Summary4 min read

Podcast Summary: "How OCD Traps You in Endless Thinking"

Podcast: Get to know OCD
Host: Dr. Patrick McGrath (NOCD’s Chief Clinical Officer)
Date: May 24, 2026

Episode Overview

This episode, hosted by Dr. Patrick McGrath, delves into the concept of rumination in the context of OCD—how those with OCD can become ensnared in endless, unproductive cycles of thought. Dr. McGrath explains how to recognize rumination, how it differs from effective problem solving, and practical strategies for breaking free and living with uncertainty.

Key Discussion Points & Insights

1. Understanding Rumination vs. Problem Solving

[00:00]
- Rumination is defined as repetitive, excessive dwelling on negative thoughts or past experiences without coming to a resolution.
- It often masquerades as useful problem solving, but the major difference is that it never arrives at a conclusion, instead fueling more doubts and “what if” scenarios.
- Quote:
  
  “Rumination can feel like problem solving to people, but it never really gets anywhere. It’s just continuing to think about thinking.”
  — Dr. Patrick McGrath [00:29]
- True problem solving is focused, guided by values, time-limited, and accepts uncertainty.

2. The Trap of Endless Doubts

[01:30]
- People stuck in rumination often find it hard to stop, feeling compelled to seek absolute certainty.
- Short-term relief may occur upon finding a fleeting “nugget” of an answer, but this quickly gives way to more doubts.
- Quote:
  
  “There’s a demand of an absolutely certain answer… maybe there’s just a little short term relief if you kind of hit a little nugget of something… but then there’s a ‘what if?’ that follows that and then there’s more doubts.”
  — Dr. Patrick McGrath [01:55]
- This cycle never provides lasting satisfaction.

3. Examples: Rumination vs. Problem Solving

[03:12]
- Example of adaptive problem solving:
  
  “If I still feel this way after the weekend, I’ll call the doctor.”
- Example of rumination:
  
  “I’m going to read endlessly on Reddit all about threads to decide if my experience counts as serious… and I still don’t quite have an answer. But hey, 75 more hours of research and I should be able to get there.” — Dr. Patrick McGrath [03:28]
- The former leads to action and resolution; the latter leads deeper into uncertainty.

4. Living with Uncertainty, Not Stopping Thoughts

[04:15]
- The objective isn’t to stop or suppress thoughts, which can itself become compulsive.
- Instead, the goal is non-engagement:
  
  “Our goal is to not engage with the thoughts as though they require some kind of resolution. We're not trying to solve things. We’re trying to live with questions, live with doubts and uncertainties.”
  — Dr. Patrick McGrath [04:38]

5. Practical Illustration: The 'Ceiling Collapse' Example

[05:10]
- Dr. McGrath shares an example of intrusive thoughts about the ceiling collapsing.
- Rumination: Obsessively seeking certainty (bracing the ceiling, drilling holes, etc.).
- Healthier response: Accepting the thought's presence, choosing inaction:
  
  “I’m going to do the rest of this thinking the ceiling might collapse on me, and I’m not going to do anything to try to think myself out of it or think about the way the ceiling’s constructed… I’m just going to let that be there.”
  — Dr. Patrick McGrath [05:22]
- Living with, not just sitting with:
  
  “Sometimes people say, 'sit with it.' I’m going to even do more than that. I’m going to live with it, right? I’m going to live with that being there, and learn that I can handle that.”
  — Dr. Patrick McGrath [06:08]

6. Learning to Tolerate Uncertainty

[06:30]
- Strengthening the skill of tolerating uncertainty helps reduce the power of obsessive rumination.
- Recognizing you can handle unresolved thoughts allows you to free energy for things that matter to you.

7. Getting Help

[07:00]
- Anyone struggling with rumination—or related OCD concerns—can seek expert help from NOCD therapists.
- NOCD offers a free 15-minute call to connect with care teams and assess how therapy may help.

Notable Quotes & Memorable Moments

On the futility of rumination:

“You never really feel satisfied because you don’t actually ever come up with an answer in those situations… There just seems to be more questions.”
— Dr. Patrick McGrath [01:49]
On allowing uncertainty:

“Rumination basically wants to know the outcome of something before it will even start… But rumination says, ‘No. We gotta know the consequences of this first before we make the decision.’ That’s impossible to do.”
— Dr. Patrick McGrath [02:38]
On creating space for real life:

“Once I know that I can handle it without having an answer, I can move on to do other things without having answers to those too, and I can be handling all sorts of things without having an absolute.”
— Dr. Patrick McGrath [06:25]

Timestamps of Key Segments

00:00-01:30 — Introduction, definition of rumination, and differentiation from productive thinking
01:30-03:12 — The experience of rumination and why it’s never satisfying
03:12-04:15 — Real-world examples of problem solving vs. rumination
04:15-05:10 — The goal: not stopping thoughts, but not engaging compulsively
05:10-06:30 — Practicing “living with uncertainty” using practical examples
07:00-end — Encouragement to seek help and NOCD resources

Episode Takeaways

Rumination in OCD is a trap of endless, unsatisfying thinking, not true problem solving.
The path forward involves learning to tolerate unanswered questions, allowing uncertainty, and disengaging from the urge for certainty.
Therapy and structured support can help people build these skills and reclaim their lives from OCD.

