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 […]
RF-ERP Preliminary Exercises
After I teach patients how to stop ruminating, I use a series of additional exercises to help them practice that skill, and apply it even when faced with a trigger. This helps to build confidence in using that skill, and also sets the stage for doing exposures in the context of not ruminating. As in […]
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 […]
The Core Fear
Understanding the Core Fear is foundational to effective treatment of OCD, and can unlock even the most baffling cases. Dr. Elna Yadin introduced the idea that each person with OCD has a ‘Core Fear,’ and that their avoidance and compulsions are aimed at preventing it. This idea is very powerful, because OCD symptoms can seem […]
Awareness, Attention, Distraction, and Rumination
An essential part of treating OCD is distinguishing between mental processes that can and cannot be controlled. This can be especially confusing when it comes to attention. Confusion about this leads, in turn, to confusion about distraction, as well as to difficulty eliminating rumination. The purposes of this article are: (1) to explain what aspects […]
ERP Exercises for Compulsive Rumination
I use the series of exercises in this article to help patients practice eliminating compulsive rumination. Per Targets and Rationales for RF-ERP Exposures, the goal of these exercises is not to make the patient anxious. Rather, the goal is for them to learn that they can control rumination, even when they encounter a trigger. Some […]
When You Have OCD but You’re Not Afraid of Anything: Treating ‘Just Right’ OCD, Random Rituals, and Compulsive Behavior
As discussed in A Simple Explanation of OCD, OCD always centers on a fear of making an irreversible mistake that leads to experiencing a certain form of emotional distress forever; this is the Core Fear. But sometimes a person with OCD will say that they aren’t afraid anything bad will happen if they don’t do […]
Treating Two Types of Contamination OCD
This article discusses two types of Contamination OCD. As discussed below, some contamination cases may reflect aspects of both types. Type 1 In the first type, the person is afraid of contamination because they are afraid that the contamination could cause something else bad to happen that could have permanent emotional consequences. An example of this would […]
‘Thought Suppression’ Has Nothing to Do with Rumination, so Why Does It Feel like You Can’t Stop?
Let’s start with a thought exercise: Imagine you were solving a complicated math problem, and I asked you to stop. Would you have trouble stopping? You would not. Keep this in mind as you read on. ‘Thought suppression’ and ‘the rebound effect’ refer to the idea that sometimes trying not to think about something causes […]