Compulsive Rumination

Barbara Heffernan • July 31, 2024

Rumination is SO painful!  You can recover from compulsive rumination. Here are 4 concepts to help you begin healing.

Compulsive rumination is so painful. It is so painful to have something going around and around in your head.

 

 You don't want to be thinking about it anymore, but you still are. It intrudes, popping up all the time.

But! There is help for this.

So if you are ruminating and you feel that it is compulsive rumination, it is worth thinking about the concept of “compulsivity.” If something is a compulsion, it means that you can't not do it. But you know that not doing it is an option.

 

Maybe you know there is an option not to do it because other people don't do it. Or maybe there's been times in your life where you haven't done it. So, you know there's an option not to do it, but you can't not do it.

 

So the first thing I would like to ask you is what is the “secondary gain” that comes with that compulsion? A secondary gain is an underlying advantage. It may be hidden. And I know this will sound counterintuitive (and I can hear you saying, “How ridiculous! There is no advantage!”), but all compulsions actually do have some type of secondary gain.


Compulsive behaviors might give us a nanosecond of relief of our anxiety. Compulsive behaviors might make us feel like we're doing something productive.

 

So what is the compulsive rumination doing for you? Has your compulsive rumination tricked you into thinking that you need it?

 

For example, people with health anxiety often compulsively ruminate, and while they know it is compulsive, they also feel like, “I have to worry about this. It's my health!”

Or someone in school might feel, “I have to worry about this. I have a critical test!”

This is where knowing the concept of productive worry versus unproductive worry is helpful, which I’ll explore below!

 

So with that as a background, I want to talk about four things that can help you from a self-help point of view.

 

#1: Fully convince yourself that your rumination is not productive and understand what productive problem solving is

 

Our human brain is geared to look for problems. It is geared to anticipate future problems and to look at past events and identify problems so we know what to do differently in the future. Our brain is geared to doing this to help our survival.

 

Unfortunately, it gets off course because it can get stuck going over and over something, which is not productive.

 

Productive problem solving often has to bring in looking at a problem from a number of different points of view. Rumination tends to go over and over the same information from the same point of view with the same type of thinking.

 

Let's say we had a fight with a friend and we're worried about it. It went poorly and we can't figure out whether we did something wrong or whether they did, and we just keep going over and over it. We probably just keep feeling badly about ourselves and-or badly about our friend… and we are not getting anywhere.

 

If we bring in an outsider point of view, it can be very helpful. Or we journal about the situation, and explore what cognitive distortions are driving the rumination. Once those are identified, we can write out “ What can I do to think about this differently?”

That helps us move more towards problem solving.

 

And then, sometimes problems don't have a solution! So our brain is stuck, ruminating about a problem over and over that can't be solved.

 

We can't solve something that happened in the past. We can sometimes learn from it with perspective and therefore change behavior going forward, but not always. And we can't change the past.

 

If the problem is in the past, it can help to write about how your rumination is not helpful, identify the cognitive distortions with go with realizing that the problem can't be solved, and look for that “secondary gain.”

Because until you're fully convinced that you don't need your rumination, you won't be able to let it go.


# 2 Label Your Thoughts

So once you're fully convinced you don't need your rumination, then my recommendation is that you begin to label your thoughts. So when you are ruminating, label it. You could say it out loud, you could say it in your head, “This is rumination. This isn't helpful.”

The same thought swirls into your head, “This is rumination. This isn't helpful.”

So you interrupt it. You don’t give in to it.

You can remind yourself that our thoughts are not all true (most aren’t actually!).

Now what will help you do this is…


#3 The Observer Brain


The observer brain is the part of the brain that observes your thoughts. The observer brain is not looking at the content of what you're ruminating about (the mistake you made, the fight you had with your friend, the problem in the future). The observer brain is looking at the process. The observer brain is saying, “Hmm, that's a ruminative thought process.”

The Observer Brain is developed through mindfulness, meditation, psychotherapy, and spending time non-judgmentally observing your thoughts.

We learn a lot about ourselves when we utilize our observer brain!


And developing this part of our brain, leads to…

#4 Rewire Your Brain by Changing Habitual Patterns.


With habitual patterns, we develop a pattern of response in our brain. The activated synapses begin to fire together and become wired together! They get to know one another.

 

 Fight with friend, boom! Thought pattern triggered! Physical feelings triggered! Boom, boom, boom! Rumination.

