Think Less Live More
Live More Think Less

Think Less Live More

Metacognitive therapist offers techniques and exercises for avoiding rumination that can spur depression.

The Hazard of Overthinking

While the severity of depression varies, it is associated with overthinking. Pia Callesen, a therapist and a specialist in metacognitive therapy, explains this approach to overcoming excess rumination – that is, destructive and entrapping overthinking. She also offers practical exercises to help readers recognize and manage “trigger thoughts” that can lead to symptoms of depression. While getAbstract does not offer medical advice, Callesen’s ideas could be helpful for those who find themselves overthinking their problems.

This form of therapy is based on doing less, not more, with your thoughts and feelings.Pia Callesen

Metacognitive therapy maintains that depression stems from an attention-related condition – “cognitive attentional syndrome” (CAS). The amount of attention people give to thoughts about problems and life crises, Callesen explains, can determine whether they become depressed.

Rumination means thinking about something over and over. Typical rumination involves stewing about what’s wrong, why life is difficult and how to fix your problems. Worrying is common, but excessively dwelling on specific thoughts, such as imagining worst-case scenarios or fixating on certain concerns, can contribute to anxiety and depression. Monitoring your moods too closely also can lead to stress and depressive symptoms.

Metacognitive therapy can enable depressed people to find peace of mind and escape the belief that they live at the whim of their ruminations. Callesen offers methods to help people allow their emotions to regulate themselves, just as people breathe best when they don’t think about breathing.

For example, if a person doesn’t address and divert such thoughts as “Why am I so sad?” or “I’m not good at anything” when they first appear, they can lead to extensive rumination and potentially contribute to depressive symptoms. Instead, metacognitive therapy teaches ways to identify and address trigger thoughts before they become overwhelming.

For example, you may notice that a thought has persisted, led you into a chain of similar thoughts and altered your mood into a depressive state. Noticing when you start ruminating can help you stop.To handle triggering thoughts, set aside a specific limited time for rumination.Notice your thoughts while not letting them affect your emotions or actions. Not every thought demands your attention, Callesen emphasizes. Practice detaching from rumination and recognizing unhelpful thoughts. 

Taking Action

People who suffer from depression often put their lives on hold, believing that any step forward might lead to more negative thoughts and anxiety.

To address this problem proactively, Callesen details how people can learn to take necessary action even if they feel unmotivated. First, compile a list of tasks you must accomplish even if you don’t want to do them. From getting out of bed and eating to engaging in social interactions and pursuing your goals, fulfilling your obligations can help you create structured routines regardless of your mood or mind-set.

You can in fact be happy and cheerful while at the same time having doubts lurking in the background.Pia Callesen

Learning to embrace a decision even if you don’t feel 100% confident about your choice is a crucial step in metacognition. You may always feel somewhat ambiguous about the factors in a decision, yet you must decide in order to keep moving forward.

Callesen recommends setting a specific time frame – for instance, three months – for engaging in analysis of an upcoming major choice, limiting your thought period about this issue to only one hour daily.Spend that hour, and no more, each day analyzing and observing these thoughts, while consciously letting them come and go.After this period of time, make a decision that prompts you to act. Employ detached mindfulness about any lingering doubts or trigger thoughts.


Medical professionals often address depression with antidepressants, but the effectiveness of these medications varies from patient to patient. Certain medications work for some people, but, depending on the individual and the prescription, medications may not suppress everyone’s depressive symptoms. Some medications carry a risk of relapse and generate negative side effects, such as decreased libido.

Medications produce a noticeable reduction in depressive symptoms for about 50% of patients. However, Callesen says patients should not discontinue any medication without a doctor’s supervision and warns that some patients face an increased risk of suicidal thoughts when they discontinue antidepressants. Other people may experience worsened symptoms or persistent rumination, despite medication. For mild or moderate depression, considering alternatives to medication is an option.

Medication seemingly enforces the problematic idea that a lack of serotonin is the only cause of depression. But depression also is closely associated with rumination and other toxic thought patterns. Building discipline over your thoughts is more difficult than taking medication alone, but it offers long-range benefits.

As you learn to control your reactions to your thoughts and decrease rumination, your levels of depression should improve. Often, disciplining your mind involves keeping busy, so try to actively redirect your thoughts to engage in meaningful activities.

Ruminating keeps you dwelling in the past or dreading the future. When you become caught up in rumination, you are never fully present and may avoid the daily activities of life. Over time, depression can set in, and time can pass you by.

Thoughts don’t matter, but your response to them does. Professor Adrian Wells

Instead of avoiding life, actively practice dealing with its challenges. As you gain experience in managing trigger thoughts, your belief in your control over your life and thoughts will increase.


Callesen insightfully highlights the connection between thoughts and emotions as she explains strategies people can embrace to cultivate a more balanced mind-set. Her work derives from cognitive therapy, which many people have found effective for dealing with depression. As a practitioner, Callesen writes with an academic precision that proves welcome throughout the book. She avoids breathless self-help prose, exhortations to the reader and cliches. Callesen lays out a specific set of – for many readers, recognizable – problems, and then offers workable solutions in chronological order. Metacognition, she writes, can help people escape cycles of incessant thinking and regain peace of mind. Readers with no experience of cognitive therapy or those who feel trapped by their thoughts may find Callesen’s approach effective and easy to embrace, though the author probably would be the first to recommend getting professional medical attention if needed.

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