Do you ever find yourself dwelling on something inconsequential that happened a long time ago? Are you still thinking about how badly you embarrassed yourself in front of Sally Sue in the second grade? Today’s guest has a method to help you stop!
Sometimes reviewing past failures or setbacks can be healthy, a way to avoid making the mistake again. But when processing turns into ruminating, it is time to make a change. If you find yourself continually revisiting negative thoughts that just won’t go away, listen in as Dr. Tara Sanderson gives us some tips on how to stop ruminating once and for all!
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Guest information for ‘Ruminations and Worrying’ Podcast Episode
Tara Sanderson is a licensed psychologist, author and clinical supervisor in Oregon. For over 20 years Tara has been helping people learn the skills to live their best lives. Using tools from cognitive behavioral therapy, motivational interviewing, mindfulness and dialectical behavior therapy, she specializes in working with clients who struggle with perfectionism, overachieving, anxiety and depression.
About The Psych Central Podcast Host
Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from Gabe Howard. To learn more, please visit his website, gabehoward.com.
Computer Generated Transcript for ‘Ruminations and Worrying’ Episode
Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.
Announcer: You’re listening to the Psych Central Podcast, where guest experts in the field of psychology and mental health share thought-provoking information using plain, everyday language. Here’s your host, Gabe Howard.
Gabe Howard: Welcome to this week’s episode of The Psych Central Podcast. Calling into the show today, we have Dr. Tara Sanderson. For over 20 years, Tara has been helping people learn the skills to live their best lives, specifically specializing in working with people who struggle with perfectionism, overachieving anxiety and depression. She’s also the author of Too Much, Not Enough. Dr. Sanderson, welcome to the show.
Dr. Tara Sanderson: Thank you so much for having me. I’m really excited to be here today.
Gabe Howard: We’re really excited that you’re here, too, because anxiety is kind of a big topic. It’s something that really is discussed among people who really don’t spend a lot of time discussing mental health. I’ve kind of noticed, especially in the last 15 years, that people are willing to say that they’re anxious more than they would be willing to say that they’re having a mental health crisis or even depression. It’s sort of becoming a little bit mainstream. Is that what you’re seeing?
Dr. Tara Sanderson: Absolutely. And I think that anxiety is something that is so relatable to everyone. We’ve all felt that nervous feeling in our belly and now can start extrapolating out to noticing when I have that nervous feeling and I’m not going onstage or I have that nervous feeling when I’m not going into a weird situation. It becomes much more noticeable. And I think everybody is starting to get that close comparison to what other people are feeling.
Gabe Howard: What I specifically like speaking purely as a mental health advocate is that we used to call this like nerves or butterflies, and now we’re starting to use words like, I’m anxious. I have anxiety. Do you think that’s a good move to actually call it by its actual name rather than sort of speak about it in like whispers and code?
Dr. Tara Sanderson: Absolutely. I think that one of the benefits of that is it normalizes it for everyone. That we can have this global word that we all know kind of what it means. I think there is a little bit of a con in the way that like some people say they have anxiety or experiencing it in one way and other people then compare themselves to it. And there’s this weird you-don’t-have-anxiety-like-I-have-anxiety kind of thing. But I think that globally, everybody sharing that they’re really struggling is a good thing.
Gabe Howard: Whenever people compare their symptoms with one another and do that, I have it worse than you have it, etc. I always call that the suffering Olympics.
Dr. Tara Sanderson: Oh.
Gabe Howard: It’s like, what difference does it make, what level we’re experiencing it? We really should be focusing on the idea that we’re both experiencing it. I lead a lot of support groups and I say, really, how does how does figuring out which one of you are worse off help the greater good? How does it help you get better? And that usually refocuses it when it comes to anxiety. You did touch on a point that there’s a big difference between being nervous about maybe taking the bar exam and actually suffering from anxiety. Can you sort of tell us the difference between just general nervousness and actual anxiety?
Dr. Tara Sanderson: The way I like to break it down is the actual anxiety, when you look at the DSM diagnosis, the Diagnostic and Statistical Manual — that is how we kind of define each of the different disorders — is that anxiety, generalized anxiety, is a pervasive issue. It’s not, it doesn’t just affect you in one area. It affects you all over the place. There are these thought processes and ways that they think about things that are different from folks who are just struggling with getting ready to take the bar exam or going on stage and doing a presentation. One of the areas that really impacts people I think the most is the idea of rumination. And that’s the area that we think about things in a negative way over and over and over again to kind of beat ourselves up over it.
