0:01 Today we're going to talk about
0:02 rumination. When I was a third-year
0:04 psychiatry resident, I had a group of
0:06 patients that came into my office with a
0:08 couple of different diagnoses. One
0:10 person had a mood disorder, one person
0:11 had an anxiety disorder, and one person
0:14 had PTSD. And so, as I started working
0:16 with them, I started doing psychotherapy
0:17 because that's what a third-year
0:18 resident is supposed to do. I had a
0:20 wonderful supervisor. So, I started
0:22 therapizing them, right? So we we worked
0:24 a lot on their emotions, emotional
0:26 processing, things like journaling,
0:28 doing things like thought logs that look
0:29 at the relationship between their
0:30 thoughts, their actions, and their
0:33 behaviors. But despite doing all of this
0:34 emotional work, they didn't seem to be
0:36 getting better. And when I was sitting
0:38 in the room with them, it just just sort
0:40 of felt to me like their minds were out
0:43 of their control. No matter how much we
0:45 talk about how hurt they feel, their
0:48 mind would start spiraling in some kind
0:50 of direction. So I started doing
0:52 something a little bit unorthodox. I
0:53 sort of looked at that this and I sort
0:55 of said, "Okay, like this mind is going
0:57 way off track. They get stuck in these
0:59 cycles of repetitive thinking. Let's
1:01 just learn how to shut off the mind." So
1:03 I started teaching them more stuff from
1:04 like yoga and meditative traditions and
1:06 then something kind of funny happened.
1:07 So then I got called into my program
1:09 director's office one day and she asked
1:10 me like, "So how are things going with
1:12 this set of patients? How are things
1:13 going with the supervisor?" And I said,
1:15 "Honestly, like things seem a little bit
1:16 hard. You know, I'm I'm trying to do
1:18 psychotherapy with them. It doesn't seem
1:19 very effective. I'm teaching them some
1:21 like yoga and meditation techniques.
1:23 Those seem to be working like okay, I'm
1:25 not quite sure. And that's when she
1:26 informs me that the supervisor that I'm
1:28 working with is essentially firing me.
1:29 She says that this supervisor that
1:31 you're working with feels like she can't
1:33 work with you anymore. And I was like
1:34 really shocked and I was like, did I do
1:36 something wrong? Like you know why? Like
1:39 I was a bit confused. And she said well
1:40 like you know the supervisor says that
1:42 you're sitting with these patients and
1:43 you're doing something but it's not
1:45 psychotherapy. and she's a psychotherapy
1:47 supervisor, so she can't like guide you
1:49 in something unless you're willing to
1:51 like do that thing. So, thankfully, it
1:53 turned out to be totally fine. I don't
1:54 think the supervisor made a mistake or
1:56 anything. In fact, I think it was a
1:58 really really pro move on her part. She
1:59 recognized that I was doing something
2:02 that has value and that I probably
2:04 needed a different kind of guidance to
2:06 learn psychotherapy and sort of blend
2:07 these two things and that was awesome.
2:09 It worked out great. A lot of the stuff
2:11 that I ended up doing with my patients
2:13 was actually pretty effective. And a lot
2:14 of that stuff is like when we think
2:16 about something like rumination or
2:18 depression or anxiety, we don't really
2:20 think about how can I control the mind
2:23 itself or how can I put my mind in a
2:25 phys or how can I put my brain in a
2:27 physiologic state where we are less
2:29 likely to ruminate. So if you guys want
2:31 info like that, check out Dr. K's guide.
2:33 We have a ton of great techniques in
2:35 there about sort of shaping your brain,
2:37 shaping your body, and shaping your
2:39 mind. And what I didn't realize at the
2:40 time is that these were patients who
2:43 were ruminators. These are patients who
2:45 repetitively think about something over
2:48 and over and over again. It's almost as
2:50 if their mind is turned against them.