 

You can think about your brain as if you're walking a path on your lawn or in the woods or wherever. The more you walk it, the deeper the groove gets.

 

So, putting in place those things that can cut that pattern is part of the recovery process.

There are a number of different techniques and approaches that do this. The main thing to keep in mind is that when we have a behavior that is linked with a type of thought, that is reinforced. So if we can change either the thought or the behavior that goes with it, we are beginning to rewire our brain.


I have a free webinar called Rewire Your Brain for joy and Confidence which focuses on how and why these habitual patterns develop and what we can do about them. I talk about how we can actually change the chemical composition and the gray matter of our brain through our thoughts and behaviors!

Let me know what you thought of this blog in the comments below, and feel free to ask any questions!

And if you'd like to view this material in
video format, please click here.

Blog Author: Barbara Heffernan, LCSW, MBA. Barbara is a licensed psychotherapist and specialist in anxiety, trauma, and healthy boundaries. She had a private practice in Connecticut for twenty years before starting her popular YouTube channel designed to help people around the world live a more joyful life. Barbara has a BA from Yale University, an MBA from Columbia University and an MSW from SCSU.  More info on Barbara can be found on her bio page.

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By Barbara Heffernan April 29, 2025
Sometimes is seems that anxiety runs in families, but not everybody has it. Other times, someone might have anxiety when no one else in their family does. In this article, I will discuss the current state of research regarding whether anxiety is genetic and inherited. I will also address whether this knowledge matters, and if it does, why it matters. The role genetics plays varies by specific anxiety disorder. Toward the end of this article, I will provide a summary of current research findings for generalized anxiety disorder, panic disorder, specific phobias, agoraphobia, and social anxiety disorder—the five anxiety disorders that primarily apply to adults in the DSM-5-TR. I will also include obsessive-compulsive disorder because, while it's no longer classified as an anxiety disorder, many readers ask about OCD, and there is significant overlap. Before examining specific disorders, it's important to understand the research methodology and findings in general terms. I'll break down concepts like familial aggregation and concordance rates in twin studies to provide an accessible and understandable overview. The Science Behind Anxiety and Genetics Anxiety is a common human experience. However, it becomes a disorder when it is excessive, interferes with daily life, or impacts overall functioning or happiness. Anxiety disorders are prevalent—research shows that up to a third of the population will experience an anxiety disorder at some point in their life. Family history and genetics are definite risk factors, but they are not determinants. There is no gene for any anxiety disorder that directly causes the condition . Overall, family conditioning, family history, and genetics can be viewed as influences that increase the likelihood of developing a disorder, but they are not determinative. Understanding the Research Methods When researchers observe anxiety disorders clustering within families, this is called "familial aggregation." Research indicates that having anxiety in a first-degree relative can increase your risk of developing an anxiety disorder anywhere between three and 17 times compared to someone without that family history. However, families influence us in many ways. We learn from our parents' behavior, we mimic others' coping mechanisms, and we adopt patterns of behavior from those around us. These behaviors can be passed down through generations without necessarily indicating a genetic link. To determine whether anxiety truly has a genetic component, researchers often turn to twin studies. A common method involves comparing incidence rates between identical twins (who share exactly the same genetic structure) with fraternal twins (who are as genetically different as any two siblings). Most siblings share approximately 50% of the same genes, while identical twins share 100%. For clarity when reading research, it's helpful to know that identical twins are called "monozygotic," and fraternal twins are called "dizygotic"—terminology that can make research studies confusing for non-specialists. In research literature, you might encounter sentences like this regarding obsessive-compulsive disorder in twins: "There is a concordance rate of 0.57 for monozygotic versus 0.22 for dizygotic twins." To break this down for you, this sentence means that if you're an identical twin and your twin has OCD, you have a 57% chance of having that disorder, whereas if you're a fraternal twin and your twin has OCD, you have a 22% chance of having it. The concordance rate represents the likelihood that one twin will have the anxiety disorder if the other twin has it. Since OCD appears approximately twice as common in identical twins, this suggests a significant genetic contribution. However, it's important to note that even in identical twins, there remains a 43% chance that the other twin won't develop OCD. The Role of Epigenetics To summarize, most anxiety disorders appear to have both genetic and familial links, yet other factors play a very important role. These additional factors include the environment you grew up in, the environment you are in now, specific life experiences, and epigenetics. Epigenetics refers to environmental factors or life