Gabe Howard: And that’s one of the focuses of this show when I was doing the research. It was a little bit funny because I was like, well, yeah, I know about ruminating on things. I know exactly what that is. And then I realized that, wait, that’s like as far as I got, I know what it means or feels like to ruminate on something. But but that’s really it. I could not define the word rumination. What are ruminations?
Dr. Tara Sanderson: Ruminations are those deep, dark, negative-oriented thoughts that just won’t go away. When I think about things that just won’t go away, I think that they are also reinforced by ourselves. So it’s that idea that I think I’ve seen a meme about it where somebody is lying in bed and they’re getting ready to go to sleep and they’re like, oh, my day was wonderful. And then all of a sudden their eyes pop open and they say, yeah, but do you remember what you said to Sally Sue in second grade? Wasn’t that terrible? And then they stay awake all night thinking about what they said to Sally Sue in second grade. Those deep, dark things that we reinforce within ourselves, probably unknowingly and probably unwillingly. But they just stay there and they keep like going over and over again in your head.
Gabe Howard: I really love the example of Sally Sue from the second grade, and I think that a lot of people who have anxiety issues ruminate on conversations that they had earlier in the day and we just replay them over and over again, well, if I would have said this, would this have happened or if I would have said this, would this… It’s almost like we’re rehashing the same conversation or argument or disagreement or problem over and over again. And I’m guessing this probably has no benefit to us. In the example of Sally Sue, it kept you up all night. It didn’t actually resolve anything.
Dr. Tara Sanderson: Correct. And I think that’s the big difference between rumination and processing, because therapists do talk to their clients about we need to process through this stuff and processing is all about a goal of getting to acceptance and understanding and potentially moving towards growth. And rumination is all about just kind of beating yourself up over and over and over again and again, not probably on purpose. But that’s just how it rolls. And it’s so important to, like, differentiate when you’re thinking about how to get through a problem. Ruminations keeps you stuck in it like a tar pit and processing gets you moving forward. Once you’ve accepted it and get kind of comfortable with it.
Gabe Howard: Would it be fair to say that maybe one of the differences is the goal? Like, I know that when I ruminate on something, the goal is to retroactively win. I’m trying to make it better and make myself feel better about what happened. But when I’m processing something, my goal is to make it better. And it always includes steps for the future. Like, tomorrow I’m going to sit down and apologize or I’m going to ask this follow-up question or, you know, maybe I did come off a little heavy-handed. It’s much more practical and goal oriented and future-based, whereas ruminations seems, for me at least, to be past-based. I’m going to fix it retroactively.
Dr. Tara Sanderson: Yes, absolutely, rumination is all about the retroactive, it’s all about the past and it’s all about almost reliving it in a way, whether it’s reliving it to win or whether it’s reliving it to just do something different, whether it’s reliving it to feel better about yourself, that never actually works. I mean, because we can’t go back and make any changes in the past. I can’t do anything about Sally Sue.
Gabe Howard: Who is generally affected by ruminations? Is it just people with diagnosable anxiety disorders or does it expand out?
Dr. Tara Sanderson: I think it expands out, I think everybody has experienced those moments where they go, dang it, I wish I had said this differently or, you know, or if I could go back and do this differently, I would. And I think that rumination, the true part of it that really impacts people, is when it goes deep into that dark thoughts of it: I’m stupid because I didn’t say this or I can’t believe that I’m such an idiot because I did this this way thinking, gosh, I wish I had done this differently. It is some good past talk that you can grow from if you want to, or it can lead into rumination. I think anxiety folks feel this. I think depressive folks feel this. I think that people who struggle with OCD feel this in the deeper, darker ways where it just becomes, I’m bad because… I’m terrible because… I shouldn’t go out in public because.
Gabe Howard: And I think anybody who has ruminated on anything is probably asking the question now. OK, this is perfect. I understand what you’re saying. I’m agreeing with you. I do this. Now, how do I deal with it? How do I stop it? How do I get over it?