2:51 And the really shocking thing about
2:54 rumination is we may think okay like if
2:55 your mind gets caught in thought loops
2:58 or spirals like you should go see a
3:00 therapist. But actually it turns out
3:02 that if you are someone who ruminates,
3:04 therapy is less likely to be effective
3:06 for you. So this was first demonstrated
3:09 in a large-scale longitudinal studies in
3:11 which rumination prospectively predicted
3:14 the onset of major depressive episodes
3:16 and depressive symptoms in non-depressed
3:18 and currently depressed individuals
3:20 across follow-up periods ranging from
3:23 six to 6 weeks to 5 years. So what this
3:25 means is that if you were if you're a
3:27 ruminator the degree of rumination
3:30 predicts the onset of depression but
3:32 it's not just depression. large-scale
3:34 prospective longitudinal studies, that
3:35 means that studying things ahead um
3:37 prospectively, right? So, we're not
3:38 doing like a retrospective data
3:40 analysis, found that rumination
3:42 predicted subsequent substance use,
3:45 eating disorders, alcohol abuse, and
3:48 PTSD symptoms following trauma even
3:51 after controlling for initial symptoms.
3:52 So this is kind of shocking because what
3:54 this what these studies show is that if
3:57 you have a traumatic event, if you were
4:00 someone who ruminates, the likelihood
4:02 for that traumatic event to turn into
4:05 PTSD is correlated with your rumination.
4:07 So not only does rumination increase
4:09 your risk for all kinds of mental
4:12 disorders, but it actually interferes
4:13 with treatment. So it turns out that as
4:16 a PGY3, what I didn't realize is it's
4:17 not that I was doing psychotherapy
4:19 incorrectly. It's that if you're someone
4:21 who ruminates, there's a good chance
4:23 that psychotherapy won't be as effective
4:25 for you. Indeed, there is growing
4:27 evidence that elevated rumination at the
4:29 start of treatment predicts poorer
4:32 outcomes to cognitive behavioral therapy
4:34 for depression, such as increased time
4:36 to remission and reduced likelihood of
4:39 achieving remission. Rumination at the
4:41 end of mindfulness CBT treatment
4:43 predicts a depressive relapse. So that
4:45 means that when you complete a course of
4:47 treatment, if you are a ruminator, if
4:49 you're a ruminator, that increases the
4:51 risk that your depression will actually
4:53 relapse and you'll get depressed again.
4:55 For patients receiving brief CBT in a
4:57 partial hospitalization program, so
4:59 these are people who have intensive uh
5:01 care, right? They're receiving intensive
5:03 care. Baseline rumination predicted
5:06 subsequent anxiety and depression. And
5:08 the examination of symptom trajectories
5:10 indicated that when rumination did not
5:12 improve, symptoms of depression and
5:15 anxiety did not improve and were likely
5:18 to worsen over time. So this is crazy,
5:20 right? This means that if you are
5:22 someone who ruminates and you go to
5:24 treatment and you do not target the
5:27 rumination specifically that there's
5:29 this will reduce the efficacy of
5:32 treatment and in some studies may even
5:35 predict worsening depression and anxiety
5:36 despite the fact that you did the
5:38 treatment. So how is it that rumination
5:39 interferes with treatment of
5:41 psychotherapy? And why is it that
5:45 rumination predicts the the propensity
5:47 for depressive relapse, symptoms of
5:49 anxiety, for a trauma to turn into PTSD?
5:51 How does this actually happen? So the
5:53 first problem with rumination is that it
5:55 is an emotional magnifier. The first
5:57 negative effect of rumination found in
5:58 experimental studies is that it
6:01 exacerbates and prolongs existing
6:04 emotional states such as sadness, anger,
6:06 anxiety, and depression. Okay. And in
6:09 parallel it uh it elaborates and further
6:12 polarizes any thought content focused on
6:14 during the rumination. So these are two
6:16 really important things to understand.
