Autism and rumination are closely linked, as many autistic individuals experience repetitive and persistent thoughts. This can involve reanalyzing past events, worrying about future scenarios, or fixating on specific ideas.
While rumination may provide comfort or structure, it can also contribute to stress and anxiety, making it important to understand and manage effectively.
What is rumination?
Rumination is the brain’s way of repeatedly thinking about the same thoughts, often negative or distressing ones, without reaching a resolution. Rumination involves a thinking loop of mental fixation on problems past, present, or future.
These may be past experiences, a present situation, or worries and fears about the future.
Problem-solving leads to actionable steps. Rumination, on the other hand, is unproductive and can contribute to stress, anxiety, and depression. It can also cause many physiological problems, such as sleep and concentration challenges.
It can take different forms, including:
- Cognitive rumination: Persistent overthinking about past or future events.
- Emotional rumination: Dwelling on negative emotions.
- Depressive rumination: Feelings of disappointment, failure, or hopelessness.
- Anxious rumination: Worrying about uncertainty, “what if…?”
- Autistic rumination: More rigid and persistent than general overthinking.
- Rumination disorder (infancy & early childhood): Physical regurgitation of food, different from cognitive rumination.
What’s the connection between autism and rumination?
Autistic individuals are more prone to rumination due to:
- Monotropic thinking: Hyperfocus on narrow specific topics, including worries.
- Cognitive rigidity: Difficulty shifting and transitioning thoughts away from distressing topics.
- Heightened anxiety & stress sensitivity: Stronger emotional responses to sensory stimuli and stress.
- Alexithymia: Difficulty identifying and expressing emotions.
- Repetitive behaviors: Rumination may provide a sense of control or temporary relief.
Autism often co-occurs with other conditions, such as anxiety, depression, and obsessive-compulsive disorder (OCD). These can worsen rumination in the following ways:
- Anxiety: Worry and fear-based rumination are a key feature of generalized anxiety disorder (GAD) and social anxiety, both of which are highly prevalent in autism.
- Depression: Autistic individuals are at a higher risk of depression, making the link between autism, depression, and rumination quite strong.
- Obsessive-compulsive disorder (OCD): The intrusive, repetitive thoughts in OCD, especially the obsessional thinking, can resemble rumination. OCD-related ruminations are often driven by specific compulsions (behaviors or actions), whereas general rumination is more about getting stuck in thought loops.
Examples of rumination in autism
There are many instances on a daily basis where rumination can be challenging for autistic individuals. For example, some people may repeatedly think about an embarrassing current situation or analyze a past conversation in excessive detail.
This could lead to anxiety, stress, and even depression. Constantly thinking about past situations or “what-ifs” can lead to hopelessness and feelings of being stuck.
Some common questions caused by rumination may include: “What if I say something wrong in school tomorrow?” or “What if something bad happens to my family?”
A lot of individuals experiencing rumination also engage in constant mental questioning and checking. This is often about everyday situations, such as whether you locked the door or fed the cat even after checking multiple times.
How rumination manifests in autistic individuals
Rumination can appear across all ages. This can be caused by the following:
- stress triggers (social situations, mistakes, injustices, sensory overload, etc.
- the cognitive and emotional processing abilities of the individual.
Social rumination often involves overanalyzing interactions and fearing rejection. Individuals may experience intrusive thoughts like, “Did I talk too much? Why did they pause before answering? Were they secretly annoyed with me?”
This can lead to behavioral signs such as:
- appearing downcast or shameful,
- avoiding eye contact or social situations,
- being defensive,
- repeatedly seeking reassurance.
Rumination on perceived mistakes results in a hyper-fixation on small errors, leading to thoughts like, “I should have done better. Everyone will remember this forever. I failed…”
As a result, individuals may show signs such as:
- appearing distraught and upset, overexplaining or excessively apologizing for perceived wrongdoings,
- procrastinating on future tasks,
- developing a deep fear of making another mistake.
