The Science of Rumination, Intrusive Thoughts, and OCD: Understanding the Inner Workings of Our Minds


Rumination, intrusive thoughts and OCD (obsessive-compulsive disorder) go hand in hand. They feed off each other in an unhealthy way that severely taxes the mind. However, there is good news: you can break this vicious cycle and learn to think in a happier, more productive way. The key to making these beneficial changes is within each of us, waiting to be found.

What Are Ruminating Thoughts?

Rumination is repeatedly thinking about negative experiences, a past scenario, or concerns about the future. In the context of OCD, rumination occurs when individuals obsess over the same thought and engage in excessive mental review, trying to understand and solve their compulsions. A sufferer forms a knot of unpleasant thoughts that they continually pick at and try to unravel, but end up only making the knot bigger and tighter. This constant rumination leads to feelings of anxiety, depression, and decreased quality of life.

Ruminating thoughts are also commonly present in other mental health conditions, including phobias, and post-traumatic stress disorder (PTSD). Sometimes, a traumatic event, like redundancy, romantic problems or bereavement, can happen, and this can rumination.

When people ruminate, it can worsen the symptoms of an existing mental health condition. On the other hand, gaining control over ruminating thoughts helps alleviate these symptoms and promotes feelings of relaxation and happiness.

Understanding the Link Between Rumination and Intrusive Thoughts

Intrusive thoughts are unwanted, upsetting, persistent thoughts or mental images that occur repeatedly and involuntarily. For a sufferer of OCD, intrusive thoughts can take the form of obsessions: a relentless cognitive pattern where thoughts and ideas lead to unwanted urges. These preoccupations then tend to trigger compulsions: repetitive behaviours or mental acts that people perform to reduce anxiety or distress.

In addition to OCD, people with anxiety disorders, chronic stress, and postnatal depression are more prone to experiencing ruminating thoughts. However, anyone can experience this unpleasant pattern of thinking.

Examples of Intrusive, Ruminating Thoughts

Ruminating intrusive thoughts vary significantly from person to person, but common ones include:

  • Fear of contamination or germs, leading to constant cleaning and hand washing.
  • Repetitive, distressing thoughts about harming oneself or others.
  • Obsessive thoughts about mortality and death.
  • Worrying about an imagined future event, like a car accident or losing a job.
  • Dwelling on past mistakes and regrets, with persistent feelings of guilt or shame.
  • Constantly checking or re-checking things, like whether doors are locked, or appliances are switched off.
  • Thinking about sexual or violent acts that go against personal values or beliefs.
  • Persistent questioning of decisions and actions that lead to self-doubt and indecisiveness.

Obsessive-compulsive Disorder

Obsessive-compulsive disorder is a common mental health condition that affects many people worldwide. It’s a chronic and long-lasting condition characterised by uncontrollable and repetitive thoughts and behaviours that sufferers feel compelled to do again and again.

Obsessions are recurring thoughts or images that cause anxiety, like a fear of germs, aggressive thoughts towards oneself or others, or having things in perfect order. A compulsion is a repetitive behaviour a sufferer feels compelled to do in response to a particular thought, like excessive cleaning, ordering and arranging things in a particular way, or counting repeatedly. Symptoms can interfere with a person’s daily life, including work, school, and personal relationships.

People with OCD spend a considerable amount of time each day performing these behaviours, even when they recognise that they are excessive or irrational. They frequently experience significant problems due to these thoughts and ritualistic behaviours. The condition may be accompanied by motor or vocal tics in some individuals.

The Science of Obsessive-compulsive Behaviours

Although the exact causes of OCD are unknown, studies have shown that genetics, brain structure and functioning, and childhood trauma may be contributing factors to this internal process.

Research utilising imaging studies has suggested that individuals with OCD exhibit differences in the structure and functioning of the frontal cortex and subcortical brain structures. Although the connection between these abnormalities and obsessive-compulsive symptoms is not yet fully understood, investigations are underway to uncover this link.

