hey you know how when you have #ADHD sometimes your thoughts are all swirly and you just keep chewing on the same thought over and over and you can’t stop thinking about it and it’s distracting you and sometimes even putting you in a really bad mood or making you irritable?
my friend, you are RUMINATING
let’s talk about rumination
Rumination is different from normal, healthy thought. It actually is a part of ADHD and a byproduct of poor attention regulation because it’s essentially hyperfocusing…on a thought.
In a neurotypical brain, a person has greater control over regulating their attention. They can DECIDE (more or less) what to pay attention to and when they want to stop paying attention to something they consciously decide to stop… and then their brain stops.
With ADHD, we sometimes don’t have control over that process. We can’t stop even when we want to or know we should. Think about times you’ve been laying in bed using your phone or late for work because you couldn’t put down a video game. You KNEW it was time to stop but couldn’t
Rumination is basically the mental version of that. It’s problematic because it’s a big distraction and can cause us to make silly mistakes or forget things we should be attending to. it takes us far, far out of the present moment.
It also SUCKS. Nobody likes obsessing about something unpleasant (rumination is rarely pleasant) or turning an upsetting thought over and over in your mind. It can cause emotional dysregulation – essentially causing us to get in a terrible mood
Rumination + Emotional Dysregulation often leads to REACTIVITY. We have low impulse control already so being in a state of severe emotional pain and not being able to stop thinking about something often leads us to thinking we need to take action to get relief
But that action isn’t always grounded in logical, calm thought that is aligned with our long term goals so when we lash out at someone, end a friendship, quit a job, spontaneously try to do a thing without much forethought or planning… we make things worse for ourselves.
Why do we ruminate? Aside from not being able to switch our attention, rumination actually does something for our ADHD – it’s stimulating.
Yes, your brain is trying to fuck with you on purpose.
Our brains are in a chronic state of low stimulation. The ADHD brain is always scanning for the thing that is going to have the biggest payoff, stimulation-wise. Sometimes that thing is playing with itself. It might feel terrible for you to be ruminating….
…but the harder you’re ruminating, the more activity and fun and stimulation there is for your brain! Thoughts are flying, you might have an elevated heartbeat, cortisol or adrenaline are flowing…your ADHD is having a HEYDAY
understanding this is key to understanding how to STOP ruminating.
If you are ruminating & you want/need to stop, consider that your brain may need an alternative but equally intense source of stimulation. Have you been working all day? have you been denying yourself opportunities to get dopamine? Is your dopamine tank low due to poor self-care?
What can you do, RIGHT NOW, to give your brain something else to play with? Secondly, separating the ‘me’ from ‘my brain’ can be really helpful. Understanding that rumination is a part of ADHD can be helpful.
Instead of obsessively being stuck INSIDE the thought, you can step back and observe the thought and think “oh my brain is ruminating right now”, or “oh man, my ADHD really wants me to ruminate”
It sounds funny but personifying the ADHD or your brain can create just enough space to help interrupt the rumination.
Last but not least, Dr. Edward Ned Hallowell says, “don’t feed the demon” – when you’re ruminating, do ANYTHING else. Clean your room. Go for a walk/run. In fact, do any kind of exercise. Wash the dishes. Do anything but sit and ruminate – keep trying to distract yourself.Dusty Chipura on Twitter
Navigating Loops of Concern
Try to work through these questions slowly, whenever you feel like you are falling too much into a loop and getting stuck. You can do them in any order you like, and move back and forth between feelings, info and action if that is helpful. If focusing on these questions is proving too difficult, it’s possible that you are overtired/hungry/thirsty/have other bodily needs. Try to do some simple restful distracting things, go to the toilet, refuel, etc, and then come back to these questions later if they are still on your mind.
Return to these questions and your answers when needed, try to answer them further, or read back on what has been resolved, and what steps are being taken.
- Summarise the main thoughts I’m looping through in bullet points. Can I turn them into questions?
- Can I answer any of these questions? (add answers)
- Can anyone else answer any of these questions? Who/how?
- What am I certain about related to these questions?
- What am I uncertain about?
- What might be needed to resolve these uncertainties? (don’t worry if you can’t resolve all of them, or if what’s needed doesn’t seem feasible — we’re just looking at what it might take at this point)
- Are there people I can/want to talk with about this? Who? Draft some messages/imaginary conversations here.
- Add any reflections I might have on folks’ responses.
*Sometimes, I’ve found it helpful to look back at old messages or other written information, as it gives me a sense of certainty over what was written/said. If you have anything similar, you could quote them here, or save them in a folder on your phone or computer for easy access. Over time, you might find that you will only need to glance at the documents, or even just know they’re there, until you don’t need them anymore. (examples: someone telling you that they care about you; a clear list of instructions for a job)
- What are the main themes or conclusions that are emerging?
