Week 4 - Overcoming Rumination, Acceptance, and Being Present
Learning to overcome rumination, letting go of the past, acceptance, and being present with today.
Hi there!
Welcome to another blog post on Moving Forward. This week, we will delve into overcoming rumination using cognitive behavioural therapy (CBT) and acceptance and commitment therapy (ACT) techniques.
One thing that maintains depression, low mood, low self-esteem, and anxiety, is rumination. It is a cognitive and behavioural habit that puts you into a continuous cycle of negative thinking leading to negative emotions, and consequentially, increasing avoidance and isolation. It’s almost as if you have memories or events haunting or reminding you of your insecurities.
What is Rumination?
It is a process of repetitive thinking and pondering over past events, negatively resulting in a person feeling shame, guilt, down, upset, and regret. Rumination is a common symptom of depression and other mental health problems (GAD, PTSD, OCD, Eating Disorders, Personality Disorders, Bipolar Disorders, etc). When you find yourself spending hours going over and over something about the past, you’re ruminating. Going over and over things about the future is overthinking which is more in line with worry, anxiety, and stress. It is a vicious cycle of negative and unhelpful thoughts taking you on a rollercoaster ride (an uncomfortable and distressing one). These thoughts are hard to let go and stopping the cycle is difficult. If only we had a remote control where we could click on the stop button. Even if a person is activated (engaging in daily activities that they enjoy), moments of rumination can still occur, which can ruin their day.
How do we overcome it?
Firstly, using behavioural activation as that helps preoccupy your mind with beneficial activities that keep you balanced (routine, necessary, and pleasurable). Secondly, using problem-solving skills to help you break down a problem and look at practical solutions to solve it. Thirdly, write down what you can control and what you can’t then focus on what you can control and let go of what you can’t. Fourthly, set a time for rumination in the day, set a short duration between 15-30 minutes. The aim is to reduce the time you spend ruminating, even if it means you have a daily rumination allowance (similar method to what some people use to restrict their time doom-scrolling on social media). Finally, use that time to ask reflective questions, for instance, instead of “Why did that happen?” “If only I did such and such!”, ask yourself: “What could I do differently now?” “What can I learn from that?” Using reflective questions in a more learning approach helps us to shift our mindset or behaviour from regretting the past to problem-solving the future. Moreover, past experiences should be considered as learning curves. Learning is growing.
Let Go and Focus on the Present
As mentioned above, letting go is difficult and can feel nearly impossible. The emotional bandage that we can struggle to take off because it hurts. A tool here is to use what was mentioned above and shorten the duration you spend ruminating by setting aside some time in the day (15-30 minutes). You choose the time (AM or PM hours) and the duration (15, 20, 25, 30 minutes) that suits you best.
Ask yourself:
Was it worth me ruminating about that thought?
Can I do anything to change it?
Will it help me if I continuously feel guilty and shameful?
Will the ruminating about that/those event (s) make a difference to my life now?
What can I learn from that?
What can I do differently now?
The next step is to focus on the present. Meaning, that when those thoughts appear, notice them, recognise them, write them down, and go back to what you were doing before. Return to the present moment. Don’t allow your thoughts to pull you into a dark room and spiral for hours and remind yourself that you’ll deal with them later at ‘rumination time’ also called ‘roomination’. Like a meeting or an appointment, deal with it later when it comes, but if the thoughts pop up, jot them down, then go back to what you were doing.
Pit Stop:
If you struggle to think of what to do to bring yourself back to the present moment, have a list of activities or an activity menu and select the activity you’d like to do.
Dropping Anchor
This is a technique taken from acceptance and commitment therapy (ACT). It states that when we get into an emotional storm, we get easily caught up in it and end up spiralling and ultimately ruminating or overthinking. Imagine a storm in the sea and you’re the captain of a ship. To prevent your boat from getting swept up in the storm like your emotions, you could drop the anchor to hold the boat securely in place until the storm has passed.
To engage in this technique, follow the four steps FACE (see How to Stop Ruminating):
F - Focus on what’s in your control. It is challenging to control thoughts and emotions, but we can control our behaviour.
A - Acknowledge your experiences: be aware of your experiences, thoughts, and emotions. Name them, if you wish. For example, “Oh! Here comes that thought again”, be more aware of it and follow the next step.
C - Connect with your body: using small movements such as wiggling your fingers or toes to bring us back to our present moment.
E - Engage with what you were doing (before the storm): we want to turn our focus back to the activity we were doing before the storm came along.
Use the grounding technique to bring yourself back to the present.
5: Identify five things you can see
4: Identify four things you can touch
3: Identify three things you can hear
2: Identify two things you can smell
1: Identify one thing you can taste
Give it a go!
Cleaning our lenses of life
This will be touched on in week 7 (Thought Challenging = Thought Balancing) where I will teach you the thought work or cognitive technique that helps you challenge and reconstruct your negative thoughts. It does not teach us how to turn a negative thought into a positive thought, but rather how to balance our thoughts, as I like to put it, noticing that there are two sides to a coin. In short, a thought is just a thought.
More on this technique in week 7.
Being more active
Build your momentum by getting active. It isn’t easy but let’s recap briefly the three key principles of behavioural activation:
Do things gradually at your own pace and break things down into easy steps (e.g., breaking down tidying up your room into steps).
Sticking to plan and not mood (an outside-in approach). Your mood will always get in the way, but you can choose whether to listen to it or stick to your plan as best as you can. Do note that there are days (when you are feeling unwell) when you won’t have a lot of energy, it is understandable that you might not stick to plans. Don’t beat yourself up. Learn from your experiences.
Balancing the three daily activities or tasks (routine, necessary, and pleasurable), also known as RNP.
Studies have found the impact of BA (Nikandish and Sajjadian, 2024), as well as combined BA and ACT on reducing ruminations (Alirahmi, et al. 2023).
Yours truly,
Hashil
Quote of the Week
“The goal is not to get rid of negative thoughts, but rather the goal is not allow them to ruin your day and be more in control.”
What’s Coming Next
In the next blog post, I will write about managing worries and anxiety using worry management tools.
Your comments are always appreciated. I hope these blog posts have been beneficial to you.
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References
How to Stop Ruminating | Techniques to stop Ruminating. (2021, October 11). Access CBT. https://accesscbt.co.uk/how-to-stop-ruminating/
Nikandish, Z., & Sajjadian, I. (2024). The effectiveness of behavioral activation therapy on the symptoms of depression, rumination, and social-occupational functioning impairment among women with postpartum depression. Journal of education and health promotion, 13, 17. https://doi.org/10.4103/jehp.jehp_1783_22
Alirahmi, M., Aibod, S., Azizifar, A., & Kikhavani, S. (2023). Effectiveness of behavioral activation therapy and acceptance and commitment therapy on depression and rumination as a tool for health promotion on mothers with cerebral palsy children. Journal of education and health promotion, 12, 290. https://doi.org/10.4103/jehp.jehp_1552_22