When a question gets answered and comes straight back
Overthinking is the everyday word for going over the same thing without getting any further: a conversation, a decision, something that might go wrong. Carolina Vintu, PhD, Registered Psychotherapist, names persistent worry and overthinking among the concerns she works with, in adults and adolescents.
Sessions are one to one by secure video, wherever you are in Ontario, in English, Russian or Romanian.
Someone can seem calm at work all day and still be going over one email at midnight.
Where is your thinking pointing?
One word covers three habits. They feel alike from the inside, and it helps to know which one you're in. Researchers write about the first two as related habits with separate names.
Behind you
"Why did I say that in the meeting?"
Usually called rumination. You go back over what happened and what it might mean about you.
Ahead of you
"What if they don't renew my contract?"
Usually called worry. You run through what could go wrong, then run through it again.
Round one choice
"Should I take the job? One more list."
More lists and more opinions, and the choice stays open. Our article on overthinking decisions looks at this one closely.
How one small thought climbs in an evening
This evening is made up and describes nobody in particular. Look at what changes from step to step, and what doesn't.
- 9:40 pm"My manager hasn't answered my email."
- 10:15 pm"Maybe the report had a mistake in it."
- 11:00 pmReads the report twice and finds nothing. "I could have missed it."
- 12:20 am"They've probably noticed I'm not up to this job."
- 1:30 am"Should I start looking for something else?"
At 1:30 the email still has no answer, and the facts are the ones from 9:40. Only the size of the question has grown. Therapy can work on the climb: where it starts for you, and what you do on each step.
Thinking it through, or going round again?
Careful thinking is useful and nobody has to give it up. A 2008 review of the research separates rumination from more useful kinds of self-reflection, and reports evidence that rumination gets in the way of solving problems. A few questions can show you which one you're in right now:
Do I know something I didn't know ten minutes ago?
Is there a step I could take tomorrow?
Would more thinking change what I do?
Am I after an answer, or after the feeling of being sure?
These are prompts for noticing. They aren't a test, and they can't tell you what's going on for you.
What four methods do with a repeating thought
Check it like a prediction
Cognitive behavioural therapy treats "they've noticed I'm not up to this" as a forecast. You write down what you expect, then compare it with what happens.
Step back from it
Acceptance and commitment therapy spends less time on whether the thought is true. You practise holding it at a distance and choose your next move by what matters to you.
Catch the moment you drift
Mindfulness-based cognitive therapy trains you to notice when attention has slid back to the thought, and to bring it to your breath or body, with regular practice between sessions.
Ask what the checking is for
Internal Family Systems treats the side of you that keeps checking as a part with a job. You ask what it's trying to protect you from, and listen before changing anything.
What researchers measured when they aimed at this habit
Topper and colleagues, 2017: 251 adolescents and young adults with high levels of worry and rumination took a six-week cognitive behavioural training, in a group or online, or went on a waiting list. These are the shares who had each condition 12 months later.
Generalized anxiety disorder
Depression
Watkins and colleagues, 2011: 42 people with persistent depression were randomly given their usual care, either alone or with up to 12 individual sessions of CBT aimed at rumination. Adding the sessions improved remaining symptoms and remission rates. There was no comparison therapy, so the authors can't say how much came from this particular content.
Querstret and Cropley, 2013: a review of 19 studies found that mindfulness-based and cognitive behavioural work may reduce both rumination and worry, delivered online or face to face.
The six-week training was a course for young people, not one-to-one video sessions, and no figure here predicts one person's result.
Starting with a 15-minute call
The first step is a free 15-minute consultation. You don't need a referral. You can say what keeps going round, ask your questions, and then decide about a first session.
An individual session is $180 for the standard 50 minutes, and you get a detailed receipt to send to your insurer, as the FAQ explains. Carolina has more than 17 years of experience and her approach is integrative, so sessions can draw on more than one method.
If something else sits beside the overthinking, the pages on anxiety, low mood, burnout and self-esteem say how she works with those.
Questions people ask about overthinking
No, it's an everyday word. A 2013 review describes rumination and worry as key parts of depression and anxiety, so it can sit beside them. You don't need a name for it to book.
Seeing a habit and changing it are separate jobs. Sessions look at when yours starts, what it seems to do for you, and what you could try differently in the coming week.
Yes. Sleep disturbances are on Carolina's list of concerns, so the nights can be part of what you talk about. Poor sleep can also have a medical cause, and a family doctor is the place to check that.
Yes. The pages on therapy in Russian and therapy in Romanian explain how those sessions work.
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