- What am I feeling just now? Try to make some sentences starting with “I feel”… these could be physical or emotional sensations, images and metaphors.
Loops of Concern. A short self-help guide to tackling… | by Sonny Hallett | Medium
- What does my body need? Can I prioritise that? (rest? / food or water? / uncluttered spaces to look at? outdoors? exercise? fun? deep pressure? physical contact?)
- Can I write about any of the themes above? Or use a different creative outlet such as music, art, poetry, etc?
- Are there people I can check in with (either to resolve an uncertainty or to let off some steam)?
- Is there information I need to find or tasks I need to do to help resolve the issues explored above?
- List some very simple tasks based on the above points (broken down from larger tasks perhaps) for things I need to do. Tick them off if I do some.
In episode 328 I chat with Dr Russ Harris. Russ is a medical practitioner, author of the international best-selling self-help book ‘The Happiness Trap’ (as well as nine others), and is a world-renowned trainer of Acceptance & Commitment Therapy (ACT).
We discuss his book The Happiness Trap, the new second edition of the book, how ACT can help reduce rumination, Russ’s view of rumination, noticing and interrupting rumination during an exposure, he discusses the exercise dropping anchor, he guides us through dropping anchor live on the podcast, learning to make space for uncomfortable thoughts and feelings, we discuss learning to urge surf, how to stop techniques becoming compulsions, Russ shares personal examples of himself putting some of this into practice, words of hope and much more. Hope it helps.Dr Russ Harris: Rumination, urge surfing, and dropping anchor (#328) – The OCD Stories
Many autistic people get very stuck in loops of rumination and uncertainty, and the feeling of going round and round, the anxiety and worry, can be really unbearable. I call this ‘loops of concern’. This could be a result of our more monotropic minds, or it could be because we are more greatly impacted by uncertainties (or have more uncertainties to deal with) — or both. Often, these loops are centred around something we are not sure about: was that friend angry? Did I leave my phone on the bus or at home? Did I misinterpret or accidentally break a rule? Etc.Loops of Concern. A short self-help guide to tackling… | by Sonny Hallett | Medium
Ruminating means “dwelling on, brooding on, or stewing over things.”
There are two main ways we respond to emotional storms: OBEY or STRUGGLE. In OBEY mode, the storm totally controls us. And in STRUGGLE mode we do whatever we can to make it go away. And often we both OBEY and STRUGGLE simultaneously. In other words, we get “completely hooked.” Which makes it almost impossible to effectively deal with whatever problem or difficulty set off the storm.
Now let’s discuss real storms for a moment. Imagine you have a boat, and just as you’re sailing into harbor you hear on the radio there’s a strong storm blowing in. You’d want to drop anchor in that harbor both quickly and securely because if you don’t, the storm will sweep your boat out to sea. Of course, dropping anchor won’t get rid of the storm, but it will hold the boat steady until the storm passes. And shortly, you’re going to do something similar: learn how to “drop anchor” when emotional storms flare up inside you. But first let’s discuss the importance of…
Noticing and Naming
Many of the unhooking skills in this book involve a process called “noticing and naming”: noticing your thoughts and feelings with curiosity and naming them in a nonjudgmental manner (e.g., “Here’s anxiety” or “Feeling anxious”). And because, for most of us, this doesn’t come naturally and may initially seem like an odd thing to do, it’s important to understand the point of it.
When we notice and name our difficult thoughts and feelings, it reduces their effect on our behavior. How so? Well, the simple act of noticing what we are thinking and feeling and putting it into words activates part of the “prefrontal cortex” (that portion of your brain directly behind your forehead) and this in turn moderates other parts of the brain that are stirring up those emotional storms inside you.
It’s often helpful to name our thoughts and feelings with terms like “I’m noticing” or “Here is.” For example, you might say to yourself, “I’m noticing anxiety,” “I’m noticing numbness,” “Here is tightness in my chest,” “I’m noticing my mind worrying,” “Here’s a painful memory,” “Here’s an urge to smoke.”
When we first start doing this, it often seems odd or uncomfortable. But it usually helps us to unhook, at least a little. In everyday language, if I say, “I’m angry,” it seems as if I am that feeling; but when I say, “I’m noticing anger,” or “Here’s a feeling of anger,” it helps me to “step back” a little, see it as an emotion passing through me.The Happiness Trap
So, ready to try dropping anchor? Please remember, it’s not a way to avoid or get rid of those stormy thoughts and feelings (just as a real anchor does not control the weather). It’s a way to hold yourself steady so the storm doesn’t carry you off.
There are hundreds of ways to drop anchor when emotional storms blow up, but they all follow a simple three-step formula. I hope you’ll play around with this formula and create your own exercises, which you can do any time, any place, for as long as you wish. You can remember it with the acronym “ACE”:
The Happiness Trap
- A: Acknowledge your thoughts and feelings.