Past trauma and negative experiences, such as bullying or rejection, can also trigger rumination. This can be closely linked to justice-oriented rumination, where individuals obsess over fairness, rule-following, and justice.
Thoughts may include, “That’s not fair! Why didn’t anyone stop them? They didn’t get the same treatment!”
This can lead to behaviors such as:
- openly calling out individuals, including authority figures, for rule infractions,
- repeatedly raising the same issues,
- struggling to accept imperfections in rules or authority figures,
- having difficulty considering others’ points of view.
Sensory-based rumination involves overanalyzing distressing sensory experiences, often leading to thoughts like, “That hurt! What if it happens again? Why did they hit (tag) me?”
This can manifest in behaviors such as:
- avoiding peers and classmates,
- being hypervigilant and wary in groups,
- steering clear of playgrounds or group games,
- preferring social isolation, such as swinging or playing alone.
Potential causes of rumination in autism
Key causes of rumination in autism may stem from several underlying factors. Cognitive rigidity and monotropic thinking can make it difficult for individuals to shift focus, leading to persistent, repetitive thoughts.
Difficulty processing social interactions is another key factor. Autistic individuals may misinterpret conversations and struggle to understand social cues, which can contribute to ongoing rumination.
Emotional dysregulation also plays a significant role, making it challenging to distinguish emotions from thoughts and leading to a cycle of overthinking.
Sensory overstimulation can further worsen rumination, as intrusive sensory experiences may cause perseveration and prolonged distress.
Past trauma and negative experiences, such as bullying or rejection, can lead to persistent distress, with individuals replaying these events in their minds.
Perfectionism and high personal standards can also contribute to overanalyzing one’s performance and self-worth, leading to continuous self-criticism and doubt.
Autism and anger rumination
Anger rumination involves repetitive thoughts about perceived injustices, often leading to resentment and emotional outbursts.
Key differences between anger and general rumination:
- Focuses on perceived wrongs rather than personal worries.
- Leads to anger and defensive emotions rather than sadness or anxiety.
- Common triggers include social confrontation, social rejection, and masking fatigue.
The impact of rumination on mental health and daily life
The impact of rumination on mental health and daily life can be significant, often worsening anxiety and stress by keeping the brain in a heightened state of alertness.
This constant state of worry can make it difficult to relax, leading to emotional exhaustion over time.
Rumination also reinforces feelings of failure and self-doubt, which can contribute to depression and a sense of hopelessness.
Individuals may struggle to move past negative experiences, replaying them repeatedly in their minds and feeling trapped in a cycle of self-criticism.
Rumination may also increase emotional fatigue and lead to decision paralysis, as the fear of making mistakes delays actions.
For example, a student stuck in a negative thought loop about their soccer performance might quit the team due to self-doubt, even if they previously enjoyed playing.
How to manage autistic rumination
Managing rumination involves a variety of cognitive techniques that help individuals recognize and reframe intrusive thoughts, making them less overwhelming. These often include:
- Cognitive behavioral therapy (CBT): Helps recognize and replace negative thought patterns.
- Cognitive defusion (ACT & EMDR): Detaches and reprocesses from harmful thoughts.
- Mindfulness & meditation: Encourages present-moment awareness.
In addition to cognitive techniques, behavioral and coping strategies can provide practical ways to manage rumination by setting limits on negative thought patterns and engaging in various activities. These techniques may include:Â
- Scheduled “worry time”: Allocating 10-15 minutes a day to contain worries and concerns.
- Distraction techniques: Engaging in hobbies or movement activities.
- Journaling & voice notes: Externalizing thoughts to reduce mental loops.
Since rumination is often linked to emotional dysregulation, strategies that promote emotional balance and relaxation can be highly effective. They may include:
- Sensory regulation: Using fidget tools, weighted blankets, or movement to calm the mind.
- Breathing techniques: Diaphragmatic breathing to ease anxious thoughts.
- Talking to a trusted person: Processing thoughts with supportive individuals.
