Treating Sensorimotor OCD (AKA Somatic OCD)

Sensorimotor OCD (also known as Somatically Focused OCD) refers to cases in which people become hyperaware of their bodily sensations, such as their breathing, swallowing, or heartbeat.  While this might not sound so bad to someone who hasn’t experienced it, it can be profoundly distressing. Like with Pure O, the key to treating Sensorimotor OCD […]

How to Stop Paying Attention

As discussed here, directing attention is a controllable mental process, and as discussed here, directing attention is part of our definition of rumination.  Sometimes people feel like they can’t stop paying attention to something; this is especially a problem for people with sensorimotor OCD. The key to solving this problem is differentiating between something being […]

Rumination-Focused ERP: Turning Exposure On Its Head

Please note that Rumination-Focused ERP is a new and evolving approach to ERP. It has not yet been researched, and therefore to the extent that it differs from classical ERP, it is not evidence-based. In classical ERP, it is considered important that the patient feel anxious during exposure, because the goal of exposure is habituation.  […]

Understanding Pure O: You Are Not Having Intrusive Thoughts All Day, You Are Ruminating

Most people with intrusive thoughts (often referred to as Pure O) and most people who treat intrusive thoughts, think that these thoughts are involuntary and uncontrollable.   The truth is that the vast majority of what people call intrusive thoughts — almost all of them — are actually being thought or imagined on purpose, in an effort to […]

Defining Rumination

Different therapists and researchers (and farmers, actually) use the word rumination in different ways, and that makes it important to define exactly what I mean when I use that word. When I talk about rumination, I’m talking about any type of mental engagement with the problem; put another way, I’m talking about shifting into problem-solving […]

Why Rumination is a Continuous Loop

Please note that the below is an older article that requires significant revision in light of how my definition and conceptualization of compulsive rumination have evolved over the past few years. I do not think this article presents a complete, or completely accurate, description of compulsive rumination. Nonetheless, I have chosen to keep it posted […]

Rumination is a Compulsion, Not an Obsession, and That Means You Have to Stop

The fact that rumination is a compulsion is foundational to effective OCD treatment.  In order to explain why, let’s start by defining our terms: An ‘obsession’ is a distressing thought that occurs to a person.  The thought is distressing because it’s associated with the possibility of making an irreversible mistake that has permanent consequences (for […]

How to Stop Ruminating

Please note that Rumination-Focused ERP is a new and evolving approach to ERP.  Neither this exercise nor the rest of the treatment has been researched, and therefore neither is evidence-based.  Please also note that this article is for your information only and does not constitute clinical advice or establish a patient-psychologist relationship. This article describes […]

I Know How to Stop Ruminating but I Can’t Seem to Stop All the Time

(How to Stop Ruminating addressed the problems people most frequently encounter when learning how to turn off rumination.  If you don’t know how to turn off rumination at all, start with that article.  This article addresses the problems that people most frequently encounter when they know How to Stop Ruminating, but can’t seem to stop all the […]

How are You Justifying Rumination?

This article is for you if you already know that You Are Not Having Intrusive Thoughts All Day, You Are Ruminating; know that Rumination is a Compulsion, Not an Obsession, and That Means You Have to Stop; and know How to Stop Ruminating. Whenever you find it difficult to stop ruminating, the first question to ask yourself is […]