- C: Connect with your body.
- E: Engage in what you’re doing.
Our mind continually pulls us into the future: worrying, catastrophizing, predicting the worst. Why? Well, this is your mind preparing you, getting you ready for action. It’s saying, “Look out. You might get hurt. Protect yourself.”
Our mind also frequently pulls us into the past: ruminating, dwelling on painful past events, blaming ourselves (or others) for things we (or they) did (or didn’t do). This is your mind trying to help you learn from past events. It’s saying, “Bad stuff happened. You need to learn from this so you’re ready and prepared and know what to do if something similar should ever happen again.”
Ruminating, worrying, and obsessing are all essentially problem-solving processes. When we ruminate, we tend to fixate on problems in the past: Why did this bad thing happen? (Or Why does it keep happening?) When we worry, we’re preoccupied with problems in the future: What if this bad thing does happen? When we obsess, it may be about the past, present, or future, or even an alternative reality: How different our life would be if only XYZ.
Our mind is basically a problem-solving machine, always focusing on two main problems: (a) how to get what we want, and (b) how to avoid what we don’t want. When we ruminate, worry, or obsess, we can think of it as “problem-solving in overdrive”; our mind’s going over and over the problem, full speed ahead, desperately trying to come up with a good solution. But it’s like a car stuck in the sand: the engine’s on full throttle, the wheels are spinning wildly—but the car is going nowhere.
In other words, ruminating, worrying, and obsessing are all forms of ineffective problem-solving. These cognitive processes eat up a huge amount of our time, energy, and attention and are usually incredibly slow to deliver a solution.
So why do we keep doing it? Well, these processes are always triggered by some sort of problem: difficult situation(s), difficult thought(s), difficult feeling(s), or any combination thereof. And in response to these triggers, we ruminate, worry, or obsess, attempting to solve the problem.
The alternative to ruminating, worrying, or obsessing about your emotions is to notice and name and allow them, to make room for them, and treat yourself kindly. And if you can spare a minute, ask yourself, “What does this emotion tell me really matters? What does it suggest I need to attend to?” As I said in chapter 14, often (not always) you’ll find this emotion is pointing to something very important: a problem you need tackle, a fear you need to face, a behavior you need to change, a relationship that deeply matters, or a loss you need to come to terms with.The Happiness Trap
I also wonder about the role of monotropism in mental health generally and rumination in autism. Rumination isn’t an environmental stimulus, so this isn’t stimulus-driven exogenous attention capture, but we’d generally prefer it if our attention wasn’t captured by these thoughts. Of course, I’m not ignoring the reality many of our mental health challenges are probably driven by us being a marginalized group of people who are more likely to have unpleasant experiences than neurotypicals. Whatever the role of monotropism in rumination, I think context and life experience are also vital to understanding autistic mental health.Revisiting monotropism – Autistic Scholar
It is also possible that, at least in part, hyper-arousal is also related to underlying symptoms of anxiety, which have been found to be elevated among those with ASD (Zaboski & Storch, 2018). While we did not specifically assess anxiety in this study, this is a possible explanation. In addition, individuals with ASD have been shown to experience sensory hyper-sensitivity, which in turn may cause them to feel more agitated, hypervigilant, and generally aroused (Green & Ben-Sasson, 2010). As for re-experiencing, individuals with ASD were found to report high levels of rumination and intrusive thoughts (Carne et al., 2013; Gotham et al., 2014). This tendency to “rehash” mental and emotional content is at the core of the re-experiencing cluster, and characterizes post-traumatic intrusions (e.g. constant reminders of the trauma, flashbacks). Future qualitative inquiries may examine whether the symptom clusters highlighted in our study fully capture the nature of the post-traumatic experience in adults with ASD. Notably, there is also the possibility of the increased hyper-arousal symptoms resulting from an overlap between ASD symptoms and PTSS, that is, that some similarities between symptoms that are characteristic of both conditions may inflate the level of PTSS reported by individuals with ASD.Autism Spectrum Disorder and Post- Traumatic Stress Disorder: An unexplored co-occurrence of conditions
The results indicated increased post-traumatic stress disorder symptoms, as well as elevated brooding levels, in adults with autism spectrum disorder, compared to typically developing controls. Brooding, but not reflective rumination, mediated the association between autism spectrum disorder and post-traumatic stress disorder symptoms. Rumination and cognitive inflexibility, which are common in autism spectrum disorder, may exacerbate post-traumatic symptoms among traumatized individuals who have autism spectrum disorder. Interventions targeting brooding rumination and cognitive flexibility may assist in alleviating post-traumatic symptoms in individuals with autism spectrum disorder. Future studies should examine other psychological mechanisms which may underlie the autism spectrum disorder–post-traumatic stress disorder co-morbidity.
