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Autism

How to Get Out of an Autistic Thought Loop

Why repetitive thinking, rumination, and worry can impact autistic people.

Key points

  • Perseverative cognition includes rumination, worry, and getting stuck on a topic or idea.
  • Perseverative cognition involves inflexible thinking—a characteristic of autism.
  • Rigid thinking is not necessarily bad, but rumination, worry, and repetitive thoughts can be harmful.
  • Applying self-care tools, developing awareness, and avoiding triggers can help reduce the harmful effects.

I recently experienced an intense episode of getting stuck in a thought loop. I was involved in a relatively minor situation, which was unresolved and causing me some annoyance. For about two days, I became completely stuck in thinking about what I wanted to say to the person responsible, repeating the same short sentence internally, hundreds of times.

I knew it made no logical sense, and the lack of sleep and stress it caused me was far worse than the issue itself. But I couldn't get out of the loop. When I tried to—by doing something distracting, talking about other things, or focusing on work—I was immediately pulled back into the exhausting, relentless, repetitive thought pattern.

I experience this sense of being stuck far less often than I used to, partly because I try to avoid getting involved in "messy" situations as much as possible and partly because I've gotten more skilled at deploying helpful management tools. But my recent experience reminded me how badly I used to be affected.

Perseverative cognition is a "rigid pattern that involves habitual engagement of circular, looping thoughts"1 and is more common in autistic people than in the general population.2 Perseverative cognition often involves rumination, worry, or becoming stuck on a topic or idea.

Source: Eddow Arunothai, Envato

What Impact Does Perseverative Cognition Have?

Perseverative cognition is not necessarily negative. Autistic people are renowned for being tenacious and seeing through ideas others might give up on.

When it falls into the "rumination" or "worry" camp, however, it can cause extreme stress and is linked to mental and physical health issues.

Why Does It Happen?

"Inhibitory control" refers to our ability to control our behaviours, attention, thoughts, and emotion. The prefrontal cortex is the more rational, reasoning part of the brain that filters out what is relevant and important in a given moment and is responsible for inhibitory control.3

In contrast, the limbic system can be considered our emotional brain centre. The "thinking" and "emotional" brains constantly "check in" with one another. For instance, if the emotional brain responds to an unexpected noise in a fearful manner, by checking in with the prefrontal cortex, it can be reassured that the situation is safe.

At this point, the emotional response—which might have included going into a fight, flight, or freeze state—subsides, and the mind and body start to return to normal. Any worrying and ruminative thoughts will be calmed, reduced, and even stopped altogether as the rational brain chooses what to focus on. Autistic people appear to display a poor connection between the rational and emotional brain regions,4 which means that the brain can remain in an emotional state for longer than usual.

Cognitive flexibility refers to our ability to switch between mental processes in order to form an appropriate response to situations.5 Cognitive inflexibility makes it difficult to switch in this way and is a feature of cognitive perseveration.6 Indeed, inflexible thinking is one aspect of the "restricted and repetitive behaviours" required for an autism diagnosis.7

To return to my recent experience, in addition to being stuck in an emotional state, I was also stuck on this repetitive thought and phrase. The more I repeated it to myself, the more anxious, angry, and distressed I became. And the more anxious, angry, and distressed I became, the less capacity I had to reason with myself.

What to Do About an Autistic Thought Loop

If you've experienced something similar, how can you help yourself? I suggest the following steps:

1. Identify what causes the worst loops.

If, like many people, you have a range of roles and responsibilities, it's impossible to avoid every potentially triggering situation that could lead to repetitive thought loops. What you can do, however, is identify the types of situations that are the worst culprits and make efforts to minimise or avoid certain situations.

This could be everything from avoiding social media in the evening, limiting contact with people who refuse to discuss things fully or respect your viewpoint, or limiting time in social situations which have led to incessant thought loops in the past.

2. Accept that the loop is related to how your mind works.

Loops are horrible to be caught up in. Understanding that they are caused because your mind is failing to receive the "calm down" messages that most other people get, and it cannot shift as quickly as most people, can help you worry a bit less about what you're going through.

