Part 7: CBT for Cognitive Distortions

What are Cognitive Distortions?

Now that you have spent some time observing your thoughts and investigating them through cognitive restructuring, you may have noticed some patterns in thinking—types of thoughts that seem to come up again and again. We all develop mental habits—certain ways of thinking—over time. Some of these mental habits can lead us to consistently interpret situations in unhelpful ways, inconsistent with the facts of a situation, or leave out an important part of the picture. We all do this at times, usually without noticing it. It can be helpful to begin to identify these “cognitive distortions” when they occur.

For example, have you ever known someone who, when you would share a new idea or plan, always seemed to respond with some version of: “Well, that won’t work, and here’s why…”? It might seem like no matter what you proposed, all this person could see were all the many ways your plan might fail—never the benefits or the possibilities for success. You’ve even probably had these types of thoughts yourself. This is an example of one type of cognitive distortion: negative filtering.

The reality is, whether or not you consider these thoughts to be “distorted,” in order to function in the world, we need mental shortcuts—quick ways of making sense of a situation without wasting too much energy thinking about it. Oftentimes, these shortcuts work pretty well. When you’re at the supermarket buying apples, the shortcut of “all-or-nothing thinking” does its job. You see a bruised apple… bad apple. You see an apple without any flaws…- a good apple. We don’t have to examine the apple in detail, devise a list of pros and cons, or engage in any kind of analysis to figure out which apples are the ones we want to take home.

It’s when we apply these shortcuts ineffectively that they become cognitive distortions. All-or-nothing thinking works pretty well for the produce department, but when we apply the same shortcut to our spouse, the slightest flaw becomes magnified, and we start to develop resentment toward them. When we apply it to our work, anything short of perfect gets cast as a failure. When intense emotions are present, it's likely there’s at least one cognitive distortion muddying the waters of our thinking. Below, you’ll find descriptions of several common cognitive distortions.

Jumping to Conclusions
(AKA Fortune telling and Mind reading)

Have you ever predicted the future without knowing what might happen (fortune telling)? You may have had thoughts like “I’m going to get fired,” “My spouse is going to divorce me/my girlfriend is going to break up with me,” “I’m going to have a heart attack,” or anticipated any number of other (usually dire) future outcomes. Has your fortune-telling ever developed into a “what-if spiral” in which one “what if” leads to another and another in a seemingly endless cycle?

For example, we might have thoughts that progress something like this: “I’m not going to be able to finish this project tonight”—“If I don’t finish this project tonight, I’m going to get fired”—“If I get fired, I won’t be able to find a new job”—“If I can’t find a new job, I’ll go broke and I won’t be able to pay my loans”—“My spouse will leave me”—“I’ll lose my house”—“I’ll become homeless” —“My life will be over.” Our minds can go down this chain without our awareness, so that the thought of “I’m not going to finish this project tonight” is met with extreme anxiety and dread because “I’m not going to finish this project tonight” now essentially means “I’ll become homeless and my life will be over.”

Have you ever imagined that you knew what someone else was thinking (mind reading)? “So-and-so hates me,” “My boss thinks I’m doing a terrible job,” or “My friends don’t want to tell me what they really think of me.” Maybe your conclusions have proven correct at times. But our thoughts can sometimes tend toward the extreme, particularly when we are anxious, depressed, or feeling other strong emotions.

Catastrophizing

Catastrophizing can go hand-in-hand with jumping to conclusions. Sometimes, when we’re fortunetelling or predicting possible outcomes, we predict that the outcome will be so terrible that we won’t be able to manage—e.g., that the results will be catastrophic. For instance, in the example above, several of the thoughts, including “my life will be over,” could be considered catastrophizing thoughts. Other catastrophizing thoughts might be “I couldn’t handle it” or “It would be too much…” Albert Ellis, a pioneer of cognitive behavioral therapy, coined the term “awfulizing” to refer to the same process. By framing something as inherently “awful” or “terrible” rather than “difficult” or “unpleasant,” our negative emotion becomes amplified.

All-or-Nothing Thinking

Have you ever had thoughts in which there are only two opposite options (e.g., “good” or “bad,” “intelligent” or “stupid,” “success” or “failure”) and nothing in between? You may have had thoughts like, “If I don’t perform perfectly, then I have failed.” This type of thinking is also called black-and-white thinking. In reality, few situations are as clear-cut and black-and-white as our thoughts make them seem. There are many shades of gray between black and white.

Negative Filtering or Discounting the Positives

This cognitive distortion involves filtering out important information, only taking into account negative evidence while minimizing positive evidence. Thoughts like, “Sure, my professor gave me positive feedback on my presentation, but she was just trying to be nice,” or “I noticed a couple of people not paying attention because my talk was so boring” are instances of negative filtering.

With this thinking trap, it may seem as if we’re walking around the world with an invisible bubble around us. Only evidence that is consistent with our beliefs gets into the bubble. If someone believes that they’re unskilled and incompetent, they’ll focus on evidence that confirms this belief and disregard or minimize evidence that demonstrates competence.  

Overgeneralizing

Overgeneralizing involves drawing broad conclusions based on limited information. Thoughts like, “She didn’t want to go out with me. Women aren’t interested in me, and I’ll always be rejected.” Or you may have been late for an appointment and concluded, “I’m always late. I’m so irresponsible.”  With overgeneralizing, a single incident gets inflated into a perceived larger pattern that, in actuality, doesn’t exist.