6:18 Okay. The first thing that it does is it
6:21 magnifies and prolongs whatever we think
6:23 about and usually negative states. So
6:25 sadness, anger, whatever. So here's
6:26 practically what happens. So if I do
6:28 something stupid today, generally
6:30 speaking, tomorrow is a new day and I
6:32 don't have to linger with the effects of
6:34 my stupidity. If you are someone who
6:36 ruminates, the problem is that if you
6:39 make a mistake today, it causes you hurt
6:42 for the next year, for the next two
6:44 years, maybe even a lifetime. I've
6:45 worked with ruminators that had problems
6:47 in high school, like they got dumped by
6:49 their significant other and they just
6:52 like feel trapped by that particular
6:55 injury and this is like 20 years later.
6:56 You may have seen sort of examples of
6:58 this, right? People who get like sort of
7:01 frozen in time and can't move past
7:02 something. That is literally what
7:05 rumination does. So rumination takes a
7:09 single instance of damage and turns it
7:11 into dot damage until you are done
7:13 ruminating with it, which often times is
7:15 sort of never, right? Because you can
7:17 keep on replaying these thoughts over
7:19 and over and over again. So not only
7:22 does it increase the duration of
7:25 emotional injury, it also increases the
7:27 intensity. Now how does this happen?
7:28 This is something that's really
7:30 important to understand and it kind of
7:33 leads to black and white thinking. So,
7:34 this is something that's really wild.
7:36 Have you all ever been like at the
7:40 grocery store and tried to figure out
7:42 what to buy? So, you're sitting there at
7:43 a grocery store, there's lots of
7:45 different options, and then you're like,
7:46 I don't know what to buy. And you sit
7:49 there and you think about it for a
7:51 little bit. And as you think about it
7:53 for a little bit, you make a decision.
7:54 So, I want y'all to understand this is
7:58 really wild, but the more that your mind
8:00 thinks about something, the more
8:02 polarized you become. This is just a
8:04 feature of the mind. Okay, if that
8:06 sounds kind of crazy, just hear me out.
8:07 So, when I'm like, if I don't know if I
8:09 should take this job or not take this
8:11 job, what do I do? I think about it. So,
8:13 at the beginning, I may be like, let's
8:15 say here here is take job and here is
8:17 pass on job. And at the beginning of my
8:19 thinking process, I'm somewhere in this
8:20 middle area, right? But despite the fact
8:22 that I'm in in the middle area, as I
8:24 think about it more and more and more, I
8:27 start to drift this way and drift this
8:28 way and drift this way and this and then
8:32 eventually I make up my mind. So I want
8:35 y'all to think about how crazy it is to
8:37 make up your mind. I want you all to
8:40 think about how impossible it is for a
8:41 computer if a computer makes a
8:43 calculation and ends up with a question
8:44 mark. I don't know about generative AI
8:46 because they just hallucinate all kinds
8:47 of crap, right? Once you have a certain
8:49 amount of inputs, like if I have a
8:51 mathematical equation and I don't have
8:53 enough information to solve the equation
8:55 and I put it into a computer, the
8:56 computer is going to say at the first
8:58 iteration or the 10th iteration, we
8:59 don't have enough info to solve the
9:01 problem. That is not how the human mind
9:05 works. The more that we chew over things
9:07 in our mind, the more polarized we
9:10 become naturally. I wasn't sure if I was
9:11 going to break up with you. I thought
9:14 about it a lot and now I know I'm going
9:15 to break up with you. What new
9:18 information do I have? None. So the more
9:20 that we turn things over in our mind,
9:23 the more abstract we become. Right? So
9:25 as I think about things more and more
9:27 and more, I will start to deduce
9:29 abstract principles. So like let's take
9:30 the example of someone who is
9:33 ruminating. Let's say here's high school
9:35 and I never had a girlfriend. Let's say
9:36 the reason I never had a girlfriend is
9:38 because my parents were poor, right? So
9:39 like I couldn't hang out with people.