Dr. Tara Sanderson: That is such a great question, and I think one that I see all the time in my therapy clients is they want the answer to this question and they want it to be awesome and easy and let’s just do it. And I always have to tell them that I may be disclosing that Santa Claus is not real. They need to prepare themselves. It’s not going to be easy. You’re changing a thought process that has probably been in your head for a long time. And during that process of changing, you have to do things differently, you have to notice things. So the first step is stopping, stopping what you’re doing. The second you notice that you are ruminating again. You have to stop and you have to observe what’s going on. You have to look outside and inside. I use a method called SOBER. So the first two parts of the acronym are S and O for Stop and Observe. And I think that those two are the very first key elements to making a change in rumination. When you find yourself ruminating, stopping what you’re doing and observing what’s going on outside, what’s prompting this? What’s going on inside, that’s prompting this, what am I feeling? Where did I go? I noticed that a lot of times when I ruminate, I’ll be driving somewhere and I’m on autopilot in the drive like I’m driving home from work or whatever and I’m on autopilot. So my brain just starts going into a direction where sometimes I’m not an active participant in where it goes. And when I notice like, wow, I’m on autopilot. So I let my brain go in this direction instead of being purposeful about what I want to think about and where I want to grow and what I want to do. That’s when I can start noticing like, oh, when I get on autopilot. This happens. So I need to not go on autopilot unless I am prepared to work on some of these other things.
Gabe Howard: When you said that, you know, stop and observe, the first thing that immediately came to mind was that famous Bob Newhart Mad TV sketch where Bob Newhart plays a therapist and a person comes in and tells their problem that they’re having. And Bob Newhart as the therapist says, stop it. That’s all you have to do. Your therapy is over.
Dr. Tara Sanderson: Absolutely. That’ll be five dollars, please. And I don’t give change.
Gabe Howard: Yeah. Exactly. So. Right. And I don’t give change. And on one hand, as somebody who’s been through a lot of therapy, I remember seeing that and thinking, oh, my God, that I should just stop it and I’ll be fine. And for like a split nanosecond I was like, this is excellent. I no longer need to go to therapy because I’m just going to stop it. But that’s as funny as that was, and as much as I absolutely adore Bob Newhart’s comedy, that’s not practical. Right? So I imagine that there’s probably a step like how do you stop and observe, especially when maybe you’re not even aware that you’re ruminating?
Dr. Tara Sanderson: Absolutely, and I think that’s the key to this whole process, is now that, you know, the definition of ruminating, which is to continue to beat yourself up over things, to think about all these dark negative things pretty much involuntarily, that when you notice that you do that, which is the whole first key, is that you have to notice it. You have to notice when it’s happening. Then you go to step one, which is stop. And the part of that is to really just be clear with yourself that you’re not saying, gosh, you’re so terrible, stop doing that. The thought is more, hey, I’m noticing that I’m doing this. And now let’s move on to observing. Why? Where’s this coming from? It’s asking a new question. It’s being curious rather than it being beat myself up over it again, because now I’m doing this thing that I shouldn’t be doing.
Gabe Howard: And then that moves us on to B in the acronym SOBER.
Dr. Tara Sanderson: Correct. So B is all about Breathing. I’m a big fan of breathing five times and the breathing five times gives you an opportunity to take space from what you’ve seen yourself do, which is that ruminating. You’ve observed why it’s happening and giving yourself some space to get ready to move on to the next step. The breathing just gives you a moment to really connect with yourself. I’m a big fan of some active breathing, so you can just take five big, deep breaths. I tend to when I take five big, big, deep breaths, tend to hyperventilate a little bit because I just want to move on to the next thing. So doing active breathing, like tracing the lines on my hands as a part of the process of breathing. So breathing in as I cross one line and breathing out when I cross the other helps me to slow it down a little bit and really gives me the space to sink in to, hey, I’m going to do some work with myself in this moment and I need to make sure that I’m being attentive and purposeful in that.
Gabe Howard: So we have Stop, Observe, and then Breathing and then now we’re to E!
Dr. Tara Sanderson: E is Examine the options. I’d like for people to come up with five options to dealing with whatever is going on at that moment. So in this case we’re talking about ruminations. So they’ve got five options. Two extreme options and three regular ones. So an extreme option with rumination would be I’m going to sit here and reminisce about absolutely everything I’ve ever done in my entire life that has been terrible. And I’m going to purposely do that and I’m just going to sit here until I’m done with it. And at the age of 40, I have a lot of things I could have ruminate over. Right? So that’s the extreme number one. Extreme number two is I’m going to push down on this gas pedal and drive as fast as I can to see if I can distract myself from this rumination. Which both are options. Neither are great options. They wouldn’t necessarily be the best solution to your problem, but you could do that, right? I don’t like the extremes because sometimes especially being anxious, sometimes you need those extremes to give you the limits and then you can find that middle area, the gray area that makes it a little bit easier.
