What is metacognition and what does it have to do with worry and rumination?

Worry and rumination are common ‘repetitive negative thinking’ styles that are often experienced as spiralling or racing thoughts, and overthinking. ‘Worry’ usually refers to thinking on fears or uncertainties about the future, whereas ‘rumination’ are repetitive thoughts analysing the past (e.g., difficult events, mistakes we made).

What does worry and rumination feel like?

Most people will remember a time when they felt stuck dwelling on difficult thoughts or feelings. Worry and rumination may become a problem when it continues in the longer-term – and usually causes ongoing anxiety, low mood, irritability, and exhaustion.

People who struggle with worry and rumination often describe feeling stuck in a regular state of ‘analysis paralysis’ inside their heads, which can feel overwhelming even if the person is functioning well with their daily activities. These thought spirals can feel like playing a frustrating, endless game of ‘whack-a-mole’, where a new worry or concern pops up to replace an older one as soon as it is solved.

Worry and rumination may make it difficult to shift focus away from negative thoughts, and onto things that are more important to use or that bring a sense of pleasure, meaning, and fulfilment.  Overthinkers may find it difficult to concentrate, complete tasks, make decisions, or get to/stay asleep.

While worry is most closely related to anxiety, and rumination to depression, both thinking styles are common part of a wide range of mental-health related problems, including OCD, eating and body image disorders, health anxiety, and even chronic pain.

What is metacognition?

It may sound fancy and technical, but metacognition simply refers to how we think about our thinking and process the thoughts that pop into our minds. Thoughts (which can be verbal thoughts, mental pictures, or even urges or sensations) are cognitions, and the ‘meta’ part refers to what we do with those thoughts.

Metacognition includes the mental processes and beliefs that affect how we think, and what we think about. These mental processes include things like attention, memory, and our awareness of our thoughts and mental activity. These processes play an important role in determining what sticks in our mind at any given moment in time.

Metacognitive beliefs are the beliefs that we have about our thinking, memory, attention etc. For example, we may assume that if something keepings popping into our mind then it must be true, or that our memory is always accurate (or perhaps the opposite, that it can’t be trusted).

How does metacognition keep worry and rumination going?

T”here are specific metacognitive beliefs that have been shown to keep worry and rumination going for many people. These include believing that worry or rumination is helpful to us in some way (positive metacognitive beliefs), for example, by helping us to be prepared, solve problems, or motivate ourselves.

These beliefs can pull us into repetitive negative thinking spirals, undermining our overall attempts to change our overthinking patterns.

It’s common for people to also hold negative metacognitive beliefs that their worry, rumination, or repetitive negative thoughts are uncontrollable or dangerous in some way.

For example, we might become concerned that negative thinking will make us sick, go crazy, damage our brain, lose control of our behaviour, or even cause something bad to happen. We might even attach moral judgments to our thinking and believe that having certain negative thoughts makes us a bad person.

These beliefs often lead us to trying even harder to monitor and stop, or push away negative thoughts when they pop in, which usually results in paying even more attention to them. We might then begin to ‘worry about our worry’, or feel depressed about our depressed thoughts, making us feel worse.

Having both ‘positive’ and ‘negative’ metacognitive beliefs going at the same time is common, but problematic. It can be like pressing both the break and accelerator pedals of a car down at once. We end up spinning in the mud, getting stuck even deeper the harder we try, going nowhere. When we do this, our windscreen gets even more mud on it and our perspective becomes less unclear.  

Help for worry and rumination

Over the past couple of decades, researchers and psychologists have developed a range of useful ways, based on cognitive-behaviour therapy (CBT), to specifically help with worry and rumination.

One of these approaches is Metacognitive Therapy. This therapy involves learning a range of strategies to interrupt worry and rumination spirals by:

• Increasing awareness of when you are caught up in worry/rumination

• Learning attention retraining and mindfulness skills to be able to detach from worry/rumination and be more present-focused

• Increasing your sense of control over the worry/rumination spirals

• Helping you re-evaluate metacognitive beliefs that may be helping to keep your worry/rumination going

• Reducing excessive coping behaviours, such as avoidance, distraction, and repeatedly seeking reassurance from others, that may be unintentionally reinforcing the unhelpful attention being paid to your worry/rumination thoughts

Resources for worry and rumination

You may like to check out past blogs written by our team for some helpful tips on managing worry and rumination:

• Managing anxiety about Coronavirus (by Dr Joel Howell and Ben Pearcy)

• How to stop overthinking: Detached mindfulness (by Dr Gemma Healey)

• Mindfulness (by Dr Rachel Sim)

Written by Dr Melissa Mulcahy , Clinical Psychologist

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