experiences that trigger gene expression. Epigenetic factors play a crucial role in determining whether particular genes become activated. This principle applies across many conditions, not just mental health disorders. The developing field of epigenetics highlights an important truth: our genes do not determine our destiny. Does It Matter If Anxiety Is Inherited? This brings us to the question: Does it matter whether anxiety was inherited through family behavior or genetics? I believe this information can be a double-edged sword. In my work as a psychotherapist, I've observed that when individuals focus on their belief that their disorder is genetic, they often believe nothing can be done about it. They adopt the mindset: "I inherited this; I will always have it." If this belief prevents someone from seeking help, or doing the work needed to recover, then awareness of genetic components may not be beneficial... because regardless of the cause, anxiety is treatable . Many people can achieve full recovery, and most others can experience significant improvement. In terms of treatment approaches, the specific trigger or genetic predisposition matters less than commitment to recovery. While you might face additional challenges with family patterns of anxiety or intergenerational trauma, recovery remains possible. Whether the source was trauma or generational stress, effective tools and techniques exist. On the positive side, understanding the inherited aspects of anxiety can help people avoid feeling defective. It reduces self-blame for having an anxiety disorder. When we understand anxiety in the context of its prevalence in the general population and its presence in family histories, this understanding fosters self-compassion. And self-compassion, in turn, aids healing. An additional benefit of knowing about familial risk is the potential for earlier treatment seeking. Earlier intervention, particularly for panic disorder, correlates with better outcomes. S pecific Anxiety Disorders and Their Genetic Components Here's a summary of research findings for specific anxiety disorders: **Generalized Anxiety Disorder: Research indicates approximately a six-fold increase in the likelihood of developing generalized anxiety disorder if you have a first-degree relative with the condition. Twin studies suggest genetics contribute about 30% to GAD development. Researchers exploring specific genes associated with anxiety disorders have identified a potential link to a gene called RBFOX1, though this research remains preliminary and inconclusive. **Panic Disorder: Research shows a wide range in family aggregation odds ratios. If a family member has panic disorder, you are between three and 17 times more likely to develop it yourself. This wide range limits specific predictive value, but clearly indicates increased risk. Some genetic studies have identified a possible link to the NPSR1 gene for panic disorder. However, anxiety disorders are generally considered polygenic, meaning they involve multiple genetic regions. **Specific Phobias: Research on specific phobias varies considerably, with family influence accounting for approximately 30% to 60% of risk. This variability likely stems from the diversity of specific phobia types and triggers. **Social Anxiety Disorder: Twin studies show an inheritability rate of around 27% due to genetic components. A family history of any anxiety disorder increases the likelihood of developing social anxiety. **Agoraphobia: While not discussed in detail, agoraphobia is one of the five main anxiety disorders in adults mentioned earlier. Research indicates family history plays a role in agoraphobia development. **Obsessive-Compulsive Disorder: As discussed previously, twin studies suggest a significant genetic component in OCD. The likelihood of developing OCD if a family member has the condition increases dramatically if that person developed OCD in childhood. Childhood onset of any anxiety disorder increases the chance of genetic transmission, but this effect is particularly pronounced with OCD. Key Takeaways To summarize the major points: Despite mentioning specific genes identified in research, no gene has been found to determine any anxiety disorder, and no research to date is definitive. Given the reality of epigenetics—that environmental factors trigger genes—neither genes nor childhood environment determine destiny. Recovery is possible, as is rewiring anxiety responses in the brain. If you haven't yet viewed my free webinar, "Rewire Your Brain for Joy and Confidence," I encourage you to explore it. I discuss how our brains become wired when we connect thoughts and behaviors with specific feelings. While these patterns often develop early in life, neuroplasticity allows us to change our brain wiring. We can alter which brain regions activate and which neurochemicals are produced. By changing behaviors, we can transform our environments, and even deeply ingrained patterns can be rewired. I encourage you to watch the webinar and seek help if you're struggling with anxiety—effective treatments exist. This article covers more technical material than my usual content, so I am interested in your feedback. My next video and article with address "Why do I have anxiety?"—a common question I receive. Many wonder why they experience anxiety while their siblings don't, whether it's genetic or behavioral. That forthcoming article will explore the various causes of anxiety beyond heretability. How has understanding the genetic components of anxiety affected your perspective on your own experience? I'd appreciate hearing your thoughts in the comments below.
By Barbara Heffernan April 9, 2025
