Ruminations

The simplest definition of ruminations is thoughts that will not stop to the point they become compulsive thoughts.

Ruminations are particularly nasty because as well as creating distress by their existence, they can impact on sleep, focus, skew perspective and produce a negative feedback with action and anxious body sensations.

Interpersonal ruminations

These will include pre-interactive and post-mortem. In the case of pre-interactive, thoughts will be circling about an interaction with an individual or a group.

“What if the words don’t come out? They will think I’m stupid; my voice always gets croaky; I get nervous and end up rambling and sounding really weird then no one wants to know me; they’ll see I’m different, I just don’t fit in; I don’t know what to wear; I don’t feel comfortable wearing what they wear; I cannot do small talk; I’ll end up boring people; the best plan is to say nothing; maybe they’ll think I’m rude.” 

Before you even step out of the door, you are just totally exhausted because these ruminations may have continued for an hour or a day, even a week. The ruminations may be caused by a high level of anxiety but they will also cause higher levels of anxiety.

Post-mortem ruminations might go a little like this...

“Did I say Hello to everyone? He seemed a little quiet this week, what happened last week, did I say something wrong? Why did I have to mention quantum physics? As soon as I said that, she went quiet; did I talk too much? How much did he talk? She didn’t have much opportunity to speak? Did I interrupt him? She gave me a look; what did that look mean? Now how was it, just a very slight movement of the eyes to the left or was it to the right; and then as soon as coffee was finished they just all left; do they usually leave that suddenly or was it to get away from me? I don’t think they want me there; I shouldn’t go next week.”

Intrapersonal ruminations

These can include negative thoughts about the self, body, thoughts, behaviour, self-judgments, self-blame and comparisons to others. There can be anxieties about not achieving enough... 

“I’m thirty, I should have a house and a better job; other people have degrees; I can’t even drive; if I wasn’t such a failure I would have got that promotion; I’ve just wasted my life in this dead-end job; why didn’t I choose law?” They could be ruminations of negative self-worth, “of course I don’t like myself, what is there to like? I’m not attractive; I’m not special: I’m always so clumsy; I just mess up all the time; I’m boring; if only I was taller.”

External ruminations

Are anxieties about the world, environment or others.

“What if a nuclear war happens, people say it is unlikely but there are so many nuclear weapons; my wife is late home, I hope she hasn’t had an accident, the roads are so bad now, last week there was a terrible accident on the road she uses; now it is flu season and my gran is already quite frail if she catches it she will end up in hospital or worse.”

Intrusive ruminations

These are disturbing thoughts often on a similar theme that are distressing. They are personal to you so can be about absolutely anything.

Why do ruminations happen?

Ruminations often occur with anxiety, fear of the unknown and low self-worth but they can occur for any reason. Ironically they are a way of trying to find meaning or even self sooth, to make sense of anxiety or physical feelings. Sometimes they can occur due to a lack of security or stability within the self, which leads to the fear of not being able to manage the unknown. This can come from lack of secure attachment or acute stress and acute or chronic trauma. Ruminations are like branches of a tree and underneath them is a root. The root varies from person to person. It can be an expectation of rejection; a feeling of never being good enough; an expectation of no support from others.

What might help?

The severity and the cause of the ruminations means the management will vary. Therapy and exploring the self within a trusting relationship may help.

Short-term relief strategies to try include:

• Yoga, this is advocated by Bessel van der Kolk, a trauma specialist, because yoga is a form of mindfulness where you have to concentrate on the movement and the movement can help with the somatic aspects of anxiety. Running or going to the gym may also help.
• Write the ruminations down or draw them, ruminations can be the mind saying remember this, this is important, hence the thoughts keep circling. By writing them down or drawing them out you have recorded them.  
• Act-procrastination will keep ruminations circling for longer. If you have a specific task that creates anxiety, the ruminations will stop once it is done. The timescale of rumination can be reduced by not putting something off.
• Identify the emotion, behind the rumination if you are able to and express it through music, art, watching a film, reading, crying, and being kind to yourself and compassionate with your emotions.