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 […]

ERP Exercises for Compulsive Rumination

I use the series of exercises in this article to help patients practice eliminating compulsive rumination.  Since Exposure is About Learning, Not Habituation, the goal of these exercises is not to make patients anxious.  Rather, the goal is for them to learn that they can control rumination, even when they encounter a trigger. Some notes to therapists: […]

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 […]