Rumination OCD: Coping With Rumination Obsessions

When you have obsessive-compulsive disorder (OCD), you can become distressed over thoughts and worries like health issues or finances. While these thoughts can affect anyone, the problem arises when the thoughts become repetitive, and you develop behaviors that become rituals. 

You'll feel compelled to perform specific actions to eliminate these thoughts and the resulting anxiety. You might check the locks several times before going to bed at night or wash your hands compulsively. These are known as rituals, in which you repeatedly engage and cause significant distress.

Do you ever feel compelled to pick at scabs or scars and wonder why they hurt so much? You may have dermatillomania, a sign of rumination OCD. If you keep replaying conversations in your head, this can be another sign. Keep reading to learn more about rumination OCD and how you can ease your symptoms. 

Have you considered clinical trials for Obsessive compulsive disorder (OCD)?

We make it easy for you to participate in a clinical trial for Obsessive compulsive disorder (OCD), and get access to the latest treatments not yet widely available - and be a part of finding a cure.

What is rumination OCD?

Rumination occurs when you repeatedly think about something without being able to stop or move on. You may hyperfocus on something that has already happened, worry over things that haven't happened yet, and repeat thoughts out loud. 

The thinking often focuses on negative feelings or thoughts, such as fear of failure or self-hatred, and may cause distress. Rumination is a common problem that often goes undiagnosed. 

What is the difference between OCD and rumination OCD?

Classic OCD has similarities to rumination OCD. The two disorders share many symptoms, including: 

  • Excessive thinking

  • Recurrent negative thoughts and feelings

  • Repetitive behaviors.

  • Feeling anxious and distressed

Ruminating is the mental process of repeatedly rehashing details or events to gain insight into a situation or problem. This process is commonly associated with obsessive-compulsive disorder (OCD). 

Rumination is not necessarily harmful and can happen to practically anyone during times of stress. However, some people develop rumination OCD.¹ They begin to worry about things that aren't relevant, start doubting their decisions, and become preoccupied with repetitive thoughts. 

Thoughts involved in rumination

People may have many different ruminations, including 'anal-retentive rumination,' 'anger rumination,' and 'compulsive rumination.' 

Anal retentive rumination

You may spend countless hours thinking about things you have already done or thought about before. This type of thinking is called 'anal retentive rumination' (ARR) and can lead to depression.

ARR is a repetitive mental exercise where you think about something repeatedly in your mind. This rumination happens because you want to remember or think about something that bothers you. 

The main difference between ARR and everyday thinking is that normal thinking involves new information and ideas, whereas ARR does not: It’s a way to escape from being bored or depressed.

For example, you may focus on how long it takes to go to the bathroom and if you feel discomfort while having a bowel movement. When you are anally retentive, you are rigid and want to maintain your surroundings in perfect order.

Anger rumination

This rumination is the inclination to brood over negative feelings or events. It tends to cause distress and interfere with emotional regulation. Ruminating can be maladaptive and adaptive, depending on the context. 

When your mind gets stuck thinking about similar ideas or events, it is wandering. This tendency to mentally drift off can be beneficial, allowing you to relax, let go, and enjoy yourself. However, these thoughts may also be quite disturbing.

Sometimes, anger ruminating can get out of hand. When you focus too much on the thoughts running through your head, you may start feeling anxious, agitated, and depressed. For example, when you ruminate negatively about your problems, you often want to do something to handle or resolve them. 

However, anger rumination causes you to dwell on problems you won't necessarily be able to resolve without action.

In this case, ruminating can become harmful and cause distress as it gives undue attention to negative aspects of your life,² such as failure, rejection, and insecurity. It’s better to put your energy into resolving those issues instead of obsessing over them.

Compulsive rumination

This rumination causes you to worry about things that happened before that did not previously concern you. Compulsive ruminative thinking is common among people who struggle with anxiety, depression, OCD, PTSD, and substance abuse disorders. Ruminative thought patterns can take many forms, but they are always associated with some negative emotional state.

Compulsive ruminations are self-reinforcing repetitive thoughts or patterns of thinking that repeatedly occur over time. They can cause significant distress and disability, leading to severe mental illnesses like depression.

Ruminative thinking interferes with cognitive control processes, resulting in excessive negative intrusive thoughts. Such thoughts tend to focus on a particular theme (e.g., death) and come with vivid sensory experiences (e.g., seeing images of blood). These types of thoughts often trigger strong emotions and negative mood states. 

Causes of rumination OCD

1. Traumatic memory

Traumatic memory is when you remember something that happened as trauma. This OCD subtype can also occur through stress or other emotions you experience. These memories can sometimes take over your life and cause many unwanted symptoms like anxiety and depression.

2. Ruminative thought

Ruminative thought is where you think about what has already happened to you. You might have these thoughts when stuck in traffic or having trouble falling asleep. Ruminating can make you feel anxious or depressed.

3. Repetitive behavior

Repetitive behavior is also known as compulsive behavior. This behavior includes things you do, like counting or pinching yourself. Another example would be repetitive behaviors you develop to cope with anxiety, like hitting yourself or biting yourself.

Generally, rumination OCD may occur due to stress, anxiety, depression, obsessive-compulsive disorder, substance abuse, or other mental health conditions. 

Reducing rumination

Besides cognitive behavior therapy (CBT) and medication, you can take these steps to reduce how often you ruminate:

Reduce distractions

Distractions are everywhere. They can become overwhelming and paralyze you. A great way to reduce distractions around you is to create a daily routine that keeps you focused. Establishing a schedule will make you less distracted by outside stimuli.

Create boundaries

Sometimes you need to set limits to protect yourself from the negativity of others. It may be as simple as refusing to participate in office gossip. Some people thrive off negativity and may derive pleasure from being mean to others. Before allowing anyone to cross your boundaries, ask yourself whether they are violating what you’re comfortable with.

Practice mindfulness

Mindfulness is the practice of intentionally paying attention. It allows you to focus on the present moment rather than letting your mind wander to other places. Practicing mindfulness helps you step back and gain perspective, especially when dealing with difficult situations.

Work on healing

Your bad memories and experiences can take over your life and understandably leave you feeling miserable. If you can’t afford therapy, online CBT worksheets can help you reprogram your mind, heal, and create a brighter future.

The lowdown

Rumination is a normal thought process that’s part of human behavior. When ruminating occurs excessively, it can create challenges in your life where the thoughts become obsessive with no end goal. Studies show that after treating rumination OCD, people typically report less distress and lower levels of depression. If you suspect you suffer from rumination OCD, talk to your doctor.


Does rumination OCD cause stress?

Rumination is often associated with repetitive negative thoughts, such as worrying about things, which disrupt daily activities and negatively impact mood and behavior. People who experience these symptoms frequently tend to engage in self-focused negative thoughts about their situation, resulting in stress. Rumination OCD causes emotional turmoil. 

Seek professional guidance

If you are concerned about your ruminations, you may want to contact a professional.  Contact us at HealthMatch, where we help you understand your condition, inform you of your treatment options, and give you access to leading specialists. Visit our website or email

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