What is Perseveration and How to Get ‘Unstuck’ When Perseverating on Something

Inside: Learn what perseveration is, what causes it and how to get unstuck if you are perseverating on something. Plus IEP goals if a child perseverates and it’s interfering with school.

Perseveration is a term used in psychology to describe the tendency to repeat a particular behavior or response even when it is no longer appropriate or necessary. This behavior is often associated with various neurological disorders, such as autism, ADHD, and traumatic brain injury.

Perseveration can manifest in a variety of ways, including repeating words or phrases, engaging in repetitive movements, or fixating on particular objects or topics.

As someone who has worked with many IEP students for over a decade, I have seen firsthand the impact that this can have on a child at school.

While some level of repetition is normal and even necessary for learning and development, excessive perseveration can interfere with daily functioning and social interactions.

In some cases, it can also lead to anxiety, depression, and other mental health issues. It often leads to social ostracization. I’ve seen kids who are truly stuck on something and cannot get out of the thought pattern. But, because their behavior was disruptive, they were disciplined rather than helped.

Understanding the underlying causes and effective interventions for repetitive behaviors is crucial for improving the quality of life for those affected by this behavior.

1. Perseveration Definition

Perseveration is a cognitive phenomenon where an individual continues to repeat a behavior or a response even when it is no longer appropriate or necessary. As someone who has studied psychology for several years, I have come to understand that perseveration can be a symptom of several neurological and psychiatric disorders, such as autism, traumatic brain injury, and obsessive-compulsive disorder.

Perseveration can manifest in different ways, such as repeating words or phrases, performing the same action repeatedly, or fixating on a particular thought or idea. In some cases, it can interfere with an individual’s ability to learn new information or adapt to changing situations.

One example of perseveration is echolalia, a behavior commonly observed in individuals with autism. Echolalia is the repetition of words or phrases spoken by others, and it can occur immediately after hearing them or after a delay.

While it may seem odd to someone unfamiliar with this behavior, echolalia can serve as a form of communication for individuals with autism.

Another example of perseveration is compulsive checking, a behavior commonly observed in individuals with obsessive-compulsive disorder.

Compulsive checking involves repeatedly checking if a door is locked, if the stove is turned off, or if a particular item is in its place. While this behavior may provide temporary relief from anxiety, it can become time-consuming and interfere with an individual’s daily life.

In conclusion, perseveration is a complex cognitive phenomenon that can manifest in different ways.

It is important to understand that perseveration can be a symptom of several neurological and psychiatric disorders, and that it can interfere with an individual’s ability to learn new information or adapt to changing situations.

2. Three Types of Perseveration

Mental health experts often classify perseveration into 3 types.

The three categories of perseveration are:

• (1) repetition of a previous response to a subsequent stimulus (recurrent)
• (2) inappropriate maintenance of a category of activity (stuck-in-set)
• (3) abnormal prolongation of a current activity (continuous)

If your child’s perseveration is interfering with school or daily living, the 3 categories of perseveration may not matter to you. However, pinpointing which one your child is doing the most, may help a clinician with a treatment strategy.

3. Causes of Perseveration

Perseveration is a behavior that can be observed in individuals with various neurological and psychological conditions.

One possible cause of perseveration is damage to the frontal lobes of the brain. The frontal lobes are responsible for executive functioning, which includes the ability to plan, organize, and shift attention from one task to another. When the frontal lobes are damaged, individuals may struggle with these tasks and become stuck on a particular behavior or idea, leading to perseveration.

Another potential cause of perseveration is anxiety or stress. When individuals are anxious or stressed, they may become fixated on a particular thought or behavior as a way to cope with their emotions. This can lead to perseveration, as they continue to focus on the same thought or behavior even when it is no longer productive or necessary.

Additionally, individuals with certain psychological conditions, such as obsessive-compulsive disorder (OCD), may experience perseveration as a symptom of their condition. In OCD, individuals may become fixated on a particular thought or behavior and feel compelled to repeat it over and over again, leading to perseveration.

It is important to note that there may be other causes of perseveration as well, and that each individual’s experience may be unique. However, by understanding some of the potential causes of perseveration, we can begin to develop strategies to help individuals manage this behavior and improve their quality of life.

4. Is Perseveration only for Autism?

As someone who has studied and worked with individuals with autism, I have often heard the term “perseveration” used to describe a common behavior in this population. Perseveration is defined as the repetition of a particular response or behavior, despite the absence or cessation of a stimulus or reward.

However, it is important to note that perseveration is not exclusive to individuals with autism. And, you would need to visit a professional to determine if the behavior is perseveration, or just a hyperfixation. Sometimes the two terms are used interchangeably, but generally a hyperfixation is thought of as easier to overcome or resolve on its own.

A person who has hyperfixations may find that the object of their hyperinterest is no longer of interest to them after a certain amount of time. Perseveration often requires thoughtful interventions for the person to move on.