9:41 Everyone wanted to have the fancy shoes
9:43 and I didn't have the fancy shoes. So, I
9:45 considered myself unattractive and
9:46 that's why I don't have a girlfriend.
9:48 Then I go to uni and then what happens
9:51 is I struggled to adjust to uni. I ended
9:53 up getting depression in my freshman
9:56 year. Really, really common occurrence.
9:58 And since I got depression in my
9:59 freshman year, I didn't form when
10:01 everybody was making friends, I didn't
10:03 make friends. So, I kind of got left out
10:05 of all of the forming friend circles.
10:07 So, now I got kind of left behind. And
10:08 then that's the reason that I don't have
10:12 a girlfriend. And then now I started my
10:14 job but since I didn't have a girlfriend
10:16 uh in high school or college I don't
10:18 know how to talk to girls and since I am
10:22 behind now I have no girlfriend. So if
10:24 we look at this situation there are
10:28 strong contextual reasons why I've been
10:30 single my whole life. This problem
10:31 happened over here. This problem
10:33 happened over here. But then what
10:35 happens what the mind does is I chew on
10:37 this over and over and over again. I
10:39 start to come up with an abstract
10:41 conclusion which is that I am a loser.
10:43 So the the brain what the brain does
10:44 what the mind does is it looks at this
10:48 problem and it collects all of this data
10:51 and then it tries to draw an abstract
10:53 conclusion. Now here's the problem with
10:54 an abstract conclusion. The more
10:56 intelligent you are by the way the more
10:58 likely this is to happen. This is not
10:59 actionable. So what we find with
11:01 rumination is actually shocking. Even
11:03 though ruminators report that it
11:05 increases perceived insight into
11:07 problems, experimental studies
11:09 demonstrate that rumination interferes
11:12 with effective problem solving, both by
11:14 making individuals more pessimistic and
11:17 also more abstract and less able to
11:20 access specific details of how to
11:23 resolve a difficulty. Okay? And this
11:25 includes dysphoric mothers with infants
11:28 under 12 months. So this is wild. So
11:30 what this means is like this is
11:32 something that is in your brain and like
11:33 forget about all these like complicated
11:35 you know histories and know high school
11:37 this happened and college this happened
11:39 like we can study the effects of
11:41 rumination and how much it causes
11:43 problems with like mothers and infants
11:45 who are like 12 months. So this effect
11:47 can be observed over there. So it's it's
11:49 really like a neurological effect. It
11:50 happens in the brain. And so what
11:52 happens when we ruminate a lot is we
11:55 develop this abstract thing. And if I
11:58 ask someone who feels like a loser, how
12:00 well do you understand your problem?
12:01 They will say, I understand it
12:03 incredibly well. The reason that I'm an
12:04 incel is because of XYZ. I'm not trying
12:06 to bash on insults because of this and
12:08 this and this and this and this and this
12:09 and this. I understand everything. The
12:11 black pill is real. I've read so much
12:12 research. It's so true of so many
12:14 people's experiences. My understanding
12:17 is great. My understanding level is 100.
12:18 What are you going to do about it?
12:19 Nothing can be done. I don't know what
12:21 to do about it. I can't think of any
12:23 solution because I am a loser. This is
12:26 the problem with rumination because when
12:28 we make an abstract
12:31 conclusion from these highly specific
12:34 actionable scenarios, we end up with a
12:36 conclusion that is not actionable. So it
12:39 keeps us stuck. It also makes us
12:41 pessimistic which is a big problem
12:42 because not only does it enhance our
12:45 negative emotional circuitry but here in
12:48 my nucleus cumbent in my frontal loes
12:51 anytime my brain thinks about doing an
12:53 action. Should I go to the gym? Then
12:55 what my brain does is it calculates the
12:58 probability of success of that action.
