This sophisticated, often maladaptive thought process of obsessiveness-rumination-worry is a psychological process of recurrent thinking about self, past upsetting events, unresolved concerns and depressed symptoms. The silent sufferers of this process automatically rely on this problem-solving approach for any given life problem. Problematically, obsessiveness, rumination and worry is a poor, deceivingly counter-productive problem-solving option, as the evaluative nature of the common thought(s) are too abstract, redundant and limited.
Why do some folks suffer, while others do not? It is the confluence of myriad factors. The most commonly discussed factor is - wait for it - a childhood of treatment, wherein an otherwise intelligent and thoughtful child begins to over-analyze the motives and warning signs so as to better predict and prepare for the problem of parental abuse. In adulthood, the tendency becomes overused, indiscriminately applied (to all situations) and misperceived as an effective problem-solving option. Negative childhood events are just one of many biological, environmental and psychological contributors to this cognitive-personality outcome.
Understanding this, and collaboratively identifying all the advantages and disadvantages to the meta-negative thought process is the necessary first step (to promote therapeutic rapport and buy-in to the treatment plan) prior to transitioning to healthy interventions and positive change strategies.
Most maladaptive thought categories - catastrophizing, perfectionism, black and white thinking, mind-reading, etc. - are effectively treated by targeting the specific, individual thoughts with reality-testing restructuring and modification (is the thought useful and productive or not). For instance, when a client panics with worry that his plane is going to crash, cognitive therapy consists of a friendly reminder that such a catastrophic outcome is incredibly low-probability. The specific thought “a plane crash is very likely” is debated into “a plane crash is very unlikely and a calculated risk to take for a meaningful life.”
Targeting obsessiveness, rumination and worry involves targeting the thought process, versus content, which is a deeper, broader level of exploration. Specific distorted thoughts are ignored, and the client is guided through strategies designed to help pause, step-back and review the big-picture sequences of thoughts crashing through the mind’s internal land scape. In this way, the thoughts, feelings and behaviors associated with obsessiveness-rumination-worry are addressed and corrected through an analysis of the function and consequences of the thought process - discussing the development (when did it start?), context (when/where/why does it happen?), usefulness (what is its purpose?) and options (what can I do instead of it?).
Positive change develops as the client improves his or her ability to tune in to the negative internal commentary more quickly, and more skillfully redirect attention to more adaptive thoughts and concrete, specific, values-driven behaviors.
Dr. Jeremy Clyman earned a master’s and doctorate in clinical psychology (PsyD) from Yeshiva University. He completed three years of doctoral-level clinical externships in neurocognitive assessment, couples and family treatment, and cognitive behavioral for adolescents, adults and older adults.