Understanding rumination
An explainer on rumination: going over problems, feelings and yourself with 'why' questions that lead nowhere, how it differs from helpful thinking, why it is hard to stop, what it does to mood and what can help. Based on Watkins (2008) and Nolen-Hoeksema et al. (2008): a checklist of signs and a reflection added.
Written by Tarun Vermani, Trainee Clinical Psychologist Updated
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Understanding rumination
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What rumination is
Rumination means going over and over the same things in your mind: problems, upsetting events, how you feel, or what you think is wrong with you. It often takes the form of 'why' questions, such as 'Why do I feel like this?', 'Why did that happen to me?' or 'What is wrong with me?'. The questions go round and round, but they rarely lead to an answer or a plan.
Everyone goes over things sometimes, especially after a setback or a loss. It becomes a problem when it takes up a lot of time, keeps coming back and leaves you feeling worse. It is a habit of thinking, not a personal failing, and habits can change.
Helpful and unhelpful ways of thinking things over
Thinking about problems is not bad in itself. Thinking things through can help people make sense of hard events, plan ahead and solve problems. What seems to matter most is the style of thinking.
Unhelpful going over things tends to be broad and judging. It asks why, and what things mean about you or your life: 'Why can't I cope like everyone else?' It deals in big conclusions rather than details.
Helpful thinking tends to be specific and practical. It asks how and what: 'What exactly happened? What did I notice, moment by moment? What is one thing I could do next?' It stays close to the details and leads towards action.
So the aim is not to stop thinking about your problems. It is to notice when your thinking has slipped into the broad, judging 'why' style, and to move it towards the specific, practical 'how' style.
Why it is hard to stop
Rumination often feels useful. Many people believe that if they go over things enough they will understand themselves, stop making the same mistakes or be ready for the worst. So it can feel risky to let it go.
It can also, without you meaning it to, be a way of putting off something hard: a difficult conversation, a decision, or a painful feeling. Thinking about a problem can feel like doing something about it, even when nothing changes.
And it can become a habit that switches on by itself, often when you are low, tired, on your own or not busy.
What rumination does to mood
When you are already feeling low, rumination tends to make things worse rather than better. It can:
Keep low mood going, and bring more negative thoughts about yourself and the future.
Make it harder to concentrate and to remember things clearly.
Make it harder to solve problems, because the questions are too big to answer.
Get in the way of doing things, so plans and enjoyable activities slip.
Wear down relationships, if you withdraw or go over the same things with others again and again.
Rumination about the past and worry about the future are close cousins: both are repeated thinking that feels like it should help but often does not. Rumination is also linked with other ways people try to cope with painful feelings, such as drinking heavily or binge eating.
If filling this in leaves you feeling hopeless or thinking about ending your life, use your safety plan if you have one, and tell your therapist or care team. If you feel unsafe right now, call 999 or go to A&E. To talk to someone now, call Samaritans free on 116 123.
Spotting it
Rumination can be hard to spot from the inside, because it can feel like ordinary thinking. Tick any signs that you notice in yourself.
What can help
Notice it early. The sooner you catch yourself going over things, the easier it is to change course. The signs you ticked can act as early warnings.
Ask yourself a simple question: 'Is this thinking getting me anywhere? Am I closer to a plan, a solution or a step I can take?' If the answer is no, that is a cue to shift.
Move from why to how. Instead of 'Why does this always happen?', try 'What exactly happened, and what is one small thing I can do next?' Your therapist can share a sheet that helps you practise this.
Get absorbed in something. Turn your full attention to an activity you care about or enjoy, such as cooking, a walk, music, a game or talking to someone, and notice the details of what you are doing. The aim is to be involved in the activity, not to force thoughts away.
Understand what it does for you. With your therapist, you can look at what sets rumination off, what it seems to do for you and what it costs. Your therapist can share a sheet for tracking this, so that together you can find other ways to meet the same need.
Be kind to yourself. Noticing that you have been ruminating is a success, not another reason to criticise yourself.
Over to you
Write a few lines to bring to your next session. A rough answer is fine.
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When to use ‘Understanding rumination’
‘Understanding rumination’ is a psychoeducation handout based on cognitive behavioural therapy (CBT), most often used in CBT for depression and low mood.
It is designed to be read within therapy rather than as a standalone self-help tool: a therapist introduces it and discusses it with the client. You can preview the full handout above, then assign it for clients to read between sessions on any device or download it as a print-ready PDF. Where a short reflection is included, it offers space to respond to the reading.
How it works
Most people work through it in around 8 minutes. It moves through six short sections to read:
- What rumination is: Rumination means going over and over the same things in your mind: problems, upsetting events, how you feel, or what you think is wrong…
- Helpful and unhelpful ways of thinking things over: Thinking about problems is not bad in itself. Thinking things through can help people make sense of hard events, plan ahead and solve…
- Why it is hard to stop: Rumination often feels useful. Many people believe that if they go over things enough they will understand themselves, stop making the same…
- What rumination does to mood: When you are already feeling low, rumination tends to make things worse rather than better. It can: Keep low mood going, and bring more…
- Spotting it: Rumination can be hard to spot from the inside, because it can feel like ordinary thinking. Tick any signs that you notice in yourself.
- What can help: Notice it early. The sooner you catch yourself going over things, the easier it is to change course. The signs you ticked can act as early…
The handout can be read on a phone, tablet or computer, or downloaded as a print-ready PDF. If it includes a reflection, answers entered on the Formulate platform are saved automatically and shared back with the therapist for review before the next session.
The CBT approach behind it
‘Understanding rumination’ introduces a CBT approach that involves noticing the links between situations, thoughts, feelings, physical sensations and behaviour and finding practical ways to change unhelpful patterns. The aim is not positive thinking but a clearer, shared understanding of what keeps a difficulty going and practical, testable ways to change it.
Because it is a CBT tool it stays focused on the here-and-now links between thoughts, feelings, the body and behaviour, and it works best as one part of a wider course of therapy rather than as advice or a diagnosis.
Evidence & sources
This handout is grounded in established cognitive behavioural therapy theory and practice. Key sources include:
- Watkins, E.R. (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin, 134(2), 163-206. doi:10.1037/0033-2909.134.2.163
- Nolen-Hoeksema, S., Wisco, B.E., & Lyubomirsky, S. (2008). Rethinking rumination. Perspectives on Psychological Science, 3(5), 400-424. doi:10.1111/j.1745-6924.2008.00088.x
- Watkins, E.R. (2016). Rumination-Focused Cognitive-Behavioral Therapy for Depression. New York: Guilford Press.
- National Institute for Health and Care Excellence (2022). Depression in adults: treatment and management (NG222). NICE.
For use alongside professional support
Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.
If you need urgent help now:
- Emergency services: 999 — if you or someone else is in immediate danger
- NHS 111 (NHS 24 in Scotland): 111 — choose the mental health option for urgent help, in England, Scotland and Wales (in Wales, press 2)
- Lifeline: 0808 808 8000 — for urgent help in Northern Ireland, free, day or night
- Samaritans: 116 123 — free, day or night, 365 days a year
- Shout: 85258 — text SHOUT, free, day or night
- SANEline: 0300 304 7000 — 4pm–10pm, every day
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