The Liverpool View: Rumination, replies and remedies

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Professor Peter Kinderman is Director of the University of Liverpool’s Institute of Psychology, Health and Society

“We published a paper recently looking at how psychological processes such as rumination and self-blame are key parts of the pathway from negative life events to depression and anxiety.

I think there are two key messages: that it’s the events that happen to us that determine our mental health (rather than some inherent personal inadequacy or genetic flaw), and that psychological processes actually play a part in the chain of causes. They aren’t just symptoms of ‘mental disorder’.

But I’ve also received a few questions, and I think it’s worth replying. Some people have commented that these kinds of psychological models can sometimes be misinterpreted to imply that people are in some way responsible for their problems, because they are showing ‘errors in their thinking’. And, of course, several people asked what can be done to help.

”People are often blamed for how they think. The insulting label of ‘personality disorder’, for example, manages both to label people as “ill” and simultaneously blame them for their ways of thinking”
People are often blamed for how they think. The insulting label of ‘personality disorder’, for example, manages both to label people as “ill” and simultaneously blame them for their ways of thinking. As a cognitive psychologist, I recognise that how we make sense of the world is important, but also that we LEARN to make sense of the world. All the things that have happened to me in my life – my biological inheritance, my parenting, the social circumstances and cultural values around me as I grew up, my education and, vitally, the life events and traumas that I have lived through – have all shaped my views on life. My views are obviously shaped by the journey I’ve taken through life.

But one of the important implications of our research is that if we were able to “turn off” the rumination and self-blame, we’d be able to “turn down” at least some of the depression and anxiety. That’s really the basis of clinical psychology. While there are very good reasons why we each learn our own particular way of making sense of things, sometimes it’s helpful to develop new ways to engage with the world, especially in stressful times.

I’m very reluctant to offer advice but, for what it’s worth, “Kinderman’s guaranteed system for lifelong contentment, happiness and mental well-being” (that’s a joke, but hopefully some of what follows will be helpful for some people) is:

1. Get the basics right:

Eat well, nutritiously, get the saturated fat content down and the salt content low. Eat five portions of fresh fruit or vegetables a day, drink plenty of water, and make sure you’ve got your vitamins. Aim to get your BMI in the healthy zone. I don’t want to sound prudish, but don’t smoke, drink moderately and be generally quite cautious with recreational drugs. Get at least 7 hours sleep a night. Although straightforward this is all difficult, so you might like the sound advice and specific help the NHS can offer here.

2. Five ways to well-being

This is a great approach that really works. It’s recommended by MIND and the NHS and there are plenty of tips to help you take do-able steps towards better mental well-being.

a) Keep active – do something physical each day. Could be as simple as going  for a walk, or swim, or going to the gym every day.

b) Maintain your relationships – for all kinds of reasons, friends are vital. Good friends, supportive friends, friends who won’t judge you or try to take advantage of you. And we can all take steps to maintain our friendships. We can make sure we ‘phone, write, text, etc. You might even consider a kind of semi-professional approach – self-help groups for people in a similar position to yourself.

c) Learn – keep your brain active. Engage your brain. Your brain is the most fantastic machine ever created, and it needs to be exercised.

d) Give – this isn’t political brainwashing, there’s real evidence that getting involved in charitable activity (and it’s probably better to give your time and effort, rather than money) makes people happier.

e) Stay open-minded – this is perhaps the trickiest but it relates directly to rumination, so it deserves its own section.

3. Mindfulness

Rumination tends to be eased if we learn to be mindful; if we are able to be aware of, and understand how our own thoughts work. This does NOT mean taking up any kind of religious practice, but some of the practical techniques of clearing the mind of ‘clutter’ can be helpful. Again, it’s recommended by the NHS as well as being part of the five ways to well being. In part, it means becoming able to decide where we focus our attention, because if we are good at this, it makes it less likely that our thoughts will always be dragged back to our ruminations.

4. “Catch it, check it, change it”

If we’re aware of what’s happening in our own minds, we can start to change things. My colleague, Sara Tai, neatly summarized the popular ‘cognitive behavioural therapy’ or CBT as; “Catch it, check it, change it”

a) First ‘catch it”; identify what you are thinking. It’s often really useful to use a change in your emotions as a cue to examine your own thinking. So, when you notice an unhelpful emotion or a shift in mood, or when you notice that you’re doing something you know can cause problems (being snappy, for example, or drinking too much), that could act as a cue to examine your own thoughts.

b) Then “check it”. Are you (after engaging your fantastic brain in a mindful manner) thinking sensibly, wisely, proportionately, about the situation? Is your mood affecting the way you are thinking?

c) And then “change it”. Generate an alternative point of view; question the evidence for your negative thoughts and find possible alternatives.

5. Therapy

Finally… if you’ve tried all that… try therapy.

I wouldn’t recommend it for everybody, but therapy can be a chance to think things through with a professional in a calm, supportive and nonjudgmental atmosphere. I personally prefer the straightforward nature of CBT but it’s a question of finding an approach that suits you.

So… it’s hard. You aren’t absolutely guaranteed lifelong contentment, happiness and mental well-being… because we are all, ultimately, shaped by the things that happen to us. But this can help.”

Read the original report on Professor Peter Kinderman’s research, ‘Dwelling on negative events biggest cause of stress’




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