| Cognitive Behavioural Therapy, or CBT, is an | | | | ways. Firstly, most people find it rather unpleasant. |
| effective psychological treatment for a wide range | | | | The same old worries getting churned up again and |
| of psychological and emotional problems. As a | | | | again are bound to make us feel sad or anxious. |
| psychiatrist based in Edinburgh who uses CBT | | | | Secondly, rumination tends to worsen (or at least |
| techniques, I see a lot of clients suffering from | | | | maintain) depression - if you focus on how bad you |
| depression. A prominent feature of their symptom | | | | feel and how hopeless (you feel) your situation is, |
| profile is the presence of "Depressive Ruminations". | | | | then you will ignore opportunities for change. |
| The term "rumination" relates to a repeated cycle of | | | | CBT theory sees depressive ruminations as a major |
| activity - in the case of cows ("ruminants"), this | | | | obstacle to recovery from depression, and as such it |
| means chewing the cud! In CBT circles, ruminations | | | | is important for clients to learn how to deal with |
| are the repeated, seemingly endless, "stuck" ways of | | | | them. There are a range of techniques, but the ones |
| thinking seen in certain psychological conditions. It is | | | | I favour as a therapist in Edinburgh are both simple |
| particularly common in depression. | | | | and effective (and almost common sense!). |
| There can be many "themes" to an individuals | | | | If you realise you are ruminating, then now's the time |
| ruminations, but the most common is a search for | | | | to do something energetic. It's hard to ruminate |
| some sort of answer to questions such as "Why am | | | | when you're out on a run, or swimming, or doing |
| I feeling like this?" or "What could I have done to | | | | press-ups. The pain tends to get in the way! Or, if |
| avoid this?". Another common theme is one of | | | | you're not the exercise type, try refocusing your |
| remorse or regret - "If only I had done (whatever) | | | | attention. Focus (really focus hard!) on some aspect |
| differently I wouldn't be in this position now" or "I've | | | | of your surroundings - a picture on the wall, a tree, |
| ruined my life". Depressive ruminations about the | | | | the cat - and examine it for detail, noting each and |
| future are also seen - "Everything's going to go | | | | every irregularity and shade of colour. Pretend that |
| wrong". Ruminations often incorporate what a CBT | | | | you're a famous artist and that you're going to paint |
| therapist would call "Thinking Errors". | | | | the most brilliant, detailed, lifelike picture ever! Really |
| What does it feel like to ruminate? Well, I'm sure | | | | focusing on things outside of you (meaning "outside |
| we've all done it at one time or another! It's like | | | | of your head"!) helps to dislodge your thinking from |
| trying to solve an unsolvable riddle - you just go | | | | ruminative patterns. A final tactic - one that some |
| round and round inside your head, examining the | | | | clients swear by and others can't get the hang of at |
| same old "clues", time and time again. If only you'd | | | | all - is to "stand-back" ("in your head", as it were!) |
| done this, or said that, or had this, or not had that. | | | | and let your thoughts simply churn away to |
| You convince yourself that there's an answer, and | | | | themselves, whilst acknowledging them as pointless |
| that when you find it then you'll be fine. But of | | | | symptoms of your depression. By letting them "get |
| course there is no "answer". People can ruminate for | | | | on with it", and refusing to "play with them", you |
| hours in severe cases, but up to an hour is more | | | | disarm them of their depression-causing capability - |
| usual. | | | | eventually they'll get bored and go away! |
| How do you know when you're ruminating? Because | | | | The above techniques are those that I've found |
| you've stopped doing everything else! You haven't | | | | most effective working as a CBT therapist in |
| turned the page of your book for the past 20 | | | | Edinburgh. There are a number of other methods out |
| minutes, or you're standing in the kitchen with a | | | | there in the literature, and I don't claim that these |
| dishcloth in your hands, gazing off into space. If | | | | work for everybody. A good thing about the CBT |
| someone asks you what you've been thinking, you | | | | ethos is that it shies away from doctrinal doings - |
| can bet it's the same old depressive thoughts that | | | | there's no "You have to do it this way or else!" in |
| you've been carrying around for ages. | | | | CBT. So the bottom line is, use whatever method |
| Is there a problem with ruminating? Well, yes. It | | | | you find helps you the most, and say "Goodbye!" to |
| differs from other forms of thought such as | | | | those unpleasant ruminations! |
| problem-solving, or reflecting, or remembering, in two | | | | |