In past blogs we’ve discussed Cognitive Behavioral Therapy (CBT), The Cognitive Triangle (the relationship between your thoughts, feelings, and actions as they all relate to CBT), and Thought Records (a tool used to apply CBT methodology to your thoughts). In this blog we want to help you start applying CBT by teaching you about five specific patterns of distorted thinking to look out for and how to challenge them.
In case you need a refresher, Cognitive Behavioral Therapy is a powerful and evidence-based method for doing therapy. It involves recognizing and challenging distorted patterns of thought that would otherwise cause unnecessary feelings of depression, anxiety, and other negative emotions. A core idea of CBT is that acting in accordance with reality can help you feel better because our brains are wired to focus on the negative (a phenomena called the “negativity bias”) and then look for evidence that supports it (a phenomena called “confirmation bias.”) This makes humans really good at survival, but also really susceptible to things like stress, pessimism, and like undesirable emotional states. The good news is that by learning the CBT method can our brains can be rewired for happiness.
CBT begins by teaching you about common Cognitive Distortions. Cognitive Distortions are patterns of thinking that cause people to systematically misperceive reality in a way that causes disproportionate or unnecessary emotional reactions. Examples include: Labeling, Mental Filter, Personalization, Emotional Reasoning, and Jumping to Conclusions. As we discussed in our blog on stress, feeling stressed in response to legitimate stressors in our environment, such as threats to our survival or wellbeing, is adaptive. It’s only when our stress response is constantly being triggered by fabrications of our mind that our physiological response starts to become problematic.
Being depressed because your partner left you is unpleasant, but still in on the spectrum of normal responses to negative life events. Getting so depressed that you stop sleeping and eating because you suspect your partner wants to leave you -- when in fact they do not, and they keep genuinely insisting that they do not -- is unpleasant and entirely unnecessary.
Here’s how you would apply the CBT method in that situation:
Write down what you are feeling (e.g. insecure and tired).
Score and record the severity of what you are feeling (e.g. if 0 is not sad at all and 10 is suicidal, I’m about an 8 right now given that I’m not sleeping or eating normally).
Write down what’s going on that’s causing you distress (e.g. I can tell my partner wants to leave me because he thinks I’m boring -- guys always get bored with me after a few months...)
Look at a list of Cognitive Distortions (there are many variations of this list but we recommend the one by M.D. David Burns), and compare the examples to what you wrote down. Does anything that you wrote down seem like it could be distorted? (e.g. maybe I’m “Mind Reading” when I think “he thinks I’m boring,” because I am assuming that I know how he feels, even though he’s never said I’m boring. I guess it’s also “Fortune Telling” to assume that he is going to dump me, and “Overgeneralization,” to say that guys always get bored with me, I’ve had a couple good relationships that where long term and ended for reasons other than boredom.)
Consider the evidence for and against your thoughts. Try to be really strict about only writing down the facts here -- not judgments -- or if you are going to record a judgment, make sure you identify it as such. (Hint: if you use any of these words: always, never, should, everyone, no-one; strike them out and replace them with less extreme, more representative language.)
Evidence for:
We do the same thing every most weekends
He is always talking often talks about all the fun things his single friends are doing
{It feels like} we don’t talk as much as we used to, and that conversation has been replaced with TV or music
2. Evidence against:
When I ask if he wants to go out, he literally always says he would rather just stay home with me
He also usually mentions how exhausting and expensive it was to be single because it meant he never had an excuse if he didn’t feel like going out and getting wasted every weekend
He says he feels really relaxed and comfortable when he’s with me, like he can just be himself
6. Rewrite your original assessment of what’s going on.
7. Repeat steps 1 and 2.
Now if you aren’t a pen-and-paper type like me we have just the app for you. It’s called Quirk. Quirk allows you to act as your own therapist when it’s 3 a.m. and your actual therapist is asleep, or you are out and about and can’t discretely or efficiently pull out a long list of cognitive distortions. It’s no substitute for professional care, but it can be a helpful supplement and resource to people with low levels of depression/anxiety that are looking to further improve their quality of thoughts.
Now that we have completed our CBT tutorial, we can turn to the five common thought distortions and examples of how you might challenge them:
1. Magnification & Minimization: the tendency to magnify your errors/flaws and their importance, while also minimizing your strengths and their importance. The problem with only thinking your weaknesses are relevant is that you will never have an accurate perception of your contribution to any relationship, be it professional or otherwise.
Example: There was a typo in my last email to my boss, and now they want to meet with me on Monday. I’m probably getting fired.
Challenge: It’s 2020 and your boss sends 40% of her emails with “sent from my iPhone” and an emoji. She probably didn’t even notice the typo, and just wants to meet with me because I signed a new client and she wants to talk strategy.
2. All-Or-Nothing Thinking: the tendency to judge the world as black or white (a.k.a. "dichotomous thinking"). The matter of fact is that most issues are grey, so labeling the world in terms of extremes often result in misleading oversimplifications.
Example: My best-friends boyfriend, Dan, is a loser. He is 35 and he still lives at home with his parents. I don’t know why she won’t listen to my advice and dump him already.
Challenge: Dan’s mom has early onset dementia and requires full-time care, which Dan, as a registered nurse, is uniquely qualified to provide. So even though he is 35 and living at home, Dan is not a “loser.” He’s a really good guy, and that’s why my friend won’t take my advice.
3. Disqualifying the Positive: the tendency to misperceive neutral and even positive stimuli, as negative (a.k.a. “Discounting”). It’s problematic to only judge feedback as negative because it will create a lot of unnecessary conflicts in your life.
Example: Kara complimented my outfit. She was probably being sarcastic. What a b*tch. Woe is me.
Challenge: Just because Chad in accounting flirts with Kara and not me, doesn’t mean Kara is being sarcastic.
4. Should Statements: the tendency to use “should” or “ought” statements for self-flagellation, often results in feelings of shame, guilt, and self-loathing instead of motivation or change.
Example: I should be more athletic.
Challenge: Sitting here beating myself up about not being a certain way certainly isn’t going to improve things. I could become more athletic by setting realistic goals, and working towards those, but if I don’t suddenly become the kind of person who loves to lift weights that’s ok too.
5. Personalization: the tendency to blame yourself for bad things you aren’t responsible for.
Example: My son is failing Algebra, it’s all my fault. I should have hired him a tutor after his last test, but I didn’t want to spend the money. Why couldn’t he have gotten his father’s “smart” gene, instead of my stupid ones?
Challenge: My son is responsible for whatever grades he gets in school, even if intelligence is partially heritable. He could have asked for help from his teacher, the T.A., a classmate, or his father, like I suggested, but he didn’t.
These are five common ways in which human brains systematically trick us into thinking the world is worse than it really is. Now that you know what to look for, you can start to recognize these patterns in your own thoughts and correct them. Work with your therapist to figure out what your most recurrent or destructive distorted thoughts are, because those are often the ones we have the hardest times finding evidence against simply because they are so integrated into our concept of reality that they bias would-be evidence as well, or stop us from really searching (e.g. the voice in your head telling you “You can’t find evidence that you aren’t worthless, because you are worthless”). Also make sure to congratulate yourself every time you catch and correct a distorted thought. CBT is truly one of the greatest gifts anyone can ever give themselves, and their loved ones too, because trust me, they will see the difference too. Unlike with antidepressants, that stop being effective when you discontinue use, CBT is a skill, and once mastered you serve to benefit from it for the rest of your life. Start rewiring your brain for happiness today.
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Written By Sophie Wright
Originally published on 01/24/2020