For support, visit NOCD.com or download the NOCD app for more resources and access to therapy services.

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Transcript1 lines

[00:00]
A
You may wonder if you're ruminating and you know, maybe there's this thing going on in your head and you're thinking through a problem and it can feel really useful. And yeah, you know, sometimes it is, I do it. Right. But then there's a point where it stops being useful and it starts to be rumination. And this is where a lot of people don't realize that they've kind of crossed a line. What do we think about rumination? It's this repetitive, excessive dwelling on negative thoughts, emotions or past experiences without ever coming to a resolution. Right. And rumination can feel like problem solving to people, but it never really gets anywhere. It's just continuing to think about thinking. And it's really important to know the difference. If you get to a point where you have a solution and you follow through on it. Excellent. Right. But if you're finding that it's harder and harder and harder and harder to get to those solutions and you're getting stuck replaying things, analyzing things, you're in what if loops all the time. And this feels more driven by fear and discomfort than it does by trying to figure something out. And there's a demand of an absolutely certain answer in this whole experience. And maybe there's just a little short term relief if you kind of hit a little nugget of something and. But then there's a what if? That follows that and then there's more doubts and there's more questions. I'd say you're stuck in rumination if that's the case. And you will probably recognize this if you've been stuck there. It's really hard to get out of it and you never really feel satisfied because you don't actually ever come up with an answer in those situations. There's just seems to be more questions versus a problem solving experiences which is focused, time limited. Your values are helping to guide that experience and it allows for some uncertainty in this situation. In the fact that sometimes things may be out of your control and there may not be an absolute answer, but it can at least help you lead to making a decision. And that decision could be, I'm going to do this, even though I don't know for sure that it's the absolutely best thing, but it seems to be better than all the other things. I'm going to go that route and see how it goes. Rumination basically wants to know the outcome of something before it will even start. This is very difficult. I would contend that you never know if something is a right or wrong choice. Until after you've made it and you can see what the consequences are. But rumination says no. We gotta know the consequences of this first before we make the decision that's impossible to do. So let's give some examples. If I still feel this way after the weekend, I'll call the doctor. Yeah, that could be good problem solving, right? But I'm going to read endlessly on Reddit all about threads to decide if my experience counts as serious. And I'm going to then go to the library and look up things. I'm going to go online and WebMD and I'm going to do all these things and I still don't quite have an answer. But hey, 75 more hours of research and I should be able to get there. Sounds more like a rumination type of experience, right? Our goal isn't to stop thoughts. That's not what we're trying to do. In fact, that could become a compulsion if you do thought stopping, right? Our goal is to not engage with the thoughts as though they require some kind of resolution. We're not trying to solve things. We're trying to live with questions, live with doubts and uncertainties, right? We can be in the moment without forcing the thought away. We can just allow something to be there. For example, I'm going to do the rest of this thinking the ceiling might collapse on me, and I'm not going to do anything to try to think myself out of it or think about the way the ceiling's constructed or anything like that. I'm just going to let that be there. Other people would be like, oh, no, what do I do? Well, let's get a brace out just in case it would. And let's do this, and maybe we drill a little hole in there with the camera just to make sure that everything looks okay. But oh no, what if I drill into it? And that's the thing that we consider that it does follow me. Ah, what do I do? There's no answer there, right? It's just more and more doubts and insecurities and uncertainties in that experience versus I'm going to be okay not knowing 100% the ceiling could collapse on me. It is a possibility. I'm going to live with that experience. Sometimes people say, sit with it. I'm going to even do more than that. I'm going to live with it, right? I'm going to live with that, being there, and learn that I can handle that. And once I know that I can handle it without having an answer, I can move on to do other things without having answers to those two, and I can be handling all sorts of things without having an absolute. If you want help with this, if this is a skill you would like to learn how to do, our therapist can help you with this skill. Check us out@nocd.com Download the NOCD app. Either way, you can get to requesting a meeting with our care team. We'll do a free 15 minute call with you so that you can chat with them and we'll review what's going on and if it seems appropriate, set you up with one of our finely trained therapists here at NOCD who can help you dealing with rumination and any other OCD or related conditions that might be going on. We look forward to hearing from you so that you can live the life you want to live and not the life that OCD wants you.