13:00 So should I go to the gym? And what does
13:02 the the the black pillar do? The black
13:04 pillar says there's no point in going to
13:06 the gym because going to the gym doesn't
13:08 make me not a loser. It doesn't correct
13:10 for all my social skills. It doesn't
13:12 like correct for all of the things that
13:14 I've missed. It doesn't correct for the
13:16 fact that I have an avoidant attachment
13:18 style. So any point of progress is
13:20 insufficient at solving this big
13:23 abstract thing. This is the this is the
13:25 effect of pessimism on on your mind. So
13:27 when you have negative emotional stuff
13:29 that's being amplified and you have a
13:33 pessimistic thinking, it decreases the
13:36 value of action. And once the value of
13:38 action goes down, then your motivational
13:40 circuitry basically says it isn't worth
13:42 it. And if y'all pay attention to people
13:44 who are red pillars or black pillars or
13:46 whatever on the internet, you will
13:48 notice a couple of very very simple
13:50 things. The first is look at how
13:52 abstractly they're thinking. Are they
13:54 thinking concretely or are they thinking
13:56 in big sweeping generalizations? The
13:59 second thing is look at the the value of
14:02 progress in their mind. Do they say okay
14:05 like if I have this problem does moving
14:07 forward in it help at all? And they say
14:09 won't it help at all? It doesn't matter.
14:11 So progress becomes useless. And when
14:13 progress becomes useless that's how you
14:16 get stuck in time for years. The next
14:18 thing to consider is that rumination
14:21 increases self-focus and amplifies the
14:23 vicious repetitive cycle between
14:25 negative mood and cognition wherein each
14:27 increases the likelihood of the other.
14:30 The focus uh and focuses attention on
14:32 the discrepancy between one's desired
14:34 state and the actual situation making
14:37 this discrepancy more salient. Okay. In
14:39 vulnerable individuals, this pattern of
14:42 mutual amplification between negative
14:44 thinking and negative mood produces an
14:47 emotional cas cascade in which
14:49 rumination can lead to very intense
14:51 levels of negative affect. Okay. So what
14:53 does this mean? So when we ruminate what
14:55 this does is it focuses on where we are,
14:57 where we want to go and it highlights
15:00 this gap. And the more so, so I I don't
15:01 know if this kind of makes sense. Like
15:04 making progress in your life involves
15:05 moving from here to here and then here
15:07 to here and then here to here and then
15:09 here to here. But that's not how
15:11 rumination functions. It doesn't think
15:13 like that. That's the whole problem.
15:15 What it does is it looks at the gigantic
15:19 gap between where you are and where you
15:21 want to go and it just highlights all of
15:24 your shortcomings. This is the way that
15:26 it becomes an emotional magnifier. And
15:28 this is one of the mechanisms through
15:31 which it interferes with problem solving
15:32 because we're not thinking about the
15:35 next step. Our mind is literally focused
15:36 on all the things that I'm doing wrong
15:39 and all how far I have to go. So here's
15:41 the problem. Here's my actual state.
15:43 Here's my desired state. And what
15:47 ruminators will do is instead of moving
15:50 towards happiness
15:52 or progress, what they tend to do is
15:55 this feels bad
16:00 and what they try to do is move away
16:02 from feeling bad. They don't try to
16:04 actually move towards their goal. They
16:06 simply try to move away from this state.
16:08 I'm not going to grind to improve my
16:10 life. I just want to stop feeling this
16:12 way. There's one last really damaging
16:14 thing about rumination, which is that it
16:17 makes you less sensitive to contextual
16:19 changes. Okay, so let's take a quick
16:20 look. So rumination has been
16:22 hypothesized to make ruminators less
16:25 sensitive and responsive to contextual
16:27 cues and events in the world around
16:29 them, including signals of potential
16:32 reward, changing contingencies, or
16:34 interpersonal reactions. Such abstract
16:37 and internal preoccupation could prevent
16:40 ruminators from adaptively responding to
16:42 changes in the environment or from
16:44 benefiting from corrective learning that
16:47 disisconfirms negative beliefs. This I
16:49 think is arguably the most damaging
16:51 thing about rumination is that if you
16:53 make some conclusion about your life, I
16:56 am a loser and then you're at work and
16:58 then someone at work is like, hey, you
17:01 want to hang out sometime? You get some
17:04 kind of signal that you're not a loser.
