The Path of My Ruminations

What most people conceptualize as OCD is only a sliver of what actually occurs. The truth is that hand-washing, counting, re-locking doors, and checking faucets is the tip of the iceberg. I don’t have these kinds of compulsions. If I’m being embarrassingly honest, sometimes I wish I did, because then people could see not only how much I suffer, but how often. How very repetitive my obsessions are.

The compulsion that I have is called ruminating. It’s a mental checking and rechecking of feelings, thoughts, emotions, fears over and over again in order to achieve 100% certainty about how I feel about something. The problem is: there is no such thing as 100% certainty – at least as far as the human mind is concerned.

I’ve written about what my ruminations are and how I overcome them, but I don’t think I’ve laid out how they work and what the path of the thoughts to emotions and actions are. In my experience, there are two kinds of ruminations, triggered and untriggered. Untriggered ruminations come to me naturally and without any prompt. Triggered ruminations come from an event or a statement or an action.

For the sake of transparency (I’ve mentioned this in previous posts), my ruminations usually revolve around my relationship. You can read about the general gist of the different types of OCD here.

Untriggered Ruminations
Anxious thoughts drive me to feel depressed pretty much every morning. Every morning, while I am unmedicated (I stopped taking my daily meds a few weeks ago and only take them as needed), I wake up a significant amount of time before my alarm (usually between 3 – 4:30 AM). By the time I realize I’m awake and that my alarm hasn’t gone off yet, my mind is already in full force. I am contemplating pretty much every aspect of my life. Am I happy? Am I satisfied? Do I feel jealous today? Am I attracted to other people? Does my boyfriend love me? Do I love him? Does he want me around? Do I want him around? etc…

Every morning, I am greeted with this. And every morning, after I arrive at my train station, surrounded by strangers in business suits, I write in a notebook to help purge the racing ruminations. To find the real ME beneath all of the negativity and chaos running through my mind. Every morning (to varying degrees) I contemplate my relationship. Why? Baggage and fear, most likely. I have a fear of repression – of being in a shitty relationship and not realizing it. This, on top of needing control, and a diabolical fear of loss and abandonment most likely account for most, if not all, of my relationship-themed OCD. So, in order to combat this, I check and recheck how I feel about any given facet or circumstance.

Ninety-nine percent of the time, the resulting conclusion of all this thinking is: my relationship is fine/wonderful/fulfilling/great, and I am satisfied with it, the outlying 1% being standard minor complaints or dissatisfaction that occur in any relationship from time to time which can range from “Hey, he could probably help cook more often but it isn’t really that big of a deal” to circumstantial issues such as not being able to live together yet or both of us being tight on money. (I’m making a distinct effort here to not say that I am 100% satisfied because requiring certainty is a major problem related to my anxiety and I need to learn to accept less than certainty.)

These ruminations are patterned and easy to overcome (“easy” is relative. It takes lots of daily long-term work, but not nearly as much work as triggered ruminations). Because they happen daily, I can often compartmentalize them into “this is just a daily rumination, I don’t need to worry about it.” Also, these ruminations can be completely eliminated by taking medication (which I have chosen not to do).

 

Triggered Ruminations
Triggered ruminations are much more complicated and complex. They occur as a result of an outside force: a statement, a song, an occurrence in a film, an exchange between me and my significant other, a story someone tells me about a relationship, etc. Anything can be a trigger, really. And once something becomes a trigger, I have a tendency to want to avoid it (this is a common trait for people with OCD and/or intrusive thoughts).

Something like this follows a distinct path that sometimes can escalate into a panic attack. In fact, this is usually the cause of my panic attacks. Here is the course it follows (I know this method of laying it out is chaotic and messy, but I’m trying to illustrate the chaotic nature of it. It is not quite this linear, but writing is linear and limiting. This usually happens the way a fractal would function – like a tree, with a base, a trunk, and then branches giving way to more branches):

>Trigger
>Feeling of doom – inside: heart drops into stomach, heat rises to my head and face, racing thoughts start, ache in my gut that spreads to all parts of my body manifesting in anxiety symptoms.
>Fear of racing thoughts ensues. Outside: fighting back tears, avoiding eye contact, attempting distraction.
>My behavior changes, I begin to avoid people around me, usually my significant other.
>Mean voice conjures several possible negative conclusions about the trigger arise, and my mind begins to search for evidence.
>Ruminate
>Ruminate
>Ruminate
>Cognitive Behavioral Therapy (CBT) kicks in and I try to find evidence against the negative conclusion(s) my mean voice has conjured.
>Deep breaths, become calmer
>Trigger replays in my mind
>Feeling of doom repeats, anxiety escalates, sadness/fear/general upsetness escalates.
>CBT
>Grounding (holding an object or focusing on present to circumvent the fixation on the thought)
>Deep breaths, become calmer
>Trigger replays
>Feeling of doom repeats, anxiety escalates, sadness/fear/general upsetness escalates.
>Thoughts of low self-worth drive negative conclusions and I begin to realize that I need to talk about what’s in my head.
>Ruminate
>Ruminate
>Ruminate
>Feelings of shame arise as I consider discussing my thoughts.
>Hold conversation in my mind (read: practice)  about what I should say to express my thoughts without hurting feelings.
>Ruminate about how the conversation will go (this used to take weeks, now it takes a couple of minutes or an hour). It is basically a rumination process within a rumination process.
>Finally say what’s on my mind.
>Feel shame.
>Get down on myself for having the thoughts.
>Get down on myself for getting upset by the thoughts.
>Trigger repeats – now followed by anger at the thoughts, anger with self.
>Mean voice gets louder, telling me I deserve nothing.
>Branches into two potential results:

  1. Panic attack (about 20 minutes) > Lethargy > Feel better
  2. Talk through mean voice > (get reassurance) > overcome feelings of low-self worth > emotional state lowers gradually into a calm state (sometimes the anxiety cycle can reactivate all over again if I am still affected by the trigger) > feel better

 

And often, at some point, usually about when CBT kicks in, the rumination will be ABOUT the anxiety. Instead of making me upset content-wise, I realize that the thoughts are irrational, my rational mind takes over, and the rumination just keeps going on its own – like a swinging pendulum, unaffecting and unaided. The simple fact that I am ruminating can cause anxiety and emotional upheaval. It becomes about the abusive voice in my mind and no longer about the thing I’m thinking about.

Obsessions, once triggered, can continue for merely hours or days, but can go for weeks or months. Once I overcome a particular obsession, the content of it doesn’t bother me. I can think about the thing without obsessing. But months later, the obsession may occur again – triggered or not – and the same pattern will repeat.

I’ve gotten better at working through the rumination, and by “better” I mean more efficiently and quickly. It used to take me weeks to get to a rational conclusion that I can now achieve in an hour.

So there is a lot of progress – AND, now I am more likely to discuss what’s going on in my head. I am beginning to overcome the shame and avoidance, which is good in the long term. It means that I’m getting better and that I am overcoming my OCD. Maybe sometime in the near future, I won’t have to do so much work every time I am blind-sided by intrusive or upsetting thoughts.

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