Article 1

Almost everyone who has ever experienced low mood, anxiety or depression will know what we mean by ‘rumination’.For the record , this is when we find ourselves repeating the same types of thoughts over and over again. When we ruminate , we are more likely to think quite negatively about ourselves. our behaviours , the world around us and so on. We tend to judge ourselves negatively. We might compare our actions or ourselves with other people . We might even worry in a general way about why bad things always seem to happen to us.

You might wonder why part of a chapter on changing behaviour in depression should concern itself with a type of thinking .

However, researchers have recently started to understand rumination differently. One way to look at rumination is to see it in the same way as any other behaviour . It is triggered by circumstances , it has a function and it has consequences .

Let’s consider an example:-

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Simon’s story

Simon always prided himself on being a logical sort of guy. He worked as an accountant and was used to working on detailed sheets of figures. When he could not make his figures add up, he would be very meticulous in finding out where things were not correct. He used to do this systematically and always found where the problem was and then worked out how to fix it.

When he became depressed , Simon started to spend hours going over and over in his mind things that had not gone well. When he got home each evening, he would sit and replay the day’s events time and time again. He kept trying to work out what had gone wrong. For example, he had started to argue with his colleagues over trivial things-unwashed coffee cups, colleagues being a few minutes late, people making minor mistakes in their work .He would go over these events through out the evening , and would spend several hours sitting or even pacing up and down unable to get these thoughts out of his head. He would imagine many different situations and how they might go differently . He also started to ask himself , ‘Why me?’ ‘Why am I feeling like this?’

After all this, he found himself exhausted but also unable to sleep, his mind in turmoil . This meant that when he went to work the next day , he was more tired than usual . He found himself getting to work late and making mistakes.

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As we see from Simon’s story , the trigger for his rumination was not necessarily the events that initially bothered him, but getting home and sitting quietly . His thinking and pacing the room did not relieve his feelings , but he was unable to stop himself thinking in his way . Ironically , the consequence of trying to sort out his thoughts was that he himself started making the same mistakes that so irritated him about others.

A behavioural – activation approach to rumination is to ignore the content of people thoughts . The important thing to discover is the function of the rumination thoughts. Simon was using an analytical approach that he had learnt previously , and which he had found very useful indeed in his daily work. So he used it for this situation , since it had worked for him before. Unfortunately , when he used it for less logical situations like this , it was only making things worse. Unlike an accountancy problem , where he usually came to a satisfactory solution, these work situations could not be resolved through thinking . They just carried on and on in his mind.

Tackling rumination is no different from tackling other triggered behaviours. We can interrupt the trigger – behaviour – consequence cycle ; we can replace rumination with another behaviour , we can stop the avoiding the thing we are worrying about. These are just the same types of strategies we have become familiar with earlier. We use sel-monitoring , functional analysis and activity scheduling is all important for tackling rumination.

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