17:06 You get some kind of signal that oh
17:08 actually there's an opportunity right
17:10 now. There's actually contrary
17:12 information to your belief that you're a
17:13 loser. You're not stuck in this
17:16 situation forever. The nature of
17:19 rumination makes it so that you are
17:21 unable or it is more difficult for you
17:24 to change to to detect changes in your
17:27 context. So if you induce rumination, so
17:29 induced rumination interferes with
17:31 contextual sensitivity, reduced
17:34 responsiveness to infant vocalizations
17:35 in mothers with generalized anxiety
17:38 disorder or major depressive disorder,
17:40 and reduced sensitivity to infants in
17:41 mother child interactions for both
17:44 dysphoric and non-disphoric mothers. So
17:46 this is important. So we may think,
17:47 okay, like what like this is because
17:49 everybody's depressed, right? That's why
17:51 they're not responding to changes in the
17:53 context and in changes in the world
17:54 around them that afford them new
17:56 opportunities. No. So these studies
17:57 actually show that if you take a mother
17:59 who has an infant and the mother is
18:01 non-disphoric, so the mother is actually
18:03 totally doing fine and you induce
18:05 rumination in the mother, she will
18:09 become less sensitive and responsive to
18:12 the vocalizations of her infant. This is
18:14 how deep this stuff actually runs. So
18:15 the most devastating thing about
18:17 rumination is even if your circumstances
18:20 change and you can make progress, which
18:22 happens in just about every patient that
18:23 I've worked with who ruminates, the
18:26 rumination interferes with your ability
18:28 to see those kinds of changes. So then
18:30 you feel like you're stuck forever. So
18:32 now let's try to recap and understand
18:34 where this picture puts us. So if I'm
18:36 someone who's a ruminator, I have one
18:39 negative event and then I sort of play
18:41 that over and I multiply the damage
18:44 times 10. So this turns into dot damage
18:46 instead of a single instance of damage.
18:48 Then what happens is I may have a second
18:50 negative event and then I may have a
18:52 third negative event and then I sort of
18:54 end up making an abstract conclusion.
18:56 Now that I'm a loser, I have negative
18:58 emotion. I can't see any concrete
19:01 action. I become pessimistic. So it's
19:03 not worth trying. Right? And then this
19:05 becomes a self-fulfilling prophecy
19:08 because if I add these three things then
19:09 what happens? Oh yeah, I am a loser.
19:11 Look at all this evidence. Look at all
19:12 this evidence. Look at all this
19:14 evidence. But in the same way that we if
19:17 we induce rumination in non-disphoric
19:19 mothers and they start to have problems
19:21 with their infant, something very cool
19:24 happens. If we can stop rumination, a
19:26 lot of these problems will start to get
19:27 better on their own. Because the
19:30 rumination in and of itself is what is
19:31 creating the problems. And this is
19:32 something I want you all to really
19:34 understand because this is kind of a
19:36 mind-blowing moment. At least it was for
19:38 me. See, when you ruminate, you think
19:40 about your problem. So you think the
19:42 problem is out here. You think the
19:44 problem is what you see in the outside
19:45 world. That's not the problem. The
19:47 problem is in here. The problem is the
19:49 way that you are viewing things. The
19:52 rumination literally impairs problem
19:54 solving. Literally magnifies negative
19:56 emotion. So there's one additional
19:58 problem that is super scary about
19:59 rumination, which is when we get stuck
20:02 in this cycle, ruminators tend to be
20:04 more avoidant. So goal pursuit that is
20:08 focused on avoiding an undesirable state
20:10 rather than approaching a desired state
20:11 may make it hard to make sufficient
20:13 progress towards the goals as it
20:15 provides little concrete guidance
20:17 regarding necessary steps and may be
20:20 hard to definitively resolve. High trait
20:21 ruminators are more likely to have
20:23 avoidance goals than low trait
20:25 ruminators. So if we disable the
20:27 rumination a lot of things will start to
20:29 get better. So then the question very
20:31 naturally becomes how do we do that? So
20:33 the first is that rumination is
20:34 triggered by negative emotions. So this
20:37 is what's really weird in your brain.