How OCD, Rumination, and Intrusive Thoughts Affect Teenagers

OCD, rumination, and intrusive thoughts have a significant impact on teenagers, including:

  • Deterioration in academic performance – obsessive, ruminating, intrusive thoughts can lead to difficulty concentrating and consequently impact a teenager’s educational prospects. This deterioration may lead to frustration, disappointment, and lowered self-esteem, which can exacerbate symptoms.
  • Social isolation – teenagers with compulsive behaviours and unwanted thoughts may find it challenging to socialise with peers due to anxiety or fear of judgement. By avoiding social situations, a teenager becomes vulnerable to loneliness and separation.
  • Increased risk of substance abuse – teenagers with OCD, rumination, and problematic thoughts may be at an increased risk of developing substance use disorders. Drugs or alcohol may be misused to self-medicate or cope with difficult emotions.
  • Negative impact on self-esteem – mental compulsion, unwelcome thoughts and rumination, can lead to negative self-talk and shame. This negative cognitive process impacts self-esteem and self-worth, leading to a cycle of negative emotions.
  • Relationship difficulties – rumination, OCD, and intrusive patterns of thought can impact relationships with family and friends. It is often challenging for teenagers to communicate their experiences, and this may lead to misunderstandings and conflict.
  • Increased risk of suicidal ideation – teenagers with OCD, rumination, and intrusive, negative thoughts may be at an increased risk of suicidal ideation. These conditions can lead to a sense of hopelessness and despair. Without guidance, a teenager may feel there is no escape from their distressing patterns of thought.

How Parents Can Detect Signs and Symptoms of OCD, Rumination and Intrusive Unwanted Thoughts

Knowing what your teenager is thinking or feeling can be difficult as a parent. However, there are signs and behaviours that may indicate whether your teenager is struggling with OCD, rumination and intrusive thoughts. An awareness of these symptoms makes early identification and intervention more likely, and this can prevent the conditions from escalating. These can include:

  • Noticeable changes in behaviour or attitude – if your teenager is exhibiting behavioural changes, mood swings, or becoming withdrawn or irritable, it may be a sign they are struggling with a mental health condition.
  • Avoidance of certain situations or activities – if your teenager shuns people, places or activities they used to enjoy or they previously had no problem with, this may be a sign of OCD, rumination, or intrusive thoughts.
  • Changes in academic performance – if your teenager is experiencing difficulty concentrating or performing poorly in school, it may indicate unhealthy thinking patterns.
  • Repetitive or ritualistic behaviours – if your teenager engages in activities like excessive hand washing or checking and rechecking things, it may be a sign of obsessive thinking.
  • Compulsive behaviours – if your teenager struggles with behaviours they feel compelled to perform, like counting or arranging things in a particular way, this may also be a sign of developing obsessions and compulsions.
  • Negative self-talk – if your teenager expresses a feeling of worthlessness or shame, this may indicate rumination or intrusive thoughts.
  • Negative cognitive patterns – if your teenager is willing to talk about their mindset and confides they experience persistent, unwanted thoughts, for example, of violence or inappropriate sexual activities that they find uncomfortable, it is a sign that counselling and professional support are needed.

How to Stop Ruminating and Intrusive Thinking

Many people wonder how they can escape from the cycle of repetitive, negative thoughts. There are effective strategies that can help a person develop healthier thought processes, including:

