Rumination

Human beings experience a wide variety of repetitive thoughts about themselves and their lives, not all of them negative. Reminiscing, savoring, anticipating, problem-solving, and emotional processing are positive examples of repetitive thinking, and go some way to explaining why we have the propensity to engage in repetitive thought. Some types of repetitive thought are unhelpful, though—even harmful. Rumination and worry are two key forms of unhelpful repetitive thought and use of these can predict anxiety and depression (Watkins, 2016). We can conceptualize repetitive thinking about the future as ‘worry,’ and repetitive thinking about the past as ‘rumination.’ They are maintenance factors in conditions such as generalized anxiety disorder and depression (Harvey et al, 2004). Read more

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Intolerance Of Uncertainty

Uncertainty is a normal part of life – we can never be 100% sure about what will happen next. Many people feel good about uncertainty and live lives ... https://www.psychologytools.com/resource/intolerance-of-uncertainty/

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Worry is a cognitive process that involves thinking about problems that might happen in a way that causes anxiety. Not all worry is problematic – we ... https://www.psychologytools.com/resource/worry-flowchart/

Worry Postponement

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What Is Rumination?

Rumination and repetitive thought is a transdiagnostic maintenance process underpinning a range of difficulties. This information sheet explores the c ... https://www.psychologytools.com/resource/what-is-rumination/

Understanding Health Anxiety

Understanding Depression

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Anxiety stems from negative predictions about the future (and also from assumptions that one will not be able to cope with the magnitude of the threat ... https://www.psychologytools.com/resource/worry-thought-record/

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Cognitive Behavioral Model Of Generalized Anxiety Disorder (GAD: Dugas, Gagnon, Ladouceur, Freeston, 1998)

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Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/self-monitoring-record-universal/

Rumination - Self-Monitoring Record

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Worry Diary (Archived)

NOTE: An improved version of this resource is available here: Worry – Self-Monitoring Record. Older versions of a resource may be archived in t ... https://www.psychologytools.com/resource/worry-diary-archived/

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NOTE: An improved version of this resource is available here: Evaluating Unhelpful Automatic Thoughts. Older versions of a resource may be archived in ... https://www.psychologytools.com/resource/challenging-your-negative-thinking/

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Rumination Diary (Archived)

NOTE: An improved version of this resource is available here: Rumination – Self-Monitoring Record. Older versions of a resource may be archived ... https://www.psychologytools.com/resource/rumination-diary-archived/

Rumination Self-Monitoring Record (Archived)

NOTE: An improved version of this resource is available here: Rumination Self-Monitoring Record. Older versions of a resource may be archived in the e ... https://www.psychologytools.com/resource/rumination-self-monitoring-record-archived/

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Assessment

Ruminative responses scale | Treynor, Gonzalez, Nolen-Hoeksema | 2003
- Scale
  Primary Link Archived Link

Guides and workbooks

Dealing with worry in low intensity CBT | Chellingsworth, Farrand, Rayson | 2013
Archived Link

Information Handouts

11 Steps To Stop Ruminating | Jay Uhdinger
Archived Link

Information (Professional)

Get out of the TRAP and back on TRAC (for rumination and worry) | GoodMedicine
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Presentations

The how and why of rumination and worry | Watkins | 2012
Archived Link
Targeting rumination by changing processing style: experiential and Imagery exercises | Watkins | 2011
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Unwanted intrusive thoughts | David Clark | 2019
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Video

Stopping spam from going bad | Blake Stobie | 2016
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Concreteness training for rumination | Ed Watkins
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Worksheets

Ruminating thought worksheet: What to do when thoughts are unhelpful
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What Are Rumination And Worry?

Disorders That Are Associated with Rumination and Worry

generalized anxiety disorder (GAD)
depression
social anxiety
post-traumatic stress disorder (PTSD)
pain
eating disorders
insomnia
psychosis

Helpful Questions for Assessing Rumination and Worry

How often do you find yourself ruminating or dwelling on your problems?
When do you tend to do most of your worrying or ruminating?
What are the consequences of ruminating and worrying for you? How does it make you feel?
Are there any particular feelings that are warning signs that you might worry?
What tends to stop your ruminating?

Treatment Approaches That Target Rumination and Worry

A variety of treatment approaches have been identified that target rumination and worry. These include:

approaching uncomfortable thoughts and feelings rather than avoiding them;
imaginal exposure to a ‘worry script’ or ‘worry story’;
problem-solving training;
processing information at a more concrete and less abstract level;
identifying and challenging positive and negative metacognitive beliefs that may contribute to repetitive thinking.

References

Harvey, A. G., Watkins, E., Mansell, W., & Shafran, R. (2004). Cognitive behavioural processes across psychological disorders: A transdiagnostic approach to research and treatment. New York: Oxford University Press.
Watkins, E. R. (2016). Rumination-focused cognitive-behavioral therapy for depression. New York: Guilford Press.

Rumination

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What Are Rumination And Worry?

Disorders That Are Associated with Rumination and Worry

Helpful Questions for Assessing Rumination and Worry

Treatment Approaches That Target Rumination and Worry

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