Should-ing

“I shouldn’t feel this way.” “He shouldn’t have done that.” “She should have called me.” How often do you notice “should” creeping into your thoughts and statements? We may get caught up in how we, others, or the world ought to be. It’s easy to become mired in guilt and shame that we are different than we “should” be and angry that others aren’t how they “should” be. But should-ing denies the reality that things are as they are. The more you struggle with and deny reality, the harder a time you’re going to have dealing with challenges effectively.

Labeling

We categorize and label as a way of making sense of our world, but we can sometimes turn this labeling impulse on ourselves and other people, applying one-word descriptions that exclude other information. “She’s a jerk.” “I’m an idiot.” “He’s a doormat.” Usually, when we label, we use one trait or characteristic of a person to sum up their whole value as a person.

Countering Cognitive Distortions

When we get caught in cognitive distortions, our thinking can become rigid and only allow for one way of looking at a situation or one possibility, like a horse with blinders on. There are usually many ways of interpreting a situation, and it’s possible to develop your ability to think more flexibly over time, broadening your field of vision. When we work with our CBT therapy clients on countering distortions, we stress to them that the goal is to work toward a more balanced and flexible way of thinking that allows for multiple possibilities. The goal is not to throw out your first set of thoughts and replace them with new, “positive” thoughts.

Countering jumping to conclusions: Your predictions about a situation are one possibility. What are other possibilities? How likely is each possibility, as a percentage from 0% likely (will never happen) to 100% likely (will certainly happen)? For example, say you notice a mole on your arm and think, “I probably have cancer.” What are other possibilities? What is the best possible outcome? What is the worst possible outcome? How likely is it that you have cancer from 0-100%, and how likely are each of the other possibilities? What is the most likely outcome?
Learn more about mind reading.

Countering catastrophizing: You may have come to the conclusion in the previous step that the outcomes you fear are not very likely. But what if they come to pass? Instead of stopping with “I won’t be able to handle it if that happens,” think about what you would actually do if your “worst-case scenario” came true. Have you ever been in situations that were similar in any way? How did you manage? Have you ever heard of someone being in this situation and recovering? How did they do it? What are the resources you could access?

Countering all-or-nothing thinking: Think of a spectrum with the black and white thoughts on each extreme (e.g., one end of the spectrum is “I’m a failure,” and the other end is “I’m a success”). What lies between the two poles? Can a person be successful in some ways but still “fail” in others? Remember, you don’t need to throw out your original thought of “I’m a failure” and replace it with the opposite extreme (“I’m a success”). You are only trying to see the shades of gray in between black and white and recognize that there are additional possibilities.

Countering negative filtering: If you have been preferentially attending to negative evidence, seek out counterexamples in order to balance your view. For instance, if you hold the view that others do not like you, can you think of any opposing examples? Can you think of positive evidence that you may have discounted at the time? Have you ever interpreted friendly gestures as someone “just being nice” or “taking pity on” you? Is it possible those were examples of someone liking you or trying to befriend you? As you move forward, actively look for counter-evidence and try to notice when you discount the positives.

Countering overgeneralization: Recognize that one event or even a few instances do not necessarily suggest a pattern or larger truth. Focus on exceptions to the overgeneralization. Are there times it’s not true? If so, it may be helpful to be more mindful of behavior that doesn’t fit into the overgeneralization.

Countering should-ing: Think about the rules you have for how you “should” be, how others “should” be, and how the world “should” be. What is the effect of believing in these rules and imposing them on yourself and others? Is it possible that others have different expectations or standards? If so, does that mean their standards are wrong? Why or why not? For example, perhaps you have had the experience of thinking, “I shouldn’t feel this way,” when you feel anxious. Why not? What is the effect of believing that you shouldn’t feel that way? What is the effect of thinking, “It’s okay to feel this way sometimes”?

Countering labeling: Labels omit a lot of other information—think about the information that is excluded. For example, fill in the blank with a word that comes to mind when you are feeling unhappy: “I am such a ____________!” What else are you? What does this label leave out about you? What would your favorite person say if asked what information has been left out?

Having added the skill of recognizing cognitive distortions to your cognitive restructuring repertoire, begin identifying distortions in your thought records. Our therapy clients have found it’s best to identify any distortions right after identifying the automatic thoughts and before asking the probing questions from the last chapter. That way, it’s a little easier to come up with a powerful alternative response.

As with all the skills prior to this one, practice is very important. Complete one thought record daily, identifying cognitive distortions and developing an alternative response. You’ll find that sometimes one thought seems to fit several cognitive distortions. That’s okay; you can either pick one distortion and restructure it, or you can restructure all of the distortions you find. What matters is that you’re thinking about the situation from a different perspective.

Cognitive Behavior Therapy, Second Edition: Basics and Beyond. The Guilford Press: New York. – Beck, J.S. (2011).

Cognitive therapy techniques: A practitioner's guide (2nd ed.). Guilford Press. Leahy, R. L. (2018). 

Rational emotive behavior therapy: A therapist’s guide. Atascadero, CA: Impact. Ellis, A., & MacLaren, C. (1998).