Alternative hypotheses

Compare mechanisms

Compare function, sequence, patient language, and treatment leverage. The aim is not to choose a label—it is to identify which hypothesis best explains this person’s pattern.

Ask this

Which pattern better explains the sequence, protective function, and consequences: rumination or perfectionism?

Rumination

Rumination may feel like problem-solving but often maintains low mood, shame, threat, and cognitive inflexibility.

CognitionAffectBehaviour

Perfectionism

Perfectionism can drive achievement but may maintain anxiety, depression, shame, procrastination, avoidance, and burnout.

CognitionBehaviourAffect+1

Definition

ARepetitive, passive, negatively toned thinking about distress, causes, meanings, or consequences.

BA rigid pattern of setting excessively high standards and linking worth, safety, or acceptability to flawless performance.

Core process

AAttention becomes repeatedly captured by unresolved negative meanings without moving into effective action or new learning.

BConditional self-worth and threat appraisal attach high emotional cost to mistakes, uncertainty, or ordinary limitation.

Look for

ALong repetitive analysis · Difficulty shifting attention

BAll-or-nothing standards · Difficulty finishing

Patient language

A“I keep going over it”

B“If it is not perfect, it is a failure”

Maintaining cycle

ANegative event -> repetitive analysis -> mood worsens -> more negative material becomes salient

BHigh standard -> threat of mistake -> overcontrol or avoidance -> temporary relief -> standard remains rigid

Treatment leverage

AMove from repetitive analysis to values-based action or specific problem-solving.

BReduce the link between worth and flawless performance.

Check before using

AThe person is doing concrete planning that leads to action.

BHigh standards are flexible, values-based, and not associated with significant distress or impairment.

Formulation language

Rumination appears to keep the patient caught in repeated negative meaning-making, worsening mood and reducing behavioural movement.

Open full guide

Formulation language

Perfectionism appears to protect against shame through high control, but it increases self-criticism and avoidance when standards cannot be met.

Open full guide

Browse the map Use both hypotheses

Alternative hypotheses

Compare mechanisms

Compare function, sequence, patient language, and treatment leverage. The aim is not to choose a label—it is to identify which hypothesis best explains this person’s pattern.

Ask this

Which pattern better explains the sequence, protective function, and consequences: rumination or perfectionism?

Rumination

Rumination may feel like problem-solving but often maintains low mood, shame, threat, and cognitive inflexibility.

CognitionAffectBehaviour

Perfectionism

Perfectionism can drive achievement but may maintain anxiety, depression, shame, procrastination, avoidance, and burnout.

CognitionBehaviourAffect+1

Definition

ARepetitive, passive, negatively toned thinking about distress, causes, meanings, or consequences.

BA rigid pattern of setting excessively high standards and linking worth, safety, or acceptability to flawless performance.

Core process

AAttention becomes repeatedly captured by unresolved negative meanings without moving into effective action or new learning.

BConditional self-worth and threat appraisal attach high emotional cost to mistakes, uncertainty, or ordinary limitation.

Look for

ALong repetitive analysis · Difficulty shifting attention

BAll-or-nothing standards · Difficulty finishing

Patient language

A“I keep going over it”

B“If it is not perfect, it is a failure”

Maintaining cycle

ANegative event -> repetitive analysis -> mood worsens -> more negative material becomes salient

BHigh standard -> threat of mistake -> overcontrol or avoidance -> temporary relief -> standard remains rigid

Treatment leverage

AMove from repetitive analysis to values-based action or specific problem-solving.

BReduce the link between worth and flawless performance.

Check before using

AThe person is doing concrete planning that leads to action.

BHigh standards are flexible, values-based, and not associated with significant distress or impairment.

Formulation language

Rumination appears to keep the patient caught in repeated negative meaning-making, worsening mood and reducing behavioural movement.

Open full guide

Formulation language

Perfectionism appears to protect against shame through high control, but it increases self-criticism and avoidance when standards cannot be met.

Open full guide

Browse the map Use both hypotheses