Why Rumination Feels Necessary in OCD and How Therapy in Boston, MA Helps
People with OCD ruminate. A lot. I think it is the hardest part of the disorder because rumination leads to more compulsive behavior, more distress, and it can feel impossible to stop. I've talked about rumination many times in my blog posts, but it really does deserve this much attention because it is such a significant pain point for folks suffering from OCD.
But What is Rumination?
Rumination is going over the same thing over and over again in your mind. You feel like you're solving a problem. You feel like you can figure your OCD out if you continue to internally wrestle with your obsessions...but you never do. You just keep going over the same thing again and again in your mind. I've heard it called looping, worrying, and perseverating, but in OCD therapy, we typically call it ruminating.
In OCD therapy, we also consider rumination a compulsion. Yes, it is a silent compulsion, and you aren't actually DOING anything that anyone can see...but inside there is a lot going on, and it's quite painful. It's so hard to be present in life when you're ruminating-you might be going through the motions, but really you're preoccupied with an internal war with your obsessions.
Why Rumination Is Considered a Compulsion
How is rumination a compulsion? I think the best way to illustrate how rumination is a compulsion, something someone does to try to get rid of feeling distressed, is to use a hypothetical situation.
A real-life example
Let's say Jade is struggling with obsessions related to moral OCD and fears that she is a bad person. Jade also works full-time in marketing, lives with her partner, and has an active social life. She's going to work and continuing to spend time with her partner and friends, but internally, she is in pain.
Internally, she is reviewing all her past actions, even her past thoughts, and trying to figure out if she is truly a good person. Some of her memories are more problematic than others because she has done some things she regrets when she was younger and less mature. She keeps going over these memories and engaging in an inner debate about whether or not she is a good person. Most people don't notice that she's upset, but those close to her are starting to feel like she is far away, like she is dissociating.
And the reality is that Jade is dissociating because she is nowhere close to the present moment. Instead, she is quietly engaging in compulsions. She feels like if she could just figure this out once and for all, she wouldn't feel so guilty and anxious. And so she keeps at the rumination, endlessly trying to prove to herself with certainty that she is a good person so that she can stop feeling so terrible.
But it only leads to more rumination and more distress, just like any other compulsion leads to more compulsions and more distress.
Why People With OCD Feel Like They Have to Keep Ruminating
So why can't people with OCD simply let it go and stop ruminating? Well, they can...but they have to learn how to.
People without OCD ruminate too, but they have a much easier time letting the rumination go. On the other hand, when someone with OCD is triggered, they have to train themselves to stop ruminating, and it's hard (but harder to keep ruminating). OCD is saying that if you stop ruminating, your fears could come true. Looking at the example of Jade, OCD is telling her that she must figure out if she is a good person or not. And, if she doesn't figure it out, then she is at risk of being a bad person. That is really hard to turn away from your worst fear and say, "I'm not going to figure it out." It's like there is a horror movie playing in your mind that is drawing you in and scaring you, and you have to learn not to pay it any attention.
Why OCD Rumination Feels So Real
This is one of my favorite ways to explain why OCD feels so real and why it feels necessary to ruminate. Just like when you actually watch a scary movie, you start to feel fear. You might even startle if something shocking or gory happens. This is because your body doesn't know what is real and what is a movie. It's called imaginal absorption, and it happens with OCD too.
In your mind, you're visualizing, thinking, and imagining all your worst fears, and your body doesn't know if it's real or in your imagination, so it starts responding. You start feeling anxiety, panic, guilt, shame-you name it-which makes it all feel so real. The OCD nightmare starts to feel more real the more you get absorbed in your imagination and internally debate with the OCD. Because it feels so real, it feels really hard not to give it attention. It feels like your own personal nightmare is happening, and if you don't "figure it out," you won't be able to get out of the nightmare.
You Can Learn to Respond Differently to Rumination
This is why it feels necessary to ruminate. It can quite literally feel like life or death. But it's not. Just because it feels real doesn't mean it is real (just like watching a scary movie). And just because it feels like you have to ruminate, you can learn that you don't have to. Rumination is a behavior, and we can change behaviors. I will talk more about how to do this in my next blog post. Stay tuned.
Jen Lescher offers OCD counseling in Boston, MA and San Diego, CA for people struggling with rumination, intrusive thoughts, moral OCD, ROCD, harm OCD, and other common OCD themes. Working with an OCD therapist can help you build awareness of your compulsions, reduce the urge to keep "figuring it out," and learn how to stay more connected to the present moment instead of getting pulled into fear.
Take the Next Step Toward Breaking the Rumination Cycle
If you feel stuck in endless loops of overthinking, reviewing, ruminating, or trying to "figure it out," it can be exhausting. Rumination often creates the false promise that if you think about something long enough, you will finally feel certain or relieved. But more often, it just keeps you feeling more anxious, disconnected, and trapped in the same cycle.
OCD counseling can help you recognize when rumination is showing up, understand what is fueling it, and build new ways of responding to fear and uncertainty.
Reach out to schedule a consultation and learn more about OCD counseling
Explore more blogs about rumination, intrusive thoughts, moral OCD, and ROCD
Begin practicing a different response to OCD, one that is grounded in the present moment instead of fear
Additional Resources to Support Your Journey
In addition to personalized OCD therapy, I offer resources to help you carry what you're learning in sessions into everyday life. The Common OCD Themes page explores the intrusive thoughts and patterns many people experience, while the OCD and Social Life page looks at how OCD can impact friendships, dating, and relationships, along with practical ways to stay connected while managing symptoms.
About the Author: Jen Lescher
I'm a therapist, coffee lover, and someone who values small moments of presence-whether that's mindfulness, photography, or a quiet walk. Photography, especially, helps me stay grounded and curious-two qualities I bring into my work with clients.
I've been drawn to healing and spirituality since my teens and have explored many approaches, from meditation to energy-based practices. At the same time, I'm just as likely to be blasting music in the car or listening to a true crime podcast. To me, healing includes stillness, humor, movement, and joy.
I've worked in mental health settings since 2007, which shaped my belief that healing is never one-size-fits-all. It's personal, evolving, and always possible.
Training & Background
Inference-Based CBT (ICBT) for OCD - The OCD Training School & The Cognitive Behavioral Institute
Certified in Exposure and Response Prevention (ERP) - The Cognitive Behavioral Institute
Gottman Method Couples Therapy - Level 1
Master's in Social Work - Portland State University, 2012