  • Mindfulness – Mindfulness involves paying attention to the present moment in a non-judgemental way. This process is constructive for individuals experiencing intrusive thoughts, as it helps to stop thinking patterns, distances them from their thought processes, and gives them a sense of control. Mindfulness techniques help people observe their thoughts rather than get stuck in a dark cognitive loop.
  • Cognitive Behavioural Therapy – CBT is a type of therapy that focuses on changing negative thought patterns and behaviours. In CBT, individuals learn to identify and challenge a compulsion and develop new coping strategies and more realistic goals. For individuals with OCD, a type of CBT called Exposure and Response Prevention (ERP) is often used. ERP involves exposing the individual to fearful situations or objects without allowing them to perform compulsive behaviours. This approach helps sufferers stop ruminating and develop a feeling of control over their intrusive thoughts.
  • Exercise and Lifestyle Changes – Exercise has been shown to reduce rumination and affect mental health positively. Studies have found that exercise reduces symptoms of depression, anxiety, and stress, often associated with rumination. Exercise also releases endorphins, which improve mood.
  • Creative Activities – Engaging in creative activities, like art or music, can provide a positive distraction from rumination. Creative activities can help individuals focus on something enjoyable and fulfilling, reducing the intensity of their intrusive thoughts.
  • Breathe Deeply – Breathing techniques, like deep breathing or belly breathing, can help sufferers calm their minds and reduce anxiety. These techniques are helpful for individuals experiencing intrusive thoughts as they reduce the intensity of the thinking process.

Each person’s experience of disturbing thoughts and rumination is unique, and what works well for one individual may not be so effective for another. It is best to consult a mental health professional, therapist or psychiatrist, to get proper guidance and support in managing intrusive thoughts. It can take time to find the right strategy, but the payoff is a freer, happier state of mind.

OCD Treatment

It’s crucial to seek medical help if obsessive-compulsive symptoms impact daily life. Depending on its severity and how it affects an individual, OCD can be treated with a variety of approaches. The two main treatments are medication and talking therapy. If the symptoms are mild, a short course of cognitive behavioural therapy might be recommended. Severe cases may require longer psychotherapy or a combination of medication and counselling.

Cognitive behavioural therapy (CBT), with exposure and response prevention (ERP), involves breaking down the problem into separate parts and facing fears, uncomfortable feelings and obsessive thoughts without recourse to compulsive behaviours. It empowers sufferers to choose healthier thought processes.

Medication, like selective serotonin reuptake inhibitors (SSRIs), is usually recommended for those with moderate to severe OCD. SSRIs can improve symptoms by increasing serotonin levels in the brain. The medication may take up to twelve weeks to take effect, and most people need to take it for at least a year.

If neither therapy nor medication works, further treatment by a specialist team may be necessary. OCD support groups can help individuals cope with the disorder and offer socialisation, reassurance, and advice.

Help Your Teen Overcome Intrusive Thought, Rumination and OCD at The Wave Clinic

We understand how tough having OCD can be for young people. It makes them feel like they are different from others and can isolate them from their friends and loved ones. They need a supportive network of friends and family to help them through their journey to recovery. At The Wave Clinic, we offer a safe, quiet space where young people with OCD can come together and engage in transformational activities and experiences with others who are going through similar experiences.

Our collaborative living environment is specially designed to help young people develop social and executive skills alongside others. We also offer programmes that address anxiety and eating disorders, as we understand these conditions can co-occur with OCD. Our treatment plans are tailored and adapted to each young person’s unique needs to help them increase their self-esteem and get the best possible outcome.

We know that it can be worrying for family members to see a child struggling with the sometimes frightening and exhausting behaviours of OCD. At The Wave, we offer support and treatment in a caring and compassionate environment so young people can overcome challenges and live healthy, fulfilling lives. Contact us today to discover how we can help your family.

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

More from Fiona Yassin
A boy sitting at the front in a hall of empty desks, with his head on his arm.

What Happens When Kids Are Left Out of School?

Social exclusion and peer rejection can have serious consequences for young people’s mental health, leading to emotional and behavioural problems and low self-esteem. Social exclusion that is based on prejudice or bias is particularly damaging.

Read More »

Professional associations and memberships

We are here to help

Have any questions or want to get started with the admissions process? Fill in the form below and we’ll get back to you as soon as possible.


    Kuala Lumpur, Malaysia

    Dubai, United Arab Emirates

    London, United Kingdom