Clients who ruminate often think of it as a helpful problem-solving tool – that if they dwell on a problem long enough, they’ll gain new insight into how to fix it.
But as we know, rumination can keep clients stuck in cycles of depression and self-doubt.
So, in the video below, Christine Padesky, PhD will share 3 specific questions that can help clients ease patterns of obsessive negative thoughts. She’ll also walk us through a mindfulness exercise that’s intended specifically to replace rumination.
Have a look.
The answer to these questions about rumination are – Is it time to be thinking about this? Am I avoiding something? How long have I been thinking about this?
In general, once we establish that someone is doing unhelpful rumination, I generally give them like a two to three minute. I let them choose, “Do you want to have two minutes, three minutes? How much rumination do you want to do before you stop?” We literally give it a time limit and say, “At the end of three minutes, if you’re not actively problem solving, coming up with steps that are useful, then I want you to stop thinking about this and go do something. It can be something very mundane and practical like go do the dishes, or it can be something like take a walk, or it can be tuned into your sensory experiences.”
Because getting people out of their heads and into the world around them is really one of the best antidotes to rumination. I want people to get engaged with something and really pay attention to that thing. If they say, “I’m going to go for a walk,” then I’m going to say to them, “Now, how are you going to make sure you’re not ruminating when you’re walking? ‘Cause I can walk and ruminate at the same time and I’m sure you can too.” Then we’ll talk about what else could you do.
An experience I often give people is a mindfulness exercise where I’ll say to them, “Okay, while you’re out walking, I want you to play the five senses game. So I want you to notice one visual sight that you really like, and then I want you to look at that and really enjoy seeing it for a minute or two. And then I want you to go to another sense, you know, maybe find one smell you really enjoy, get up close to that smell, enjoy it. Then I want you to get one sensation. Is it the sun on your cheeks, or the breeze on your face, or is it the feel of your feet crunching on leaves or snow? And I want you to really pay attention to that and really enjoy it. And we can go tastes.” I’ll always take myself to an ice cream store if I can.”
We’ll go through the different senses and get people focusing on their sensory experiences rather than ruminating about something in their head. Usually about 10 minutes of doing some kind of activity with sensory focus is enough to get people engaged in something else.
For more expert strategies on working with depression, check out this training featuring Marsha Linehan, PhD; Pat Ogden, PhD; Richard Schwartz, PhD; Bessel van der Kolk, MD; and other leaders in the field.
Now we’d like to hear from you. How have you helped a client with depression break a rumination habit? Let us know in the comments below.
I went through extensive neurofeedback which helped me on this.
The first thing they did was map my brain to test my alpha, beta, delta, and theta waves. A doctor who I had never met, and knew nothing about me, reviewed my test results. He saw that my brain was “racing.” He wondered how I was able to function at all, since it never stopped. He said I was probably ruminating a lot. I hadn’t heard that term in ages, and never about me. However – he nailed it. I had been spending an extraordinary amount of time doing this. There was no way I could stop it. One time I was driving through gorgeous Colorado, and couldn’t stop my mind from ruminating on stupid issues. I was so angry, but I couldn’t stop it. I also couldn’t enjoy the drive at all.
So anyway – the doctor identified my symptoms, and I was shocked.
I then went through multiple neuro feedback sessions.
My brain was mapped again. The neurofeedback did exactly what we needed it to do. My brainwaves had calmed down.
The neurofeedback changed my life in many ways. Some I still don’t understand. I can now stop myself if I start ruminating. The neurofeedback helped me more than any of the many other trauma therapies I had gone through over a period of ten years.
Am going to try this on me first to stop my rumination. Most of my clients say 5 senses grounding technique helps them much better than any other relaxation. Now coming from an expert its time for me to practice.
Thank you Christine
Love from Sri Lanka
Really helpful and every client has different choices they can make.I might give examples…
Think of three things you’re goanna do ( action) NOW, or later.
Take 3 really deep breaths.letting out them out slowly.
or what worked fora client was
Say 3 Hail Mary’s ..as by the time she had finished them she had stopped ruminating.
3 being a spiritual holy number .
thanx Christine
I often suggest that the client jump up two times and move to a different position.
huh! CBT…not for everyone, everything, especially not for complex trauma
Thank you Liz. That is also my own experience. Complex trauma need complex thinking helpers, which are rare from my point of view. They are fixed in their methods and concepts and are not able to see what is really going on in their clients.
Let me add: Recognizing a person’s real needs can take more time than quick fixes allow. It requires developing strong listening skills, getting to know the people we want to serve, and being honest with ourselves about our motivations and hidden agendas.
Well, said and practical for the most part. Only issue is as you stated, ruminating is common at night, but the sensory exercise is more for daytime. The nighttime exercise would be helpful here.
I think it’s a DBT skill called Distract.
Hi Lisa,
I’m interested o hear your recommendations. Insights and tips for working with autistic people? Thanks
I agree that the use of “I want” could be quite triggering for some clients, although exploring the “why is it so triggering” could also be useful! However, I think using “I invite you to……” might be a better phrase than “I want you to….” in this scenario. There is an invitation to do something, thereby suggesting that the client has a choice.
Ruminating thoughts can be extremely hard to disrupt! One technique I suggest is that the client memorize an affirming piece of some kind; for example a prayer, passage from a religious text, poem, or lyrics from a life-affirming song (“I am woman hear me roar….”). Every time they notice the rumination happening, begin to play the mental tape of the affirmative piece. It should be at least a few sentences long and require some concentration in order to make it harder to slip back into the rumination. Repeat all day – and night – long if necessary.
I practice this too, adding mantra. It backs up the mantra with power!
I agree, that language could be triggering for some clients. A good reminder to be mindful of how the client is reacting to our words!
This was very helpful. I can relate to each of your examples. Thank you!
I find it more useful to focus on the important information contained in the content rather than be entangled in the form in which the content is conveyed.
This reply is dismissive to the max. How will we ever change the systemic barriers if we refuse to hear when people tell us how things impact them? If you are trying to empower someone, then this change in language is essential.
Very succinct, practical and useful. Thanks.
Thank you! very helpful!
Great ideas. This is very helpful. Thanks so much ❤️
Many many thanks for this!
Excellent and straightforward, thank you!!
I found this very useful and will be utilising these questions with clients where rumination is an ongoing “go to” place for them. Thank you
This was a wonderful bite to help you think about such a common problem. Thank you!! x Ute
That was fabulous, thank you!
Working with either depression or anxiety depends on whether there is trauma somewhere in the clients background. Then it’s a different task and a therapy that might require 10 years versus 3 years. I think we have many useful methods for usual cases
but where is the guidebook for truly long term work. Please – I’d love to read it.
Thank you,I found this very helpful.
Thank you! Very helpful. I appreciate the free content.
Thank you! Easy and helpful
So simple and clear. Thank you
Thank you