5. Example of Perseveration

Here is an example of perseveration. Or, not an example, as the case may be.

My son’s hyperinterest or hyperfixation is Sesame Street. He loves the show, and watches the show and reads the books frequently. However, he will watch other shows and he has no problem switching gears to eat or do other things.

If someone is perseverating on Sesame Street, they usually would refuse to watch or read anything else. They may reach a point of compulsivity where doing something Sesame Street would interfere with bathing or eating. In public, the person is unable to talk about anything besides Sesame Street.

Perseveration can also be observed in typically developing individuals, such as when someone gets stuck on a particular thought or idea and has difficulty moving on.

While perseveration is often associated with autism, it is not exclusive to this population. Perseveration can be observed in individuals with a variety of conditions and in typically developing individuals as well.

It is important to understand that perseveration is a complex behavior and may have different underlying causes depending on the individual and their specific circumstances.

6. Perseveration and ADHD

Perseveration is the tendency to get stuck on a thought, behavior, or activity, and have difficulty shifting attention to something else. It’s a common symptom of ADHD, and it can be frustrating and exhausting.

One example of perseveration in ADHD is hyperfocus. Hyperfocus is the ability to focus intensely on a task or activity that is interesting or stimulating, often to the point of losing track of time. While hyperfocus can be a valuable asset in certain situations, it can also be a hindrance when it interferes with our ability to switch tasks or prioritize our responsibilities.

Another example this in conjunction with ADHD is rumination. Rumination is the tendency to dwell on negative thoughts or experiences, and to have difficulty letting them go. This can lead to feelings of anxiety, depression, and low self-esteem, and can interfere with our ability to enjoy life and pursue our goals.

This behavior in ADHD can also manifest as difficulty with transitions. A person may struggle to shift their attention from one task to another, or to adapt to changes in the environment or routine. This can be especially challenging in social situations, where they may have difficulty following social cues or adjusting to new social norms.

7. Symptoms of Perseveration

Here are a few common symptoms of this sometimes disruptive thought loop.

• Repetitive behavior: When fixating, a person will repeat the same action or thought over and over again. For example, they might keep checking my email even though they know there are no new messages.
• Inability to switch tasks: Another symptom of stuck repetitive behaviors is an inability to switch tasks. They might get stuck on one task and have a hard time moving on to the next one.
• Difficulty with decision-making: Making decisions can be challenging for someone who is experiencing perseveration. I might get stuck on one option and have a hard time considering other possibilities.
• Rigid thinking: This behavior can also cause someone to have rigid thinking. I might have a hard time considering alternative viewpoints or ideas that differ from my own.
• Fixation on details: When a person is stuck in a loop, they tend to focus on small details rather than the big picture. This can make it difficult to see the overall goal or objective.
• Difficulty with social interactions: Finally, perseveration can make it challenging to engage in social interactions. I might get stuck on one topic and have a hard time shifting the conversation to something else.

Overall, the symptoms of perseveration can be challenging to deal with. However, with the right treatment and support, it is possible to manage this condition and improve one’s quality of life.

8. Diagnosis of Perseveration

As I delve into the topic of perseveration, it’s important to understand how it is diagnosed. Perseveration is a symptom of various neurological and psychiatric conditions, and it can be challenging to diagnose.

The diagnosis of perseveration typically involves a thorough evaluation of the patient’s medical and psychiatric history, as well as a physical examination. The doctor may also perform various tests to assess cognitive and motor function, such as the Mini-Mental State Examination (MMSE) or the Wisconsin Card Sorting Test (WCST).

In addition to these tests, the doctor may also use imaging studies, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, to look for any structural abnormalities in the brain that may be causing the perseveration.

It’s important to note that ruminating behavior can sometimes be misdiagnosed as other conditions, such as obsessive-compulsive disorder (OCD) or attention-deficit/hyperactivity disorder (ADHD). Therefore, a proper diagnosis is crucial in ensuring that the patient receives the appropriate treatment.

The diagnosis of perseveration requires a comprehensive evaluation of the patient’s medical and psychiatric history, physical examination, and various tests. It’s important for healthcare professionals to be aware of this symptom and its various causes to ensure accurate diagnosis and treatment.

9. Treatment for Perseveration

There are several options for working with persevation and trying to get unstuck.

For example, a combination of cognitive-behavioral therapy (CBT) and occupational therapy (OT) techniques can help them manage their symptoms.

CBT can be helpful in addressing the negative thought patterns that often underlie these behaviors.

OT techniques can also be useful in treating perseveration. They can develop strategies for managing their environment and routines in a way that minimizes triggers for perseverative behavior.

For example, they might work together to create a structured schedule that includes plenty of breaks and opportunities for relaxation, or they might identify specific physical cues that can help the person recognize when they are starting to perseverate and take steps to interrupt the cycle.

