Unpacking Anxiety, Worry, and Overthinking in Therapy

Have you ever found your mind swirling in a storm of anxious thoughts about the future or continuously mulling over past events? If so, you've experienced worry and rumination, two common mental habits that can significantly impact your emotional well-being and levels of anxiety. This article will help you understand the difference between worry and rumination, explore why we engage in these mental habits, and offer insights into therapy interventions that can help break the cycle.

Worry vs. rumination ("overthinking"): What's the difference?

Worry is like a whirlwind of thoughts about the future, often focused on potential problems or threats. It's like a mental checklist where we try to prepare for what might happen. On the other hand, rumination is more like a broken record, playing the same song of past mistakes, regrets, or painful events over and over again. While worry is future-oriented, rumination is rooted in the past (Mahoney, Mennin, & McEvoy, 2019).

While these mental habits can feel like unwanted guests in our minds, they didn’t appear out of nowhere. In fact, from an evolutionary perspective, rumination and worry might have played crucial roles in the survival and development of our ancestors. Let's explore the fascinating origins of these mental processes.

Why do we worry?

Worry is often a response to uncertainty or the unknown. We worry as a way to problem-solve and prepare for possible challenges. It's a natural response to life's stressors and can sometimes be helpful in prompting us to take action. From an evolutionary perspective, worry might have functioned as a protective mechanism. By anticipating potential threats or challenges, individuals could mentally prepare and strategize to mitigate risks. This proactive approach to future obstacles would have provided a significant advantage in terms of survival and resource acquisition. Essentially, worry acted as a mental simulation that allowed our ancestors to rehearse different scenarios and outcomes, facilitating better decision-making in the face of uncertainty (Borkovec et al., 2004). However, when worry becomes excessive or chronic, it can lead to anxiety and stress. It can give us a false feeling of control over a situation, without actually having a helpful impact on our lives. (If you struggle with anxiety, this article on 'Navigating Anxiety' might be helpful)

Why do we ruminate?

Rumination, on the other hand, can stem from a desire to understand or make sense of past events. We might ruminate in an attempt to gain insight or find solutions to unresolved issues. From an evolutionary standpoint, rumination might have served as a critical tool for our ancestors. By reflecting on past experiences, especially those that were challenging or threatening, individuals could extract valuable lessons and develop strategies to avoid similar pitfalls in the future. This process of learning from past mistakes could have significantly enhanced survival and adaptation in the ever-changing environment faced by early humans (Watkins, 2008). However, rumination often leads to a cycle of negative thinking without any clear resolution, contributing to feelings of sadness or depression (Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008).

What can you do about it today?

1. The first step is to notice when it occurs. You can maintain a “worry log” or a “rumination record” on your phone or in a journal and write down the thoughts that you have repeatedly. Writing these down gives you some distance from them.

2. Remember, thoughts are not facts. Quickly determine which of these thoughts are actually true, and which of them have limited basis in reality?

3. For the ones that are true, ask yourself how much control you have over the situation.

   1. If you do have control over it, think of ways you can solve the problem. A helpful exercise is to imagine you’ve solved the problem, and notice what that would look like. Really visualise that situation, and you being in it. And then think of the steps you can take to get there.

   2. If you don’t have control over it, ask yourself if there’s another way to think of the situation and find meaning within it. Also think about: how much the situation affects your day to day life... how much does it affect your physical safety in the here and now? Are you in physical danger at present? If not, bringing your awareness back to the physical aspects of your environment can help - e.g. notice an object near you, notice its colour, shape, size, texture etc. Notice your feet on the floor, and the comforting pull of gravity. You are here now, and you are safe.

Therapy Interventions for Worry/ Rumination & Anxiety

When worry or rumination starts to take a toll on your emotional well-being, it's time to consider therapeutic interventions that can help break the cycle. Here are some effective strategies that therapists use:

1. Cognitive-Behavioral Therapy (CBT): CBT is a widely used approach that helps individuals identify and change negative thought patterns. It offers practical strategies to manage worry and rumination by challenging and reframing maladaptive thoughts. Research has shown that CBT is effective in reducing symptoms of anxiety and depression (Craske, 2009).

2. Mindfulness-Based Interventions: Mindfulness practices can help bring awareness to the present moment and create a non-judgmental space for thoughts and feelings. Mindfulness-Based Cognitive Therapy (MBCT) combines mindfulness practices with cognitive therapy to specifically target rumination, promoting a more balanced perspective on past events and reducing the impact of negative thinking (Ramel, Goldin, Carmona, & McQuaid, 2004).

3. Acceptance and Commitment Therapy (ACT): ACT encourages individuals to develop a more accepting and flexible relationship with their thoughts, including worry and rumination. By learning to observe thoughts without judgment, individuals can reduce the impact of negative thinking and take actions that align with their values (Hayes, Strosahl, & Wilson, 2012).

In Conclusion

If you're worrying or ruminating, know that it's your brain's natural way of trying to gain control over or make sense of a difficult situation. The simplest thing you can do is to notice when it happens, and also bring your awareness back to your immediate physical environment - you are safe in the here and now and for most people, there is no imminent physical danger to be afraid of. Therapeutic interventions like CBT, mindfulness, and ACT can provide valuable tools to break the cycle of worry and rumination, fostering a sense of emotional balance and well-being.

If you're new here, I'm Diya John, a counselor and psychotherapist with a Masters in Psychology and a Diploma in Counselling from Australia. I founded Therapy Garden to make evidence-based counseling more accessible to expatriates, immigrants and the international community. I am based in Tokyo, but I work with clients in different parts of the world via online therapy. You can book a free consultation or read more about my areas of specialisation and services.