The Difference Between Intrusive Thoughts and Rumination

The Thinking Man, also known as The Thinker, is a famous bronze sculpture by Auguste Rodin. The figure represents intense intellectual activity and the struggle of human thought.

Rumination has been brought up more and more in OCD spaces. Just recently, there was a popular thread on the OCD subreddit about how rumination is one of the most under-discussed compulsions. You can also find several resources describing rumination and its impact on OCD treatment (Here, Here, and Here!). But what is the difference between rumination and intrusive thoughts? And how do we make sense of it in a way that’s practical for treatment?

To help clarify, I’ve come up with three metaphors that help draw a clear line between intrusive thoughts and rumination so that when you are inevitably taught skills on how to stop ruminating, it makes more sense.

Metaphor 1: The Email Inbox

Emails are kind of funny. Out of the dozens we get each day, maybe two are worth responding to. The rest? Newsletters we didn’t sign up for, sales alerts from a store we visited once, and general spam. How do we usually respond? Scan for the useful stuff, mark the rest as read (or just leave 2,000 unread notifications on your phone), and move on.

Now, imagine your brain is like an email inbox, but OCD is running the show. Instead of skipping over the spam, OCD says, “Wait, what if it’s possible that every email is important? You can never be sure without checking. Review every email.” So, you open every email, read every word, click every link, and by the end, you think, “Okay, I think they were just spam.” But the next day, OCD says, “Sure, those emails weren’t important yesterday, but what if they are today?” And the cycle repeats. Each day is lost to ruminating over every intrusive thought emailed from your brain.

Metaphor 2: The Billboard on the Highway

Thoughts are like billboards on an interstate. I live in Texas, where there’s a huge gas station chain called Buc-ee’s, and their billboards are everywhere. Between Dallas and Houston, you’ll pass at least 15. But just because I see all those billboards, does it mean I have to stop at every Buc-ee’s along the way? No.

You can’t control which billboards show up on your drive, but you do control whether you pull over. Same with intrusive thoughts. Just because your brain “advertises” a new intrusive thought, doesn’t mean you have to act or ruminate on it. You can notice the thought, allow it to exist, and keep doing what’s more important to you (e.g., having dinner, working on a project, spending time with family, exercising, etc.)

Metaphor 3: The Essay Prompt

Imagine your OCD is an English professor. Every day, it hands you a set of intrusive thoughts framed as essay prompts:

• “What if something horrible happened in your past, and you go to jail for it?”

• “What if the violent images in your mind mean you’re a danger to others?”

• “How do you know for sure you won’t cheat on your spouse?”

Professor OCD says, “You must respond to each prompt, or you will fail and your fears will come true.”

So what do you do? You urgently write a response to each question. You spend hours constructing arguments, counterarguments, explanations—just trying to get it right. But no matter how well you write your essay, OCD hands you the same prompt (or a slightly similar one), and you drop everything to start writing again.

Rumination is like mentally writing essays in response to every distressing thought. No wonder you feel so exhausted, imagine literally sitting down and typing out pages of conjecture every single time your brain throws an intrusive thought at you.

In this metaphor, freedom comes from realizing that you can hand in a blank sheet. You don’t have to do the assignment. Sure, in an actual English class, you’d flunk the course. But with OCD, you can learn to hand in a blank exam, and you’ll still get an A+, graduate, and move forward in life.

In treatment, I’ll have clients jot down their mental “essay prompts,” carry the paper around without answering the questions for a week, and then in the next session, we assess if rumination was necessary to live their lives. Can they still go to dinner with their family while an intrusive thought goes unanswered? Can they attend a football game without mentally responding to every worry? Over time, they learn they can, and so could you.

Thinking Isn’t the Problem, Rumination Is

Let’s be clear: thinking is good, and life is full of moments that need thoughtful reflection. But rumination is different. It’s like hammering a nail that’s already fully in the wall. The job’s done, but you keep hammering anyway.

If your “thinking” is repetitive, distressing, and never leads to resolution, that’s rumination.

• If you have real-event OCD and keep thinking about whether you did something horrible, even though everyone has reassured you that nothing happened, that’s rumination.

• If you love your spouse but spend all day thinking about the possibility of cheating on them, even though you’ve always been loyal, that’s rumination.

• If you are doing a driving exposure for hit-and-run OCD, but you are thinking about how you would handle being arrested for a potential accident, that’s rumination.

On the other hand, if you have a job interview and want to review questions to be better prepared, that’s thinking, not rumination. Again, the key point is that rumination is repetitive and distressing thinking that leads nowhere.

You Don’t Need to Thought Stop to Quit Ruminating

OCD loves to trick people into thinking that if rumination is bad, the solution must be to stop all intrusive thoughts. Nope. The goal isn’t to erase intrusive thoughts, it’s to stop responding to them.

Back to the billboard metaphor: You don’t need to tear down every Buc-ee’s billboard in Texas to keep driving. You just let them exist and stay on course.

Or the email metaphor: You could spend all day trying to block every spam sender, but something will always get through. Instead, recognize spam for what it is (meaningless junk), and scroll to the next unread message.

How to Stop Ruminating

Letting thoughts exist without engaging with them is the heart of learning to stop ruminating. OCD doesn’t persist because of the thoughts themselves; it’s the entanglement with those thoughts that keeps the distress alive. If you need an OCD specialist near you to address rumination and other mental compulsions, Dr. Dyer, Madison Taylor, and I are all specialists in addressing these compulsions by using ERP, mindfulness, and ACT techniques.