In addition to these techniques, there are also a number of other treatments that may be helpful for individuals with perseveration. These might include medication to manage underlying anxiety or depression, mindfulness-based practices to help clients stay present and focused, or even alternative therapies like acupuncture or massage.

Ultimately, the best treatment for perseveration will depend on the individual person and their specific needs and goals.

10. How Can You Stop Perseverating on Something?

WhenyouI find yourself perseverating on something, it can be challenging to break out of that cycle of repetitive thinking.

However, there are some strategies that can be helpful:

1. Identify triggers: Try to pay attention to what triggers the rumination. For example, if I find myself perseverating on a mistake I made at work, I might try to identify what specifically triggered that thought. Was it a conversation with a coworker? Seeing a particular email? Once I identify the trigger, I can try to avoid or minimize it in the future.
2. Set aside time to worry: If you give yourself a specific time to worry or think about something, it can help break out of the cycle of repetitive thinking. For example, I might set aside 10 minutes in the morning to think about a problem I’m facing, and then try to move on with my day.
3. Practice mindfulness: Mindfulness meditation can be a helpful tool for breaking out of perseveration.
4. Engage in a distracting activity: Sometimes, the best way to break out of perseveration is to engage in a distracting activity. This could be anything from going for a walk to watching a movie to doing a puzzle. The key is to find something that requires enough mental engagement to take your mind off of whatever you’re perseverating on.

Overall, breaking out of perseveration can be challenging, but with practice and patience, it is possible to break the cycle of repetitive thinking.

11. IEP Goals for Perseveration and Perseverating Behaviors

Individualized Education Program (IEP) goals for perseveration, or repetitive behaviors, should focus on promoting flexibility, reducing rigidity, and developing alternative strategies. Here are some examples of IEP goals that address perseveration:

1. Goal: [Student’s Name] will demonstrate improved flexibility by engaging in a variety of activities without perseverating on a specific topic or object for more than [specified duration] in [specified number of instances].
2. Goal: [Student’s Name] will develop self-monitoring skills to recognize when perseveration occurs and will implement at least two strategies to redirect their attention or shift focus in [specified number of instances].
3. Goal: [Student’s Name] will demonstrate improved social interactions by initiating and maintaining conversations with peers or adults without perseverating on a single topic for more than [specified duration] in [specified number of instances].
4. Goal: [Student’s Name] will utilize visual or verbal cues provided by the teacher or peer to assist in transitioning away from perseveration and towards a new task or activity in [specified number of instances].
5. Goal: [Student’s Name] will engage in flexible thinking by generating at least two alternative solutions or ideas when faced with a situation that triggers perseveration in [specified number of instances].
6. Goal: [Student’s Name] will practice self-regulation strategies (e.g., deep breathing, taking a break, using a sensory tool) to manage anxiety or stress associated with perseveration, reducing the occurrence of repetitive behaviors by [specified percentage] in [specified duration].
7. Goal: [Student’s Name] will participate in therapeutic interventions or strategies (e.g., cognitive-behavioral therapy, social skills training) to develop coping mechanisms and reduce perseveration behaviors in [specified number of instances].

12. Living with Perseveration

Perseveration can be a challenging condition to live with. Here are some ways that perseveration has impacted me:

• Difficulty with transitions: These folks often struggle with transitioning from one task to another. Once they focused on something, it can be hard to switch gears and move on to something else. This can be especially challenging in a work or school setting, where a child may need to switch between tasks frequently.
• Repetitive behaviors: Perseveration can also lead to repetitive behaviors. For example, you may find yourself tapping a foot or repeating a certain phrase over and over again. These behaviors can be distracting to others and socially ostracizing.
• Social challenges: Perseveration can also impact my social interactions. They may have a tendency to talk about the same topic over and over again, which can be off-putting to others. They may also struggle with picking up on social cues and may miss important nonverbal cues from others.

Despite these challenges, there are strategies that are helpful in managing perseveration.

Here are a few that have worked for my clients:

• Creating a routine: Having a set routine can be helpful in managing perseveration. By knowing what to expect each day, the child is less likely to get stuck on one particular task or behavior.
• Taking breaks: When we see a child getting stuck on a particular task or behavior, taking a break can be helpful. Going for a walk or doing something else to clear the mind can help them come back to the task with a fresh perspective. (like a brain break or sensory break)
• Peer Groups: It can also be helpful to seek support from others who understand what you am going through. Whether it’s through a support group or talking to a friend who also experiences perseveration, having someone to talk to can make a big difference. Most schools will tell you that they cannot do this due to “privacy issues.” You’ll have to decide if you want to pursue this anyway, or look for such a group outside of the school setting.

Living with perseveration can be challenging, but with the right strategies and support, it is possible to manage the condition and live a fulfilling life.