Separate lines of research in autism spectrum disorder and post-traumatic stress disorder have shown that the two may share several vulnerability factors. One of those is ruminative thinking, that is, one’s tendency to re-hash thoughts and ideas, in a repetitive manner. This article examined the role of two rumination types as potential factors connecting autism spectrum disorder and post-traumatic stress disorder: brooding (continuously comparing one’s current condition to one’s desired condition) and reflection (an introspective effort to cognitively solve one’s problems). A total of 34 adults with autism spectrum disorder (with no intellectual impairment) and 66 typically developing adults completed questionnaires assessing post-traumatic stress disorder symptoms and rumination. The results showed increased post-traumatic stress disorder symptoms in adults with autism spectrum disorder, compared to typically developing adults. Brooding rumination was also higher among those with autism spectrum disorder. Finally, brooding, but not reflection, served as a mechanism connecting autism spectrum disorder and post-traumatic stress disorder, that is, those with autism spectrum disorder showed increased brooding, which in turn predicted more post-traumatic stress disorder symptoms. This study has potential clinical implications. Rumination and cognitive inflexibility, which are common in autism spectrum disorder, could exacerbate post-traumatic symptoms among individuals with autism spectrum disorder who experience traumatic events. Interventions targeting brooding rumination and cognitive flexibility may assist in alleviating post-traumatic symptoms in individuals with autism spectrum disorder.
According to Nolen-Hoeksema’s (1991) well-accepted Response Styles Theory, rumination refers to repetitively thinking about the cause, consequences, and symptoms of one’s negative affect. The theory argues that there are inter-personal differences in people’s characteristic response patterns to negative mood. These patterns subsequently have an effect on the course and intensity of this mood. rumination refers to repetitively thinking about the cause, consequences, and symptoms of one’s negative affect.Nolen-Hoeksema and colleagues (2008) indicated that there is a positive association between a ruminative response style and increased negative emotions, decreased goal-directed activity, and burnout in inter-personal relationships. Rumination is typically considered as a dysfunctional emotion regulation strategy, which individuals employ in an inflexible manner. In line with Response Styles Theory, rumination was commonly associated with psychopathology, including depression and obsessive-compulsive disorder (Aldao et al., 2016). In recent years, the study of rumination was enriched by categorizing it into two sub-types: (1) brooding (continuously comparing one’s current condition to one’s desired condition) and (2) reflection (an introspective effort to cognitively solve one’s problems), with research showing the adverse effects of the former, and the positive effects of the latter (Wu et al., 2015). Repetition, which is a central component of rumination, is a defining aspect of ASD. Indeed, increased rumination was found among individuals with ASD (Gotham et al., 2014). Rumination is also associated with PTSD, with longitudinal studies showing that the endorsement of rumination shortly after a traumatic event serves as a predictor of later PTSD (Kleim et al., 2007). Both intrusions and rumination are quite common in individuals suffering from chronic PTSD (e.g. Michael et al., 2007; Williams & Moulds, 2007). An increased tendency for rumination may both facilitate the development of post-traumatic cognitions, as well as maintain them once they have developed. This may be particularly true for brooding rumination, which was found to be associated with symptoms of post-traumatic re-experiencing. As noted by Valdez and Lilly (2017), “Passively thinking about the causes and consequences of trauma can provide internal retrieval cues for intrusive trauma memories that can elicit further rumination” (p. 12). This notion also echoes Ehlers and Clark’s (2000) cognitive model of PTSD, which highlights the bidirectional association and mutual maintenance between re-experiencing and rumination. Interestingly, when looking at reflection rumination separately, this cognitive pattern was found to be associated with post-traumatic growth (PTG), which is considered a salutogenic outcome of trauma exposure (Stockton et al., 2011).
…compared to TD participants, those with ASD reported significantly higher total PTSD scores, as well as higher scores on the PTSD clusters of hyper-arousal and negative alterations in cognition and mood. Marginally significant differences were also found on PTSD intrusion symptoms (p = 0.077). ASD participants also reported higher levels of brooding rumination, as well as marginally significant higher reflection scores (p = 0.053).
This study examined the role of rumination in the ASD-PTSD co-morbidity. We have shown a significantly higher incidence of PTSD, as well as higher levels of some PTSD clusters, among those with ASD. Participants with ASD, as well as participants with a probable PTSD diagnosis, reported increased brooding rumination. In addition, brooding rumination, but not reflection, mediated the association between ASD and PTSD symptoms.The comorbidity between autism spectrum disorder and post-traumatic stress disorder is mediated by brooding rumination – Ofer Golan, Nirit Haruvi-Lamdan, Nathaniel Laor, Danny Horesh, 2022