The repetitive thought processes are usually placed downstream than other more structural factors, such as maladative schemes (neuronal circuits consisting of emotions, memories, painful cognitions) that affect the psychopathology of a subject.
However, they should not be underestimated, as they become maintenance factors Often important for various problems and often hinder treatment.
In fact, in therapy, you can work on the origin and on the final part of the psychopathological process. The initial structures, in fact, such as the schemes, activate and cause a suffering that is managed through the “final streets” (repetitive thoughts). These are used just as a coping strategies, to manage emotional pain. However, these strategies are dysfunctional and can also become real symptoms.
Persevening cognitive processes: repetitive thoughts
We can therefore define these repetitive thoughts such as Perseverant cognitive thoughtsi.e. cognitive/attentive recursive processes whose purpose is usually regular painful emotional states or increasing well -being.
In reality, these strategies increase unpleasant emotions and dysfunctional images of themselves.
They are therefore invisible coping strategies (cover), which produce symptoms. For example, before an abundant it is likely that the person has brooded: brooding increases the state of emotional activation (for example anxiety) which must then be managed to the binge to regulate.
The number of these perseveral cognitive processes is limited. Below are the types and in detail the description of each of them.
Rumination
Ruminare implies evaluating what happened in the past or what is happening in the present, as if it were a sort of reflection, even if it is a negative revaluation of what happened or as soon as it happened in a recursive way.
Always produces a Lowing of moodso much so that we find it in the purest form in depressive disorders.
There are several subtypes such as: the depressive rumination, against factual, angry, self -criticism, interpersonal (focused on negative interpersonal events).
We often find it in the form of questions (“Why did I get to this point? And if I had done in another way? “).
Mobble
The brooding implies an anxious anticipation of negative scenarios.
It is aimed at the future and is characterized by phrases such as “And if then …“. It is often found in generalized anxiety disorder (DAG), and when it has an interpersonal content it can characterize avoidant, employee, paranoid and borderline personality disorders.
It is the anxious anticipation that relational or situational aspects will go wrong.
Threat monitoring
The monitoring of the threat (typical of panic disorder and generalized anxiety disorder) is an attentive strategy that leads to confirmer bias as, if the person begins to monitor he will focus selectively on what he is looking for.
It is often used in monitoring sensory states with consequent somatosensory amplification: For example, a person who fears a panic attack, if he begins to fathom his body, it is very likely that he will find physiological alteration that he will interpret as confirmation of his fears.
When interpersonal is characterized by a hypervigilance towards interpersonal danger signals. The speeches, non -verbal signals and interpersonal dynamics to confirm the idea, usually negative, are monitored that we think the other has of us.
Maladaprrive Dreaming
Another type of repetitive thought is the maladaptive daydreaming, characterized by compensatory fantastic members that can be easily attributable to the life of the individual, which replace human interaction and/or interfere with interpersonal or professional functioning.
It is an excessive form of “daydream“, Which produces a rewarding experience based on a imagination of a parallel reality. This mode of thought needs time and loneliness to be able to immerse yourself fully.
It performs the function of reducing stress and pain, through the improvement of mood; guarantees a sort of company and intimacy.
At interpersonal level, the themes are compensatory nature: violence on the other, idealization of the self (competence, social recognition), power and control, rescue and escape and sexuality.
Because these processes are maintained despite the suffering they bring
Despite the obvious negative consequences, these coping methods are maintained by people due to the following maintenance factors:
- the metacredances on repetitive thoughts. The individual has beliefs regarding the usefulness or danger of carrying out these thought processes. Positive metacredances concern, for example, the idea that continuing to think about something can help to be prepared for the future (as for the brood). Those who have negative metacredances believe that this mode of thought is uncontrollable and therefore cannot do anything about it, letting themselves be overwhelmed.
- The repetitive thoughts fulfill in order to limit pain or increase wellness, and therefore are maintained at the expense of the chronic situation of suffering that cause.
- Many people do not realize that they are such repetitive thoughts that determine a large part of the pain experienced in a situation. For example, if my boyfriend leaves me, partly I will be bad for this loss, but partly I will suffer because I continue to ruminated.
So suspend these dysfunctional strategies has a cost, and that’s why they are difficult to abandon.
For example, if I think I have a disease, not thinking about it would lead me to have a strong activation linked to the fear of being vulnerable (i.e. a maladative scheme).
Possible treatments
The third generation approaches of the cognitive behavioral approach have focused on moving the therapeutic work from the content to the process.
Among the other Wells (2018) with his metacognitive therapy (Metacognitive Therapy, MCT) whose intervention focus will be centered on processes dysfunctional cognitive and on metacognitions and therefore on the way in which the person reacts to cognitive content.
The ACT (Acceptance and Commitment Therapy, Harris, 2011) also shifts attention to the process, providing useful strategies for hiring an accepting attitude towards unpleasant painful states and pursuing its values.
Interpersonal metacognitive therapy (Dimaggio et al., 2019) integrates a part of work in its approach aimed at developing a healthy attitude of observation of one’s thoughts/painful images in order to interrupt the repetitive thoughts that maintain psychopathology.
Purposes of interventions
Entering more specifically to work on repetitive cognitive processes it is essential to start identifying the set of coping strategies that uses the patient to manage the painful state (What did he do in response to that painful mental state?). Always paying attention to the Cover and Cognitive conduct, identifying the temporal hierarchy with which they are implemented: for example, the patient first mulls and then uses the binge or vice versa?.
Secondly, it is important to understand what are the purposes below the use of these repetitive cognitive strategies and the consequences of putting them into practice. For example, in a patient with emotional dependence, thinking in a desiring way to the partner helps her to get out of an intolerable devitalized void, but the consequence of this mode of thought is however craving, that is, an unstoppable desire to feel/see it.
Or again, the person with a deep sense of inadequacy every time he feels the possible criticism can use rumination, to reassure himself on the fact that no one has really judged it (Before you start brooding what was her image at that moment? At that moment what your mind needed? What is the first thing his mind does? If at that moment he decides not to treat that mental state, how does the mind behave? Is it at zero cost?).
Once this is understood, the goal is to increase awareness on the desire for implementing repetitive thought, stop to create a space to reflect on what is happening in one’s mind, regulate emotional activation and not “do anything”, but take on a position of image/painful thought observer, without “being dragged inside”, thanks to the use of specific techniques.
Finally, contact self -healthy quality capable of facing the painful image/thought, without therefore the use of repetitive thought is therefore more necessary. That is, a part that feels emotions, but remains in contact and does not require dysfunctional behaviors to manage pain.
What is the approach used what seems common for the treatment is that it seems to be fundamental not the “thing” we think, that is, the content of thought, but the “how” we think of ourselves, of the events and reality around us, and therefore work to intervene on this.
BIOGRAPHY
- Dimaggio G., Ottavi, P., Popolo, R., Salvatore, G. (2019). Body, imagination and change. Interpersonal metacognitive therapy. Raffaello Cortina publisher.
- Harris, R. (2011). Make act. A practical guide for professionals at the Acceptance and Commitment Therapy. Franco Angeli.
- Wahl, K., Ehring, T., Kley., H, Lieb, R, Meyer, A., Kardon, A., Heizel, C., V, Mazanec, M., Schonfeld, S., (2019). Is negative repetive Thinking in Transdiagnostic Process? A Comparison of Key Processes of RNT in Depression, Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, and Community Controls. Journal of Behavior Therapy and Experimental Psychiatry. 64, 45–53.
- Wells, A. (2018). Metacognitive therapy of anxiety disorders and depression. Erickson, Trento.
