David James Olney

18 September, 2026

What’s the difference between meditation and rumination? One can open the door to calm insight, while the other can lead us into a spiral that leaves us less able to deal with the world.

Both can involve sitting still and paying attention to what is going on inside us. Both can look like serious thinking. However, what matters is where that attention takes us, and whether we can bring it back.

I have just finished listening to Norman Swan’s new book, The Brain Cliff. It was equally enjoyable and interesting to listen to a book about maintaining a healthy brain that concentrated on what works, rather than all the things that can go wrong. Throughout the book, Swan introduces an inspiring cast of people in their nineties and beyond who are still lucid, engaged and engaging.

That is a much more attractive prospect than simply accumulating birthdays. I want to remain capable of doing things, learning things and contributing something useful to other people’s lives. Being alive at ninety would be good. Being interested in being alive at ninety would be considerably better.

Swan’s practical priorities include regular exercise, varied plant foods, less alcohol, attention to blood pressure and cholesterol, social connection, new learning, purposeful activity and better responses to stress. Leaving paid employment need not mean abandoning challenge or contribution. These themes emerge in his interview about the book.

A lot of this is within our power to incorporate into ordinary life, even if our circumstances make some changes easier than others. None of it is a guarantee. We can improve our chances without pretending to control every outcome.

However, it is not this list of useful things to do that I keep meditating on. The strongest message I took from the book concerns the relationship these elderly people have with adversity. Swan describes them succinctly: “They get over it. They problem-solve. They don’t ruminate.”

It is tempting to turn that observation into a recipe for healthy ageing. I think it is more useful to treat it as a question: what might we gain by learning to stop revisiting experiences in ways that make it harder to move forward?

When thinking stops helping

Rumination is more than excessive analysis or endless planning. In their influential paper Rethinking Rumination, Susan Nolen-Hoeksema, Blair Wisco and Sonja Lyubomirsky describe a response to distress in which people repeatedly dwell on their symptoms and their possible causes and consequences, without moving into effective problem-solving.

The distinction concerns the process as much as the subject. Remembering an argument, considering a mistake or feeling grief does not automatically mean we are ruminating. Here, I am using rumination to mean the unhelpful, repetitive brooding that keeps distress circulating.

Consider two ways of returning to an unpleasant conversation. In the first, I work out what upset me, acknowledge my part in what happened and decide whether I need to apologise, ask a question or establish a boundary. I might still feel unhappy, but something has become clearer.

In the second, I replay the conversation, rehearse the reply I should have made and construct increasingly elaborate explanations of why people always treat me badly. Tomorrow, I can begin the exercise again. I have spent considerable effort thinking, without giving myself a better way to act.

This is why meditation and rumination need to be distinguished by more than whether we are quiet. I use “meditating on” in the everyday sense of reflective consideration. Mindfulness meditation adds a more specific practice: noticing thoughts, feelings and sensations, and returning attention without having to pursue every thought. Neither requires us to feel calm immediately or to make our minds blank.

The useful question is whether our attention remains flexible. Can I learn something, feel what needs to be felt and return to what I am doing? Or does the same thought keep demanding another hearing without supplying any new evidence?

A loop that makes us less capable

There is a useful analogy here for anyone following the AI and human agency debate. In AI, recursive self-improvement means a system improving its own capabilities in ways that also increase its capacity to produce further improvements. Anthropic describes the prospect in terms of AI autonomously designing and developing its successor. The improved system can then contribute to another round of improvement.

The recursion is the feedback: the result of one round changes what the next round can achieve. This remains an ambition with substantial technical constraints, rather than an inevitable route to unlimited intelligence.

Borrowing the structure of that idea, I think we can describe destructive rumination as recursive self-enfeeblement. This is my metaphor, not a clinical diagnosis or a claim that human brains operate like language models.

An unpleasant experience produces distress. Repeatedly dwelling on it strengthens a threatening interpretation. That interpretation makes it harder to consider alternatives or take a useful step. The resulting sense of helplessness then becomes further material for the next round of brooding.

Each pass through the loop can reduce the resources available to interrupt the next one. We become less confident about acting, while giving ourselves more reasons to keep thinking. The machinery remains busy, but our freedom to do something useful contracts.

“Self” describes where the feedback occurs. It does not mean that people deliberately choose to weaken themselves. Someone struggling with depression, trauma, financial insecurity or persistent pain may have very good reasons to find disengagement difficult. Naming a pattern should help us change it, rather than give us another reason to blame the person caught in it.

The distinction I care about is between reflection that restores agency and repetition that consumes it. We do not need to turn ourselves into relentless improvement projects. Sometimes the useful outcome is simply being able to enjoy lunch without retrying yesterday’s argument.

The body participates in the conversation

In my own life, I have noticed that people who spend a lot of time ruminating often seem more anxious, find their emotions harder to regulate and struggle with more persistent health problems. That is an observation, not a study. It cannot tell me which problem came first, or what else might explain the pattern.

