Rumination as a compulsion and how to treat it

I am feeling conflicted when it comes to treatment and would like some advice. I suffer from Pure O, and all of my compulsions are in the form of rumination. If my therapist tells me to ‘lean in’ to the thoughts and even dissect and think about that thought/worry more - is this not akin to telling someone with contamination OCD to mindfully wash their hands? The initial microsecond thought is the normal human thoughts everyone gets - that’s normal and can’t be stopped, the rabbit hole ruminating that follows is technically analytical thinking therefor it should be able to be stopped. Does this resonate with anyone and has anyone experienced similar? I’m definitely experiencing some OCD around treatment and my therapist (am I doing this right etc) but I also feel my question is valid and I want to ensure I am following the right treatment path. Thank you!

"Pure" OCD

Username: FIMILIFIMILI

Date posted: 2y ago

I would address this concern with your therapist and ask for them to clarify what exactly they mean. Based on what you've said, there is either some kind of communication misunderstanding..or the therapist is not properly trained in ERP. And I would hope they know what they're doing.. 😬

Username: salvationsalvation

Date posted: 2y ago

I am not sure what they mean by "lean in". I practice ERP for rumination by writing down what my OCD fears and looking at that piece of paper without engaging in mental compulsions like mental calculations or trying to disprove the fear. Just looking at that upsetting scenario on paper and accepting the uncertainty of that situation, until my anxiety dissipates somewhat. I would not just engage in rumination by itself.

Username: Kiki84Kiki84

Date posted: 2y ago

@salvation Lean in as in - lean in to the feeling of discomfort and explore those thoughts more as opposed to trying to rid yourself of them. However I worry that this would in-fact be fuelling the rumination. At the moment It feels like my mind is on loop just thinking about OCD and treatment - I know this is OCD in itself! If I just let the thoughts be there - am I performing a compulsion? If the rumination is the compulsion then I should be stopping the looping thoughts all together right? I find the conflicting pieces of advice confusing!

Username: salvationsalvation

Date posted: 2y ago

ERP entails provoking an OCD obsession while abstaining from performing a compulsion to ease the discomfort. It's difficult to say exactly what that means for you without knowing what obsessions you have. For example, if I am obsessed with the idea that I might have done something morally wrong but forgotten about it, I would write "I might have done action X". My compulsion would be mentally trying to recall and assess whether or not I did action X. This is rumination. The point of ERP is to sit with the with the discomfort that I have because of the obsession without doing a compulsion.

Username: Stacy QuickStacy Quick

User type: Therapist

Date posted: 2y ago

Check this out:https://www.treatmyocd.com/blog/the-rumination-trap

Username: Stacy QuickStacy Quick

User type: Therapist

Date posted: 2y ago

I also like to recommend this video:https://youtu.be/a-QR_1KoJ80

Username: Kiki84Kiki84

Date posted: 2y ago

@NOCD Therapist - Stacy Q. Thanks Stacy - this was the episode I listened to which got me thinking and questioning the advice from my NOCD therapist to lean into the uncomfortable thoughts and actively think about them. Dr Greenberg would say this is fuelling rumination/compulsion. Very confusing!

Username: Miro

Date posted: 3y ago

The hardest thing about ocd treatment is to stop doing the compulsions. I have "pure O" and I do alot of mental compulsions and I've been doing them for a long time and I got used to them. I don't even need to do anything or expose myself to anything to trigger my anxiety. The thought can just pop in my head and I start getting anxious. I know I shouldn't be giving them attention or engaging in them but sometimes I feel it's too hard and I just can't resist. Can anyone give me any helpful advice?

"Pure" OCD

Username: Anonymous

Date posted: 2y ago

ERP question

So I’m starting therapy this week but I’ve been trying to use ERP myself, my main compulsion is rumination which I wasn’t even aware was a compulsion. I’m trying to do ERP but when I focus on observing the thought it goes, I dunno if I’m focusing too much on actually how to follow ERP or is this normal? I feel like I might be subconsciously blocking thoughts because I know how bad it is when I go down the rabbit hole, but then I also worry that the anxiety goes too quickly and that I’m finding it too easy to ignore the thought?

Username: Bayliespeaks

Date posted: 1y ago

Looking for pure O specific advice

Hey every body, I'm looking for some advice specific to pure O ocd. 1. My therapist has given me some response phrases to practice for my intrusive thoughts, the ones I'm using are mainly "maybe maybe not", " sure whatever", "your probably right" and "I don't have to figure this out right now". My main concern is using these phrases two often or so broadly that they become compulsive. 2. Since most of my compulsions are mental I find it difficult to control them. Sometimes my brain will automatically reassure itself or reflexibly perform a compulsion without me even wanting to engage with it. If anyone who struggles with/has struggled with this has any tips or advice I'd really appreciate it

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Rumination as a compulsion and how to treat it

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