Finally, making adjustments to the surrounding environment can help reduce triggers and create a more supportive atmosphere for managing rumination. Consider the following:
- Predictability & routine: Reducing uncertainty-induced stress.
- Social scripts: Preparing scripted responses for future interactions.
- Limiting overexposure to triggers: Reducing contact with anxiety-inducing stimuli.
How you can support an autistic individual struggling with rumination
Rumination can be very difficult for individuals experiencing it, and it can impact their daily functioning. Caregivers can help their loved ones by:
- Validating feelings without reinforcing the rumination. For example, you can show understanding by saying, “I can see that this is really bothering you.“
- Using a “thought parking lot” to offload worries in a journal.
- Teaching cognitive flexibility to challenge rigid thinking. You can try shifting their focus by asking, “What would you say to a friend who had this thought?“
- Encouraging mindfulness & sensory regulation to ease distress.
- Providing structured distractions in areas of interest to break through stuck thoughts.
- Modeling healthy thinking patterns through positive self-talk exercises.Â
- Offering closure for unresolved issues to reduce uncertainty. Use clear explanations and steps.
- Seeking professional support in CBT, ACT, or OT if rumination disrupts daily life.
From overthinking to overcoming
Autistic rumination often stems from difficulties in cognitive flexibility, emotional processing, and social interpretation. Recognizing triggers and using the best autism support practices and strategies can help manage these thought patterns effectively.
FAQs
Q: Is rumination linked to autism?
A: Rumination is commonly linked to autism. Autistic individuals often experience repetitive thoughts due to differences in cognitive processing and anxiety regulation. Research suggests that difficulties with cognitive flexibility and heightened anxiety contribute to persistent rumination in autism.
Q: Does autism cause overthinking?
A: Autism does not directly cause overthinking, but many autistic individuals experience persistent or repetitive thoughts due to heightened anxiety, sensory sensitivities, or difficulties with uncertainty. Overthinking in autism is often linked to a strong need for predictability and detailed information processing.
Q: How do you get out of autistic rumination?
A: Breaking out of autistic rumination often involves strategies like cognitive behavioral techniques, mindfulness, or redirecting attention to a structured activity. Reducing stress, using grounding techniques, and addressing underlying anxiety can also help manage repetitive thought patterns.
Q: What disorder causes rumination?
A: Rumination is commonly associated with disorders such as depression, anxiety disorders, and obsessive-compulsive disorder (OCD). It is also present in autism and rumination disorder, a condition where individuals repeatedly regurgitate and re-chew food.
References
Williams, Z. J., McKenney, E. E., & Gotham, K. O. (2021). Investigating the structure of trait rumination in autistic adults: A network analysis. Autism, 25(7), 2048-2063. https://journals.sagepub.com/doi/abs/10.1177/13623613211012855Â
Golan, O., Haruvi-Lamdan, N., Laor, N., & Horesh, D. (2022). The comorbidity between autism spectrum disorder and post-traumatic stress disorder is mediated by brooding rumination. Autism, 26(2), 538-544. https://journals.sagepub.com/doi/abs/10.1177/13623613211035240Â
Arwert, T. G., & Sizoo, B. B. (2020). Self-reported suicidality in male and female adults with autism spectrum disorders: Rumination and self-esteem. Journal of autism and developmental disorders, 50(10), 3598-3605. https://link.springer.com/article/10.1007/s10803-020-04372-zÂ
Hedley, D., Uljarević, M., Cai, R. Y., Bury, S. M., Stokes, M. A., & Evans, D. W. (2021). Domains of the autism phenotype, cognitive control, and rumination as transdiagnostic predictors of DSM-5 suicide risk. PLoS One, 16(1), e0245562. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245562 Â
Ibrahim, K., Kalvin, C., Marsh, C. L., Anzano, A., Gorynova, L., Cimino, K., & Sukhodolsky, D. G. (2019). Anger rumination is associated with restricted and repetitive behaviors in children with autism spectrum disorder. Journal of autism and developmental disorders, 49, 3656-3668. https://link.springer.com/article/10.1007/s10803-019-04085-y
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