There’s a famous quote by the philosopher Epictetus that states, “people are not disturbed by things, but by the view they take of them.” This is the essence of Cognitive Therapy, perhaps the most popular type of therapy practiced today. The goal of the treatment is to teach patients how their own thoughts dictate their feelings. Through practice, people are capable of not only recognizing how their cognitions impact how they feel, but also of changing their thoughts.
All of us are prone to making Cognitive Distortions, thoughts that are not entirely accurate, yet are accepted as completely true. In fact, the only difference in the mindsets of depressed vs. non-depressed individuals is the intensity and frequency of these distortions. In other words, all of us create a certain degree of misery in our own heads (which is why I tell all of my patients, ‘we’re all crazy’).
Below is a list of some of the most common Cognitive Distortions, taken from the popular self-help book, The Feeling Good Handbook, by David Burns, M.D. I suspect some of these will look familiar to you:
1) All-or-Nothing Thinking: Seeing the world in black or white, rather than in shades of gray.
2) Overgeneralization: Seeing a single negative event as a never-ending pattern.
3) Disqualifying Positives: Rejecting positive experiences by claiming they “don’t count” for an arbitrary reason.
4) Jumping to Conclusions: Making negative interpretations without definitive facts to support the conclusion.
5) Magnification (also called Catastrophizing): Exaggerating the importance or awfulness of negative events.
6) Emotional Reasoning: Assuming because something feels true, therefore it must be so.
7) Should, Must and Ought: Using statements suggesting there is a definitive way the world needs to function, especially when life is perceived as unfair.
8) Personalization: Seeing the self as the sole or primary cause of a negative event without evidence to support this conclusion.
So if these types of thought patterns get us into trouble, what can we do about it? A few simple tips:
Observe, Observe, Observe!
Nothing is more important for mental health than self-awareness. Merely recognizing a Cognitive Distortion can often decrease its frequency and magnitude. In graduate school, I was prone to extensive use of Magnification (e.g., If this patient report is late, the professor will absolutely kill me. I’ll be kicked out of school!”). I carried a small notebook with me at all times and simply made a notation every time I thought in this way. After a few weeks, I didn’t need the notebook any longer, as I caught myself in real time, which deflated its effects. Bonus tip for those who want to note their Cognitive Distortions: if you are feeling something that is both negative and very intense, you are probably engaging in one of the eight thought patterns above.
People in Cognitive Therapy are encouraged to think like scientists. They are taught to treat their thoughts not as fact, but as hypotheses that can be tested. For example, when patients overgeneralize about negative work performance and describe themselves as losers because of a bad day on the job, they need to test out that theory. Does one day override four others of good work? Can a good employee have, at times, a bad performance? What about in the past year, have their been good efforts during that time? By using a burden of proof approach, people begin to recognize that the way they are viewing events is often skewed and, therefore, leading to extremely negative emotions.
Talk to Yourself the Way You Would a Friend
Many people find it easier to recognize flaws in thinking when they envision another person doing it. I often encourage my patients to imagine a friend having the same thought process. Thus, I would ask, “would you allow your buddy to simply buy into the idea that his boss is furious at him simply because she didn’t smile when she said hello (Personalization)? Maybe the boss was in a rush, preoccupied, angry about something unrelated to your friend? If you’d challenge your friend to think about this situation differently, you need to do it for yourself as well.”
A crash course such in Cognitive Therapy such as this can be helpful to some, but know this is just the tip of the iceberg and there are dozens of techniques to help change maladaptive thinking. For more, consider seeking out a therapist who is an expert in this approach, or pick up a self-help book. In addition to The Feeling Good Handbook mentioned above, I also recommend Mind over Mood by Drs. Greenberger and Padesky.
Check out Dr. Rob's new book, Crazy: Notes On and Off the Couch
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