Scientifically proven, simple technique to calm an amygdala hijack. This blog describes this simple technique, provides the scientifically proven benefits of using this technique and shares 7 steps to implement this technique in the most effective way! Based on Lieberman's scientific research on affect labeling. The Technique: Affect Labeling Affect labeling is putting into words what emotion you are feeling.
By Barbara Heffernan March 24, 2025
Understanding the Fawn Response The Fawn response is a behavior developed in childhood, often connected to complex trauma. It could even be little "t" traumas on an ongoing basis, where as a child, you learned to subjugate yourself to the caregiver in order to stay in relationship and survive. This becomes a deeply ingrained survival behavior which can become habitual. As you grow up, it gets applied to all situations. This blog will go through nine components required for healing. - The first three focus on internal work - The next three are more practical, action-oriented techniques - The last three address deeper psychological work Internal Work (Components 1-3) # 1. Recognize that fawning developed because it was necessary at the time Understand that fawning was a survival strategy, and it might have been the very best choice available to you. It may also have been, in many ways, the only choice. Even today as adults, there are situations where choosing a fawning-type behavior might actually be the best choice. This is important to understand because we don't want to eliminate this response entirely—we want to get to the point where it's not an automatic go-to reaction. Instead, we want to reach a place where you can consciously think, "I'm choosing to do this right now." Acknowledging that this developed as a survival strategy helps prepare you for the next two components. [ For more information on what the fawn response is and why it developed, read this blog] # 2. Begin to acknowledge and validate your own feelings If you grew up in an environment where you learned to fawn, my guess is that not only were your caregivers not paying attention to your feelings, but you also had to subjugate your own feelings to the point where you weren't aware of what you were feeling. As an adult, it's necessary to begin recognizing and identifying your emotions: "I'm feeling angry" or "sad" or "frustrated" or "irritated." Begin to acknowledge and even verbalize what you're feeling. The simple act of labeling your emotion calms down your fight-flight-freeze response and increases activity in the areas of the brain that help you solve problems. There is research that shows this happening via fMRIs! # 3. Practice self-compassion Understanding why this behavior developed can help you practice self-compassion. Changing these behaviors is hard and takes time. If you find yourself automatically fawning and later yelling at yourself, try not to do that—you're basically re-traumatizing yourself for a behavior you learned for survival. Instead, try noting it with self-compassion: "Interesting, I fell into that pattern again." And then connect this to the next step by adding, "I fell into that pattern again because of this situation." Observe with compassion rather than judgment. Practical Tools (Components 4-6) # 4. Identify situations that trigger fawning behavior Notice which situations trigger your fawning behavior. As you review these situations, see if there are patterns similar to those you experienced as a child. They may reflect situations that were emotionally or physically dangerous, or that created a rift between you and your caregivers. Identifying these situations helps you understand what patterns became embedded in your emotional brain. As you observe these patterns, bring in self-compassion and that observer mindset. This approach is much more productive than criticizing yourself. As you identify these patterns, you can connect them to current situations: "This situation at work with a difficult authority figure is recreating this childhood pattern for me." You are bringing in your frontal lobe to analyze the emotional reaction, which helps you realize, "That was threatening to my very existence when I was a child, but it is not threatening to my existence right now." This recognition is crucial because automatic fawning behaviors come from a need to survive immediate danger. The uncertainty of longer-term consequences (like losing a job) might be problematic, but it's not an immediate survival threat. Differentiating between then and now helps calm your fawn response. # 5. Keep a journal to track people-pleasing behaviors Keep a journal for 30 days. Journal on this question: "Did I say or do something today to please someone else that was at my own expense?" As you review the events of each day, you might realize, "I didn't do it this situation, but I did do it in those five situations." Again, maintain self-compassion with no judgment—just observe and be aware this will take time. This question gets at the heart of the issue: What did you do today that ignored your own values or needs in order to stay in relationship with someone else, avoid criticism, or prevent rejection? Verbalizing this through an audio journal or writing it down utilizes different parts of your brain that help you comprehensively understand what's happening. # 6. Practice emotional regulation tools daily Implement diaphragmatic breathing, grounding exercises, or any techniques that calm your physiology. Practice these regularly, not just in the middle of triggering events. You can weave these practices throughout your day. Set an alarm for three different times during the day, and when it goes off, simply take three deep diaphragmatic breaths. No one needs to know you're doing it—you can do it anywhere, and it's free. While it might not feel immediately helpful, you're