Nevertheless, there is research that gives us reason to take the observation seriously. Nolen-Hoeksema and her colleagues describe links between rumination, depression and anxiety, alongside impaired problem-solving and erosion of social support. Their account helps explain why being absorbed in distress can make it harder to do the things that might relieve it.

The effects are not confined to how we describe our mood. Psychologist Cristina Ottaviani’s research synthesis on perseverative thinking and the brain–heart relationship discusses evidence linking rumination and worry with increased heart rate, blood pressure and cortisol, and reduced heart rate variability. The underlying idea is that repeatedly representing a threat can keep a stress response active after the event itself has ended.

These are physiological associations and possible pathways, rather than proof that a particular thought causes a particular disease. Still, they make the familiar separation between mental and physical health look inadequate. The body participates in the conversation we are having with ourselves.

Present-moment awareness belongs in this discussion, but it needs careful handling. Remembering the past and imagining the future are useful human abilities. We would be in serious trouble without them. The difficulty is becoming trapped in a mode of thinking that we cannot readily leave when the present needs our attention.

In research developing a questionnaire about beliefs underlying pain rumination, Robert Schütze and colleagues found that negative beliefs about pain-related thinking were associated with lower mindfulness, greater distress and greater interference from pain. This supports investigating attention and pain together. It does not establish that insufficient mindfulness caused the pain.

There is also a plausible social cost. When my attention is repeatedly pulled into an internal dispute, I have less of it available for the person beside me. That is my interpretation of how the loop can spill into relationships, rather than a claim that every distracted person is becoming isolated. Separate longitudinal research on social relationships and health connects social integration and support with physical health indicators across the lifespan. Together, these findings make disconnection worth considering, while leaving the full causal chain unproven.

The connection to Swan’s subject is especially intriguing. A 2020 study led by Natalie Marchant associated repetitive negative thinking with subsequent cognitive decline and, in imaging samples, markers of Alzheimer’s pathology. This was observational research. It did not show that rumination causes dementia, or that stopping it prevents dementia. It gives researchers a worthwhile question, not worried readers a prediction about their future.

What my shoulder taught me

The question became personally interesting for a different reason. I experienced chronic pain in my left shoulder for more than a year. Comprehensive physical therapy did not resolve it. Having done a heap of reading to understand why, I now know considerably more than I expected to about the relationship between difficult emotions and persistent pain.

When I approached my sore shoulder as potentially involving emotional stress and learned pain responses, and began journaling, the pain disappeared after about a month.

That experience changed my life in a very practical way. It also changed what I was willing to investigate. However, the sequence does not prove exactly what caused the pain or why it stopped. My recovery is a reason to take the research seriously, rather than a substitute for it.

Based on the definition above, I do not recognise myself as someone habitually caught in rumination. I certainly do not regard rumination as an established explanation for my shoulder pain. My experience made me curious about how emotional processes and pain interact, including processes that differ from my own.

The pain literature commonly calls pain sustained by learned threat responses “neuroplastic pain”. The related clinical term “nociplastic pain” refers to altered pain processing without clear evidence that tissue damage or a lesion of the sensory nervous system explains it. The International Association for the Study of Pain also recognises that different pain mechanisms can coexist.

These terms are related, but not interchangeable explanations for everything that hurts. Nociplastic pain does not, by definition, mean suppressed emotion caused it. Nor does an unsuccessful course of physical therapy establish an emotional cause. A proper assessment still matters.

Within that more careful understanding, rumination becomes a credible part of the picture. A review by Randy and Lori Sansone describes associations between rumination, greater pain and poorer outcomes. Much of the research uses the Pain Catastrophizing Scale, which assesses rumination alongside helplessness and magnification. Thinking repeatedly about pain is therefore already an established research subject, although that is not identical to brooding about every aspect of life.

I would frame the possible loop this way: pain captures attention; attention becomes fearful monitoring; fearful monitoring makes pain more threatening; and the threat makes it harder to disengage. Disrupted activity and relationships may give the loop further material. Pain can start this process as well as be amplified by it.

We therefore need to resist turning an association into a label for sufferers. Chronic pain does not tell us what sort of person someone is. Equally, rumination does not explain chronic illness as a whole. The defensible concern is that, for some people, these difficulties may reinforce one another and deserve to be treated together.

Learning a different response to pain

Howard Schubiner, author of Unlearn Your Pain: The Science of Recovering from Chronic Pain, Fatigue, Anxiety, and Depression, has helped turn this possibility into a programme of clinical research. His work asks whether some persistent pain can improve when people change learned responses to threat and address emotional conflicts that help sustain them.

With psychologist Mark Lumley and other collaborators, he has developed and studied emotional awareness and expression therapy. Their account of the approach combines education about pain with recognising and expressing difficult emotions, processing stressful experiences and changing problematic relationships. The proposal is that, for suitable patients, this can help alter processes maintaining pain.

It is an approach that makes room for anger, sadness and fear. Being endlessly positive is not the assignment. Recognising an emotion and responding constructively to it may be more useful than either avoiding it or repeatedly analysing why we should not feel it.