Dr. Tara Sanderson: I may not be willing to ruminate on all of my things from the last 40 years, but maybe I’m gonna give myself a couple of minutes to ruminate and see how it feels. That’s a much more gentle in the middle option. Maybe I think about I’m going to call a friend and talk it through with them and just make sure that I wasn’t crazy when I said such and such. You know, in that conversation, that’s four options. Yeah. Maybe a fifth option is that I’m going to turn on the radio and listen to it pretty loud and see if I can just kind of kick myself out of the funk for a minute. Any of those options are fine. And coming up with two extremes and three middle ground gives you some room to kind of figure out what’s going to help me really in this moment? Is processing it through with a friend going to help? Is purposely ruminating more gonna help? What’s really going to do the best for me at this point?
Gabe Howard: And then this all leads us to the last letter in the SOBER acronym, which is R.
Dr. Tara Sanderson: The almighty R, which is Response. Choose one. And the truth is, it doesn’t matter which one you choose. You can absolutely push the fuddled out and do that part of it. And I always like to remind people there are consequences to all actions. So you also may get a ticket and that may be an unintended consequence of you trying to deal with your rumination. But that’s a possibility. You totally could do that. Any of the options are fine, because if they don’t work, if they don’t do what you were wanting them to, you can always go back and pick some more options and try again. There is nothing permanent about decisions that we make in the area of trying to navigate through some of these ruminations or any other choices. And I think it’s really important that we give ourselves some grace in that. To say like, hey, I’m going to choose this one and see how it works out. If it doesn’t work, I’m going to go back to the drawing board and pick something else.
Gabe Howard: We will be back after these messages.
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Gabe Howard: And we are back speaking with Dr. Tara Sanderson. When we look at SOBER as a tool, as a tool that we can use, what barriers might come up to folks trying to use this tool effectively?
Dr. Tara Sanderson: It’s super important that they do that, people do that all five letters. You can skip the breathing. But I just noticed that when I skip the breathing, I don’t really get clarity on those five options. I have a lot of people who just skip the observe part of it and they go from stopped to options. That doesn’t really work as well either, because you haven’t figured out the core of what’s going on. So remembering the acronym is kind of step one and then doing all the steps is the other barrier.
Gabe Howard: And how do people overcome that?
Dr. Tara Sanderson: While I have them write it down. I’m a big fan of doing it themselves. So when I’m in session with folks, I don’t have a worksheet or a handout for this method. I make them take out a piece of paper or use the journal that they bring along to therapy and say, we’re gonna or I’m going to walk you through writing this down for yourself and then we’re gonna practice it a bunch. And that really does help because it’s in their own handwriting. They’re not taking home a piece of paper and throwing it on the counter. Like they did it themselves. They’ve kind of taken that tactile response to getting something new in their head. And then we practice it a lot. I recommend that people practice this on every decision you make throughout a full day. Everything from, am I going to put my seatbelt on in the car? To am I having cornflakes or oatmeal for breakfast? To do I go pick up the kids from school today? Like that’s a decision you actually get to make. I will also say please pick up your children from school, but you get choices in that. And I think that the more we recognize that every single thing is a choice from do I brush my teeth today, to taking a shower, to wearing a seat belt, to driving the speed limit. And when we notice and make those intentionally, the more we are able to then make other decisions intentionally. Like, am I going to sit here and perseverate on something that happened in second grade? No, I am not. That is not how I intentionally want to use my time today. So I’m going to choose to do something different.
Gabe Howard: It’s interesting that you pointed out that so many of the decisions that we feel are requirements, we have to, are actually choices that we make. Now, as you pointed out, we absolutely want to care for our kids in the best manner possible, but we could choose not to. And in fact, we are aware that some people do choose not to. Does looking at every choice as an intentional choice give us more power and help with things like anxiety and ruminations? Or is it all a big distraction? It seems really weird to say to most people, hey, you don’t have to pick up your kids from school if you don’t want to.
Dr. Tara Sanderson: I think that it isn’t necessarily all about power, but it is all about being focused on intention. And when I think about not picking up my kids from school, well, I don’t actually have kiddos. But when I think
Gabe Howard: Me neither.