20:39 When your amygdala activates, when you
20:41 start to experience negative emotion, it
20:43 triggers in a habitual way the
20:45 ruminative thought process. So if you
20:46 start to have a bad day, then the
20:48 rumination triggers. Now here's what we
20:50 need to do. We need to separate
20:54 ruminative from problem solving. Right?
20:56 So all rumination is going to do is make
20:58 us think more and more abstractly. Is
20:59 going to polarize our thoughts and is
21:00 going to interfere with problem solving.
21:02 So, this sounds so weird, but like when
21:04 we ruminate, we think we're trying to
21:05 figure out a problem. Like, we're trying
21:07 to we're trying to find a solution. It
21:09 actually is very bad at doing that. So,
21:11 here's what we need to do. When we
21:13 ruminate, usually it's triggered by a
21:15 negative emotion. This negative emotion
21:17 needs to be dealt with separately. So,
21:18 if you're ruminating, you're not going
21:19 to solve your problem. So, we got to
21:21 start solving our problem outside of
21:23 rumination. Separate these two things.
21:25 Instead, what we need to do is some kind
21:27 of focused emotional regulation
21:29 technique. So, you can do nadish
21:30 pranayam. We teach a lot of stuff about,
21:32 you know, emotional regulation. Check
21:33 out Dr. K's guide. It'll really help
21:35 with all this kind of stuff. Okay. Deal
21:37 with that negative emotion. Once the
21:40 negative emotion is gone, then what we
21:41 want to do or we're not feeling that
21:43 negative emotion very actively right
21:45 now. Stop the rumination. What we want
21:46 to do is then we want to engage in
21:48 problem solving. So problem solving
21:52 should only be done when you are happy.
21:53 Only be done when you're happy. There's
21:55 a second aspect of problem solving,
21:56 which is remember that the reason that
21:58 our problems feel unsolvable is because
22:01 we're overly abstract. What can I do
22:04 today to become no longer a loser?
22:06 That's not something I can do. Maybe I
22:07 can work out. Maybe I whatever. There's
22:09 all kinds of practical things I can do,
22:10 right? But it doesn't feel like it
22:12 works. So instead, what we need to do is
22:15 really focus on concrete thinking and
22:17 watch out for the pessimistic angle. So
22:19 what we need to start doing is acting.
22:20 We need to start thinking in a very,
22:22 very concrete way. And this is where the
22:24 solution that I want y'all to do is the
22:27 solution that will be insufficient.
22:29 Watch out for that pessimistic thinking.
22:32 Don't stop. Don't quit something just
22:34 because it isn't going to work. If it is
22:36 moving you in the right direction, then
22:38 you should just do it. That's it's as
22:40 simple as that. So, watch out for that
22:42 negative kind of thinking. The third
22:44 thing that we need to do is look at our
22:47 context and improve context. So even if
22:49 you feel like a loser today, chances are
22:52 your situation is different than the way
22:54 that it used to be. Chances are that for
22:56 each situation that you think makes you
22:59 a loser, there was some context that was
23:01 contributing to that. And now you may
23:03 say, "Oh, but I've like fallen so far
23:04 behind. There's no way I can recover.