The evidence includes a randomised trial led by Yoni Ashar, with Schubiner among the authors. It studied 151 adults with primary chronic back pain. After four weeks, 66 per cent of those assigned to pain reprocessing therapy reported being pain-free or nearly pain-free, compared with 20 per cent in an open-label placebo group and 10 per cent receiving usual care. Benefits were largely maintained at one year.

Pain reprocessing therapy helps patients reinterpret appropriately assessed pain sensations as less threatening. Those results are substantial, but they concern a selected back-pain population and a particular treatment. They do not establish that every chronic pain condition is reversible through thinking differently, or that rumination caused the participants’ pain.

A 2024 trial led by Brandon Yarns provides complementary evidence. Among 126 older veterans with chronic musculoskeletal pain, 63 per cent receiving emotional awareness and expression therapy achieved at least a 30 per cent reduction in pain after treatment, compared with 17 per cent receiving cognitive behavioural therapy. The study used an approach developed by Lumley and Schubiner. Its predominantly male veteran sample also limits how confidently we can generalise.

These treatments overlap, but they are not the same. One concentrates on changing the perceived threat of pain; the other gives particular attention to emotional experience and expression. Their success supports investigating several routes into persistent pain, rather than declaring that one psychological mechanism explains them all.

It also helps explain why the work of Nicole J. Sachs interested me. Sachs is a psychotherapist whose teaching grew from her own experience of chronic pain. In her account of that experience, she describes receiving a degenerative spinal diagnosis at nineteen and being warned that her future would be severely restricted, including the possibility of having children. She later became pain-free after encountering John Sarno’s work, went on to have three children, and incorporated these ideas into her practice.

Her method, JournalSpeak, uses private expressive writing to give difficult or unacceptable feelings somewhere to go. In an interview with Jordan Harbinger, she describes writing for twenty minutes and then throwing the writing away. It is not intended to become an archive of grievances to reread and rehearse. Her teaching also includes settling afterwards and responding to oneself with compassion.

There is a useful distinction here between giving a feeling expression and giving it unlimited editorial control. Writing can allow us to acknowledge something painful and return to life. If it simply becomes another way of rehearsing the same accusation, the fact that we have bought a notebook does not make it therapeutic.

Sachs’s explanation is that expressing previously avoided emotions can help reduce a nervous system’s sense of threat. That is her therapeutic model. Evidence for related psychological treatments should not be presented as proof of every claim made for JournalSpeak, or as a guarantee that her specific method will work for everyone. Clinical experience and personal recovery stories can generate valuable questions; controlled trials must test them.

This distinction does not diminish what happened to my shoulder. It makes it possible to describe my experience honestly without promising another person the same result.

Returning to the life in front of us

The research question I would like pursued is therefore more precise than whether rumination and chronic pain occur together. We already have evidence that they do. We need to know when rumination helps maintain pain, when pain drives rumination, which other conditions sustain both, and who benefits when treatment specifically interrupts that relationship.

Researchers could measure pain-related rumination separately from general brooding, track changes over time, and test whether reductions in rumination precede improvements in pain and function. Sleep, mood, physical disease, treatment and social circumstances would all need attention. A treatment helping pain does not, by itself, identify why it helped.

What would change my mind? If better studies found that rumination mainly followed pain, rather than helping maintain it, I would need to narrow my argument. If interventions reduced rumination without improving pain, that would weaken the proposed treatment pathway. Both findings would still leave good reasons to relieve the distress of rumination itself.

Meanwhile, there is a practical question we can ask without waiting for every mechanism to be settled: is the way I am thinking helping me to understand, respond or reconnect?

If it is, continue. If it is not, another hour of the same thinking may be a poor investment. A concrete question, a manageable action, a conversation or a deliberate return to the activity in front of us may offer a different direction. When the pattern is entrenched, appropriate psychological support can help develop that flexibility. Getting help is itself an exercise of agency.

I began with the thought that rumination should be avoided at all costs. Having meditated on it, I think that wording asks for trouble. Becoming frightened of our own thoughts could supply yet another subject to ruminate about. We need to learn to recognise and loosen the loop, while allowing ourselves to have difficult feelings.

That is what makes Swan’s book such a useful starting point. Thinking about being lucid and capable at ninety opens a door to asking how we want to live now. The task is to cultivate habits that leave us more available to experience, to other people and to constructive action.

Reflecting on yesterday is valuable when it helps us move forward. Recursive self-improvement is an interesting analogy for that possibility. Recursive self-enfeeblement names the danger of repeatedly reducing our own room to move. Neither metaphor should become a verdict on someone living with pain or illness.

The relationship between rumination, persistent pain and long-term health remains a work in progress. It deserves research that is both ambitious and careful, and care that takes the whole person seriously. In the meantime, we can practise returning from the argument in our heads to the life in front of us.

I would like to be engaged and engaging at ninety. Paying attention to what helps me do that today seems a reasonable place to begin.