3. Explore different ways of trying to break the loop.

What helps you get out of a thought loop? If you have someone who is prepared to listen in a supportive manner, talking—over and over if necessary—can be a way of moving through the loop.

If talking doesn't work for you, or you don't have someone to talk to in this way, writing things down can be helpful. Don't worry what comes out, even if it's the same thing repeatedly.

Distraction techniques can be helpful and doing anything, no matter how small, can help shift your attention. Mindfulness and meditation can also help people learn to stop engaging so much with their intrusive thoughts.

4. Explore a different loop.

Getting from a loop state to a calm, undirected state is often impossible. But not all loops are bad. Instead of ruminating on something that is causing a stress state, is it possible to shift your attention to a special interest? Is there something that can take your mind down a rabbit hole in a way that might be intense but isn't damaging to your health?

5. Look after your self-care needs.

Like many of my clients, I'm more likely to get caught up in a destructive loop when I'm tired, hungry or generally stressed. When I'm feeling generally well, it's less likely that a loop will floor me to the extent it did recently. Developing healthy emotional regulation is an ongoing process.

6. Avoid substance abuse.

People with level 1 autism are more at risk than the general population for substance abuse.8 Autistic people commonly use drugs and alcohol to fit in socially or cope with mental health issues.

Like many autistic people I talk with, I discovered early on that drinking heavily softened the thought loops or made me so inebriated I ended up in a blank state. But what starts off as a short-term solution leads to higher levels of anxiety and depression and weakens your resilience to staying stuck in destructive and unhelpful thought loops. It also means you are less likely to develop healthy coping mechanisms.

If your thought loops are preventing you from leading a fulfilled, happy life and are impacting your mental or physical health, it is worthwhile seeking support from a suitably qualified mental health professional. Find one near you in the Psychology Today Therapy Directory.

References

1. Ottiavani, C (2018) Brain-heart interaction in perseverative cognition. Psychophysiology, 55,7, https://doi.org/10.1111/psyp.13082

2. Clancy F, Prestwich A, Caperon L, O'Connor DB. Perseverative Cognition and Health Behaviors: A Systematic Review and Meta-Analysis. Front Hum Neurosci. 2016 Nov 8;10:534. doi: 10.3389/fnhum.2016.00534. PMID: 27877119; PMCID: PMC5099163.

3. (Barbas 2016). Barbas, H & Garcia-Cabezas, MA (2016) How the prefrontal executive got its stripes. Current Opinion in Neurobiology, 40, 125-134

4. Richney, JA, Damiano, CR, Sabatino, A, Rittenberg, A, Petty, C, Bizzell, J, Voyvodic, J, Heller, AS, Coffman, MC, Smoski, M, Davidson, RJ, Dichter, GS (2015) ‘Neural mechanisms of emotion regulation in Autism Spectrum Disorder’, Journal of Autism Developmental Disorder, 45(11), p3409-23

5. Dajani DR, Uddin LQ. Demystifying cognitive flexibility: Implications for clinical and developmental neuroscience. Trends Neurosci. 2015 Sep;38(9):571-8. doi: 10.1016/j.tins.2015.07.003. PMID: 26343956; PMCID: PMC5414037.

6 Ottiavani, C (2018) Brain-heart interaction in perseverative cognition. Psychophysiology, 55,7, https://doi.org/10.1111/psyp.13082

7. Hollander, E and Ferretti, CJ (2023) Special Report: Autism Spectrum Disorder and Inflexible Thinking—Affecting Patients Across the Lifespan, Psychiatric News, Published Online:23 Mar 2023https://doi.org/10.1176/appi.pn.2023.04.4.34

8. (Butwick 2017). Butwick, A, Langstrom, N, Larsson, H (2017) ‘Increased risk for substance use-related problems in autism spectrum disorders: a population based cohort study’, Journal of Autism and Developmental Disorders, 47(1), p80-89

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