruminating thoughts.

Meet our therapists today to begin your next consultation and start your journey to Wellness.


  1. NIMH: Obsessive-Compulsive Disorder
  2. International OCD Foundation: About OCD
  3. American Psychological Association: Rumination: A Cycle of Negative Thinking
  4. American Psychological Association: What is Cognitive Behavioral Therapy?
  5. Start My Wellness: Cognitive Behavioral Therapists
  6. Start My Wellness: Mindfulness Therapists
Dr. Anton Babushkin

Author: Anton Babushkin, PhD

Looking for a Therapist? Start My Wellness has highly experienced Licensed Therapists that are currently accepting new patients.


Blog Posts Tags: Anxiety | CBT | OCD
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