Every day I am having conversations with clients and therapists in training regarding how to stop rumination. Rumination is when we leave our senses in the here and now, go up into our minds, and try to solve something that is creating distress. It usually robs us of our time and energy and leaves us deeper in doubt and anxiety. Rumination is often present with anxiety and OCD.
So how do we help our clients stop ruminating? There are several practices that I teach my clients, all of them fairly simple but none of them provide quick and easy relief.
One practice is attention training. You can find this on you tube. Attention Training is when you focus on a sensory experience while ignoring other sensory experiences, honing your ability to give your attention to the thing you are choosing, not what your brain is choosing.
Another practice is mindfulness. Ask your clients to get absorbed in a worry for a minute and then have them stop. Ask what they had to do to get absorbed in the worry? They usually answer, “I had to go up into my mind.” Ask if they were aware of what was going on around them when they were absorbed in their worry. They typically are not aware. Ask them if they had to close their eyes or look down; blocking out visual sensations. The answer is always, “yes”. Then have them practice staying connected to one of their senses while also becoming absorbed in the worry. Tell them to notice what’s different. It’s almost impossible to become absorbed while staying present.
Finally, I practice meditation with my clients in session and, ideally, they practice it out of session. One of the most powerful messages to come from meditation is that is doesn’t matter how many times you get swept up by the thoughts in your mind, what matters is your ability to see it and come back to your breath. As you practice this with your clients, encourage them to expect to be carried away and to gently bring themselves back in a non-judgmental way.
As your clients become better at bringing themselves back from the stories in their mind, they may see that they do have agency over rumination. They can recognize they have left the present moment, have gone into their mind, and can pivot back to reality. Once they are back in the here and now, they will need skills to hold space for distressing emotions and uncertainty. Trusting that anxiety will pass as they take steps to get back into their day and what they value.
Helping your clients stop ruminating is an important part of therapy for anxiety and OCD. You and your clients will need to practice these skills consistently and trust the process. Each step they take is one step closer to getting their lives back.