23:06 The context doesn't matter." That's the
23:07 ruminative thinking. That's the
23:09 pessimistic thinking. That is the
23:11 thinking of insufficiency. So, what I
23:13 want you all to do is really look at be
23:16 on the lookout for any opportunity for
23:17 change. Look at, okay, does this one
23:20 person is this person like inspiring me
23:21 a little bit? Could this person be like
23:23 one of my writing buddies? I could
23:24 review their writing, they could review
23:26 my writing. Is this person maybe like
23:28 this person asked me if I wanted to hang
23:29 out sometime? And then the pessimistic
23:30 thinking is like, oh, they're not going
23:32 to want to be date me or whatever, which
23:33 is totally fine, but I'm going to hang
23:36 out with them anyway. So, so be very,
23:38 very sensitive to changes in context.
23:40 And here's the other critical critical
23:42 critical thing. So when I work with
23:45 people who ruminate, one really good way
23:47 to tie this all together is to try to
23:49 improve your context. Don't worry about
23:51 solving your problem because nothing is
23:52 going to work to solve your problem,
23:54 right? What can you do to increase your
23:56 context? Let's say you're alone and you
23:57 don't have any girlfriends or whatever,
23:59 boyfriends, whatever. What can you do to
24:03 increase your improve your context? What
24:04 can you do to put yourself in a
24:07 situation where a girlfriend or a
24:09 boyfriend is more likely to arise? Can
24:11 you make platonic friendships with
24:13 people of the opposite gender and then
24:15 ask you to hook hook you up with
24:16 someone? Maybe set you up on a blind
24:18 date. If you're struggling in the
24:19 professional side, can you start to do a
24:21 little bit more networking? Talk to your
24:23 boss a little bit. Focus on the context.
24:25 Even if you were a loser, look at the
24:27 environment around you and how can you
24:29 improve your environment just a little
24:31 bit. If y'all do these things, then
24:32 there's a good chance that your
24:34 rumination will improve because we're
24:37 targeting the rumination directly. The
24:38 last thing that I'm going to leave y'all
24:41 with is a meditation. So, this is where
24:42 when we get stuck in the cycle of
24:44 rumination, there's one meditation that
24:46 I I found it really helps my patients a
24:48 fair amount, which is the meditation of
24:51 what's the next thought. So, anytime you
24:52 have a thought, anytime you start to
24:54 ruminate, one thought leads to another,
24:56 leads to another, leads to another, but
24:58 you're trapped inside those thoughts. Oh
24:58 my god, then this is going to happen.
24:59 this is going to happen. This is going
25:01 to take a step back because this is what
25:04 I ended up doing with my patients that
25:05 ended up getting the supervisor
25:06 uncomfortable with me is I started
25:08 teaching them things like this. I
25:09 started teaching them what's the next
25:10 thought. Go meta for a moment and
25:12 observe the process of rumination. Just
25:14 ask yourself, okay brain, what thought
25:16 is next? Okay, brain, what thought is
25:18 next? Okay, brain, what thought is next?
25:20 We don't dwell on the thought. We don't
25:21 wallow in the negativity. Okay, now
25:23 you're upset about this. Okay, fine.
25:24 What are you upset about next? What's
25:25 the next thought? What's the next
25:27 thought? What's the next thought? So
25:28 this is very important to understand
25:30 because when we ruminate we are inside
25:32 each thought and often times we don't
25:35 have the strength of will to control or
25:38 disrupt those thoughts. We can't stop
25:39 the chain. So we're going to do
25:41 something else. We're going to float
25:42 above it and we're just going to ask the
25:44 brain, what's the next thought? Okay,
25:45 what's next? Okay, what's next? We're
25:46 not going to get caught up in it. What's
25:48 next? What's next? And something really
25:50 cool will happen. The chain will run
25:53 through, but you won't get emotionally
25:55 amplified by it. If you are getting
25:56 emotionally amplified, that means you're
25:58 getting lost in, oh, then this is gonna
26:00 happen and this is gonna happen. No, let
26:01 it let it run. Just let it run. Okay,
26:03 borrow. What's next? What's next? What's
26:06 next? What's next? And if you use this
26:08 exercise, you may find that it calms you
26:10 down a little bit and then you can
26:12 engage in the uh contextual problem solving.
26:13 solving. [Music]