Dr. Tara Sanderson: About it and picking up the kids from school. I think about the option isn’t I just leave them there necessarily because you come up with five options. One could be I leave them at school forever and I’m never picking them up. That’s an extreme option. Totally a choice, but probably not our best. Right? Another one is, you know, I call my neighbor and see if my neighbor will pick them up or ask someone from the school to drop them off or call the school and tell them to take the bus, because I don’t want to leave what I’m doing to go get them. Those aren’t abusive or neglectful or terrible choices. They’re just choices. And I think giving ourselves the freedom to say things can just be choices. And I have options, decreases the anxiety and decreases the pressure that we are supposed to be doing something else. Like I’m supposed to be a perfect parent or a perfect wife, or I’m supposed to be doing enough, and that if I don’t do enough, I’m not meaningful or valuable or worthy. And giving yourself the freedom to say, no, it’s all just choices, and I have options, gives us some just peace.
Gabe Howard: I absolutely love that. Dr. Sanderson, I’d kinda like to flip the script for a moment. You know, we’ve been talking about how other people can use this SOBER tool to make their lives better. But how do you personally use this tool to improve your outcomes in your life?
Dr. Tara Sanderson: So in the book, I talk a little bit about my love of food. I definitely have a tender relationship with anything sweet or bready or salty. Really, it’s kind of like all food. So SOBER has helped me so much in really identifying my connection with why is this food what I crave right now? So there are some foods that make you feel warm and fuzzy. There are some foods that you eat when you’re excited. There’s food you eat when you’re bored and using SOBER has given me an opportunity to really assess in those moments and not go overboard when I’m not doing that purposely. A big bowl of popcorn I feel like I’m pretty justified in going overboard on when I’m watching movies with friends or doing a big like gathering. But eating an entire bag of mini chocolate chips is probably not ever really in my best benefit. And yet I totally would do it if I’m not being intentional in that moment. Having a handful every now and then or adding some into your mouth while you’re baking chocolate chip cookies, it’s like those are all kind of normal-ish things. But when I get on autopilot and I start having a lot of emotional feelings, especially around rumination of choices that I’ve made, sometimes that handful becomes twelve handfuls if I’m not being intentional. So giving myself permission to just say like, hey, I’m noticing that I’m feeling really tempted right now about a decision I made or about a conversation I had.
Dr. Tara Sanderson: And what I want is to just dive into the mini chocolate chips in my freezer. Is that really what’s best for me? Let’s take a few deep breaths with that. Let’s do some options. Do I get out the bag and just go at it? Do I get out a little handful of them and put it back away and walk away? Do I completely avoid it by going for a walk and see if I can get through this feeling without having to eat it? You know, I try and think of a bunch of options and then I pick one. And sometimes it is absolutely I am willing to navigate this from the perspective of I’m just going to eat as many chocolate chips as I want and I will stand there and eat them. And during that process, my job is to keep checking in with myself. Is this still what I want to do? Are there other options that would make me feel better? Where am I at? Because I know that I can always U-turn after five handfuls. I can U-turn and say I’m done. I don’t need to eat the whole bag. After one handful. I can U-turn after no handfuls. I can. It’s a really nice tool that I use. Just to try and keep myself in check about what I’m eating and how that’s impacting me, not just physically, but emotionally.
Gabe Howard: Thank you so much for sharing that. And of course, now I desperately want chocolate chip cookies. So thank you for that.
Dr. Tara Sanderson: You’re welcome.
Gabe Howard: Dr. Sanderson, thank you so much for talking to us about ruminations. It’s really incredible and it’s really helpful. Now, your book is called Too Much, Not Enough. Can you tell us where we can find it?
Dr. Tara Sanderson: Sure. So my book is called Too much, Not enough: A guide to decreasing anxiety and creating balance through intentional choices. It is on Amazon as hardback, paperback, and as an e-book. And coming soon it will be an audio book. It’s being recorded right now. I’m so excited.
Gabe Howard: That is very cool, and Dr. Sanderson, do you have your own website where people can go and check you out and interact with you?
Dr. Tara Sanderson: I do. So my website is just DrTaraSanderson.com. So it is DrTaraSanderson.com. And there’s a link to my book, and there is a link to my practice and you can find out all about me.
Gabe Howard: That is very cool. Well, thank you so much again for being on the show. We really appreciated having you.
Dr. Tara Sanderson: Thank you again. It’s been wonderful.
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Nancy Kalina Gomez Edelstein, NBCC, LPC completed her graduate doctoral course requirements in Psychodynamic Psychology at The George Washington University and received a Master’s in Clinical and Counseling Psychology at Columbia University.