Treatment recommendations for perseveration depend on the underlying issue for which perseveration is a symptom as well as the specific perseverative behaviors. Cognitive behavioral therapy and medication are common treatments. Cognitive behavioral suggestions include things like “gaining attention” or becoming present and aware of the current moment to help shift the brain, managing any anxiety that might be prompting the behavior, having a broader range of topics to discuss or activities to do, and setting a time limit on the behavior. Various medications have also been found to be helpful. Given that many who struggle with perseveration are children or those with other medical issues, a caregiver is often the one who helps the person get “unstuck” or who can set up boundaries around the behaviors.
The Bible tells us it is important to control our thoughts: “We demolish arguments and every pretension that sets itself up against the knowledge of God, and we take captive every thought to make it obedient to Christ” (2 Corinthians 10:5). So seeking to manage perseveration makes biblical sense. It is right and appropriate to seek help when our brains seem to continually get stuck in an unhelpful pattern. Being able to manage our thoughts and behaviors is ultimately a work of the Holy Spirit who produces self-control and leads us into truth (Galatians 5:22–23; John 14:16–17). For those who are in Christ, dealing with perseveration will not be simply about following therapeutic recommendations or getting the correct medication dose; they have the Holy Spirit’s help as well.
One way believers can potentially help in their perseverative behaviors is through Scripture memory. When the Word of God fills our minds and hearts, we more easily recognize truth and more willingly yield to His Spirit in us. If an unhelpful thought comes into our minds that we cannot seem to let go of, we’ll have something ready with which to replace it. Psalm 1:1–3 says, “Blessed is the one . . . whose delight is in the law of the LORD, and who meditates on his law day and night. That person is like a tree planted by streams of water, which yields its fruit in season and whose leaf does not wither—whatever they do prospers.” Philippians 4:8 tells us, “Whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things.”
If perseverative behaviors are prompted by anxiety, we can remember, “Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus” (Philippians 4:6–7). We can pray and rest in God to soothe us and thus perhaps more easily desist the perseverative behavior.
Relating with a person who struggles with perseveration can be challenging. It is natural to be frustrated when another person is persisting in situationally inappropriate behavior. Recognizing that the other person is made in the image of God (Genesis 1:27) and seeking to view him or her as God does will help. We can remind ourselves that the perseveration is a symptom of a disorder or a disease. Usually, the other person is not intentionally annoying us. We can empathize with the struggles. We can do our best to help the other person get “unstuck,” possibly using some of the therapeutic suggestions above. Parents or caregivers of those who struggle with perseveration can help set boundaries on the behaviors as well as ensure safety. We can view their perseveration as an opportunity for us to love well. Paul encouraged the Thessalonians, “We urge you, brothers and sisters, warn those who are idle and disruptive, encourage the disheartened, help the weak, be patient with everyone” (1 Thessalonians 5:14). In doing so, we can also “rejoice always, pray continually, give thanks in all circumstances; for this is God’s will for you in Christ Jesus” (1 Thessalonians 5:16–18). Bearing with and helping those who struggle with perseveration is an opportunity for us to rely on the Lord for His equipping. It is also a view into His love for us. He bears with all of our weaknesses.
In some ways, perseveration could even be an image to us of what our sin must look like to God. How often do we persist in worshipping a lifeless idol or repeating a sinful behavior, even when we know those things don’t lead to any useful end? When we struggle with perseveration or see someone else exhibiting perseverative behavior, we can use it as a prompt to praise God for His mercy and grace and to ask Him to help us avoid sin. What we should be persistent in is our walk with God. Imagine if we all perseverated on Scripture or in prayer. Imagine if the persistence of the person we see stuck in a perseverative cycle was the same persistence we had in pursuing God. While the one leads to no helpful end, the other leads to something of inestimable eternal worth.