By Michael D. Anestis, M.S.
We've all done it before. First, something bad happens. Next, we think about how bad that thing is and all the other times similar bad things have happened to us. Then, we think about how ridiculous it is that bad things like that happen in the first place and how these things don't happen to other people. From there, we think about other things that shouldn't happen and how upsetting it is that things don't just go the way they should. The next thing we know, a huge slice of time has gone by, our mood is sour, and we can't even remember exactly what it was that got us thinking this way in the first place. This phenomenon is called rumination, which Susan Nolen-Hoeksema of Yale University defined as a tendency to passively think about the meaning, origins, and consequences of our negative emotions (Nolen-Hoeksema, 1991).
Research has shown that frequent rumination leaves individuals highly vulnerable to several problematic outcomes, particularly future episodes of depression (Papageorgiou & Wells, 2004). Individuals can ruminate about a variety of things, with the content of the ruminative thoughts having an impact on the problematic outcome. For instance, Rusting and Nolen-Hoeksema (1998) found that ruminating after anger resulted in an increase in the degree to which individuals expressed feelings of anger. Collins and Bell (1997) found that rumination predicted aggressive behaviors in response to perceived insults. Bushman, Bonacci, Pedersen, Vasquez, and Miller (2005) found that, when individuals were instructed to ruminate after an experimental provocation, they were more likely to display aggression towards others, including individuals who had nothing to do with the provocation.
Not everyone who ruminates does so chronically, but rumination is a fairly stable trait. In other words, even though just about everyone ruminates from time to time when they become severely distressed, there are many individuals who ruminate habitually regardless of their initial level of distress. This is especially problematic because researchers have found that rumination predicts the future onset of a variety of problematic behaviors. Nolen-Hoeksema, Stice, Wade, and Bohon (2007) found that rumination predicted future increases in both bulimic symptoms (e.g., binge eating and purging) and substance abuse. In other words, individuals who ruminate but do not binge and purge or abuse substances are more likely to engage in these behaviors in the future than are individuals who do not ruminate. Although at first these behaviors might not seem to have a lot to do with rumination, this finding actually makes a lot of sense. Rumination simply does not feel good. Our negative thoughts build off one another, fueling increased negative emotions, which in turn prompt more negative thoughts. This vicious cycle keeps going until we become distracted, take steps towards resolving the problem, or become exhausted. To some individuals, the second option seems impossible and the third option seems too distant, so they engage in behaviors capable of immediately taking their mind off the problem. Taking drugs, while obviously problematic in the long term, can serve as an immediate escape. Additionally, there is convincing evidence that binge eating has mood regulatory effects by causing the release of certain neurotransmitters (e.g., dopamine) in the reward centers of our brain (Wolff, Crosby, Roberts, & Wittrock, 2000) and diminishing negative affect (Smyth et al., 2007). So, not only is rumination problematic in the short term because it prolongs bad moods and increases their severity, but it also increases the likelihood that individuals will engage in harmful behaviors in order to escape their own thoughts.
As it turns out, rumination is harmful regardless of who does it, but not everyone is equally likely to ruminate. Women are significantly more likely to ruminate than are men (Butler & Nolen-Hoeksema, 1994; Nolen-Hoeksema, Morrow, & Fredrickson, 1993), and this difference in rates of rumination partially mediates the relationship between biological sex and depression (Nolen-Hoeksema & Morrow, 1991; Nolen-Hoeksema, Parker, & Larson, 1994). In other words, studies have shown statistically that a significant portion of the reason that women have higher rates of depression than men do is that they ruminate so much more frequently. There are numerous hypotheses regarding why women ruminate more often than men, but there is no question that this tendency is real and that women are therefore at greater risk for developing mood disorders and a litany of problematic behaviors due to maladaptive patterns of thinking.
So, if rumination is so bad, why do we do it so often? Paradoxically, when we ruminate, we often feel as though we're working towards a solution to the problem. If somebody tells us to stop ruminating, we become irritated because it feels as though that individual is asking us to overlook how important the situation is. For one reason or another, when we ruminate, it becomes very difficult for us to realize that we are taking a passive problem solving approach destined to prevent any resolution and certain to exacerbate and prolong our bad mood. In fact, we even do this with friends - going back and forth talking about all of the problematic implications of a negative event in a process known as co-rumination. This paradoxical situation is one of the primary reasons why cognitive behavioral therapy (CBT) focuses on teaching individuals to recognize their thoughts, challenge them by determining the evidence for and against their veracity, and enacting proactive solutions towards resolving the problem.
So what can you do if you or a loved one ruminates frequently? If this is not causing you clinically severe distress, first you can try monitoring your own thoughts and, when you catch yourself ruminating, immediate ask yourself what specifically you can do right now to take a tangible positive step towards resolving the problem, even if that step is small. If rumination is causing significant problems, your best option is to find a therapist who practices empirically supported treatments (EST's). EST's are therapies like CBT for depression that have been tested repeatedly and have been shown to be effective. Finding a therapist who uses EST's is pivotal because non-empirically supported approaches to therapy sometimes simply involve talking to the therapist about how bad you are feeling rather than talking with the therapist about ways to resolve the problem. Why is that a problem? Because talking to the therapist about your feelings without working towards solutions is no different than ruminating on your own or co-ruminating with a friend. That's right - in other words, the wrong type of therapy is likely to either make the problem worse or simply fail to make it any better. If you are unsure where to find a therapist who uses EST's, you can start by looking at our EST Clinics link.
There are many ways to reduce your tendency to ruminate and we will touch on many of these options in future posts. In the meantime, when you find yourself stuck in your own head, chewing over a negative event or a possible negative event looming in your future, remember that doing this never solves the problem. There's nothing wrong with thinking about your mood as long as your thoughts result in a plan.
Mike Anestis is a doctoral candidate in the clinical psychology program at Florida State University.
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