stimulating a different part of your nervous system that helps you realize, "In this situation, it would not be life-threatening if the relationship were severed. I'm not in a situation where my immediate survival is at stake." When you feel safe enough, your normal breathing pattern will naturally be diaphragmatic. It's all a feedback loop—a body-based technique that communicates to the rest of your brain. The fawn response is differentiated from the fight-flight-freeze response. Sometimes they're grouped together, but I think it's more useful to separate them (I'll cover this topic in the future if you're interested—let me know in the comments). The fawn response uses different parts of the nervous system and brain because it's largely about staying in connection with others. That said, knowing whether your underlying response is fight, flight, or freeze beneath the fawn behavior can be helpful. People who fawn typically have either a flight response (wanting to run away) or a freeze response. Fighters rarely develop the fawn response. I recently created videos and blogs about calming the fight-flight-freeze response that might be useful for you. Deeper Work (Components 7-9) # 7. Recognize your negative core beliefs Identify what beliefs developed when you were young that led you to fawn, and what beliefs developed as a result of fawning. A common belief for people who fawn is "my needs don't matter," or even " I don't matter." Other common beliefs include "I'm not good enough," or "I'm powerless." A general feeling of being in danger is also common. Identifying these negative core beliefs and beginning to use tools to rewire them is extremely helpful. [I have a free PDF that helps you identify these beliefs and learn tools to rewire them. You can find it by clicking here ]. # 8. Learn to recognize and separate from limiting thoughts Notice when your behavior is driven by your negative core beliefs, whether you're fawning or not. You might operate from these beliefs almost all the time, even when not actively people-pleasing. Begin to separate yourself from these thoughts. Not all of our thoughts are true. Not all of our beliefs are true. We can "diffuse" from our thoughts by using our observer mind: "Interesting, I'm thinking that again, but I know it isn't necessarily true." A helpful technique is to "practice as if." If you feel like your needs don't matter, pretend that they do matter. Ask yourself, "What would I do right now if my needs mattered?" You can practice this approach in small ways. Your behavior, even if it is coming from a place of pretense, will actually begin to rewire these beliefs. # 9. Establish healthy boundaries I've placed this component last because establishing healthy boundaries isn't simply about saying "no." (Sometimes saying no is a healthy boundary, but sometimes it's not—and boundaries encompass much more than that). Healthy boundaries require a deep understanding of yourself and your values, and an understanding of where you end and others begin. To truly understand healthy boundaries requires deep inner work. The other components we've discussed, particularly emotional regulation, are prerequisites for establishing boundaries. Until you develop a certain level of emotional regulation, it's nearly impossible to implement healthy boundaries. When your amygdala is firing with the fight-flight-freeze response, your response is automatic and happening too quickly for your rational brain to intervene. Your rational mind might know "I should be saying no right now" or "I should leave this conversation," but the panic response has already set in, and your brain is focused solely on keeping the relationship intact and staying safe by avoiding conflict. This is why healthy boundaries aren't just about learning more information. You've probably read extensively about boundaries and have cognitive awareness of what healthy boundaries might look like. Then you get frustrated when you can't implement them because no one talks about the fact that boundary-setting starts with emotional regulation. Healthy boundaries also require healing negative core beliefs and knowing (even if you don't yet feel it ) that you can be safe without maintaining a toxic relationship, you can be safe even when there's conflict. A Structured Approach to Healing In my boundary program , I've designed an approach which walks you through the CORE components of healing and establishing helthy boundaries. The program helps you: develop the emotional regulation you need to begin to set boundaries identify and heal the negative core beliefs that are driving unhealthy boundaries learn assertive communication (as opposed to passive or aggressive) understand how to set boundaries and consequences and begin to do so! (For more info on the boundary program, click here) Learning assertive communication is essential because people with fawn patterns often use passive communication. Assertive communication represents the middle ground between passive and aggressive communication. It embodies the principle "I'm okay, you're okay." Many people who fawn misinterpret assertive communication as aggressive, and since they don't want to be like their aggressive abuser, they default to passive communication. But there is a healthy middle ground. As always, I'd love to hear your thoughts and questions—please comment below. I truly hope this is helpful, and I'll see you next week.
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Do you find yourself automatically people-pleasing? Automatically becoming subservient to others? If yes, you might have the fawn response. Read this blog to understand what the fawn response is and why you might have developed it.
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