Cognitive distortion

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Cognitive distortions are exaggerated or irrational thought patterns that are believed to perpetuate the effects of psychopathological states, especially depression and anxiety. Psychiatrist Aaron T. Beck laid the groundwork for the study of these distortions, and his student David D. Burns continued research on the topic. Most notably, Burns’ 1989 book, The Feeling Good Handbook[1] presented information on these thought patterns along with a proposal of how to eliminate them.

Cognitive distortions are thoughts that cognitive therapists believe cause individuals to perceive reality inaccurately. These thinking patterns often are said to reinforce negative thoughts or emotions.[2] Cognitive distortions tend to interfere with the way a person perceives an event. Because the way a person feels intervenes with how they think, these distorted thoughts can feed negative emotions and lead an individual affected by cognitive distortions towards an overall negative outlook on the world and consequently a depressive or anxious mental state.

History

In 1972, psychiatrist, psychoanalyst, and cognitive therapy scholar, Aaron T. Beck, published the book, Depression: Causes and Treatment.[3] He was dissatisfied with the conventional Freudian treatment of depression. He concluded that there was no empirical evidence for the success of Freudian psychoanalysis in the understanding or treatment of depression. In his book, Beck provided a comprehensive and empirically supported look at depression – its potential causes, symptoms, and treatments. In Chapter 2, Symptomatology of Depression, he describes certain “cognitive manifestations” of depression, including low self-evaluation, negative expectations, self-blame and self-criticism, indecisiveness, and distortion of body image.[3]

In 1980, Burns published his book, Feeling Good: The New Mood Therapy,[4] (with a preface from Beck) and nine years later published The Feeling Good Handbook in 1989. These books built on Beck's work, delving deeper into the definition, development, and treatment of cognitive distortions, specifically in regards to depression or anxiety disorders.

Main types

The cognitive distortions listed below[1] are categories of automatic thinking, and are to be distinguished from logical fallacies.[5]

Always being right

Being wrong is unthinkable. This cognitive distortion is characterized by actively trying to prove one's actions or thoughts to be correct, while sometimes prioritizing self-interest over the feelings of another person.[6]

Blaming

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The opposite of personalization; holding other people responsible for the harm they cause, and especially for their intentional or negligent infliction of emotional distress on us.[6]

Example: a spouse blames their husband or wife entirely for marital problems, instead of looking at his/her own part in the problems.

Disqualifying the positive

Discounting positive events.

  • Example: Upon receiving a congratulation, a person dismisses it out-of-hand, believing it to be undeserved, and automatically interpreting the compliment (at least inwardly) as an attempt at flattery or perhaps as arising out of naïveté.

Emotional reasoning

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Presuming that negative feelings expose the true nature of things, and experiencing reality as a reflection of emotionally linked thoughts. Thinking something is true, solely based on a feeling.

  • Example: "I feel (i.e. think that I am) stupid or boring, therefore I must be."[6] Or, feeling that fear of flying in planes means planes are a very dangerous way to travel. Or, concluding that it's hopeless to clean one's house due to being overwhelmed by the prospect of cleaning.[7]

Fallacy of change

Relying on social control to obtain cooperative actions from another person.[6]

Filtering

Focusing entirely on negative elements of a situation, to the exclusion of the positive. Also, the brain's tendency to filter out information which does not conform to already held beliefs.

  • Example: After receiving comments about a work presentation, a person focuses on the single critical comment and ignores what went well.

Jumping to conclusions

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Reaching preliminary conclusions (usually negative) from little (if any) evidence. Two specific subtypes are identified:

  • Mind reading: Inferring a person's possible or probable (usually negative) thoughts from their behavior and nonverbal communication; taking precautions against the worst reasonably suspected case or some other preliminary conclusion, without asking the person.
    • Example: A student assumes the readers of their paper have already made up their mind concerning its topic, and therefore writing the paper is a pointless exercise.[5]
  • Fortune-telling: predicting negative outcomes of events.
    • Example: Being convinced of failure before a test, when the student is in fact prepared.

Labeling and mislabeling

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A more severe type of overgeneralization; attributing a person's actions to their character instead of some accidental attribute. Rather than assuming the behavior to be accidental or extrinsic, the person assigns a label to someone or something that implies the character of that person or thing. Mislabeling involves describing an event with language that has a strong connotation of a person's evaluation of the event.

  • Example of "labeling": Instead of believing that you made a mistake, you believe that you are a loser, because only a loser would make that kind of mistake. Or, someone who made a bad first impression is a "jerk", in the absence of some more specific cause.
    Example of "mislabeling": A woman who places her children in a day care center is "abandoning her children to strangers," because the person who says so highly values the bond between mother and child.

Magnification and minimization

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Giving proportionally greater weight to a perceived failure, weakness or threat, or lesser weight to a perceived success, strength or opportunity, so the weight differs from that assigned to the event or thing by others. This is common enough in the normal population to popularize idioms such as "make a mountain out of a molehill". In depressed clients, often the positive characteristics of other people are exaggerated and negative characteristics are understated. There is one subtype of magnification:

  • Catastrophizing – Giving greater weight to the worst possible outcome, however unlikely, or experiencing a situation as unbearable or impossible when it is just uncomfortable.
    Example: A teenager is too afraid to start driver's training because he believes he would get himself into an accident.

Overgeneralization

Making hasty generalizations from insufficient experiences and evidence. Making a very broad conclusion based on a single incident or a single piece of evidence. If something bad happens only once, it is expected to happen over and over again.[2]

  • Example: A person is lonely and often spends most of her time at home. Her friends sometimes ask her to come out for dinner and meet new people. She feels it is useless to try to meet people. No one really could like her.[7]

Personalization

Attributing personal responsibility, including the resulting praise or blame, for events over which a person has no control.

  • Example: A mother whose child is struggling in school blames herself entirely for being a bad mother, because she believes that her deficient parenting is responsible. In fact, the real cause may be something else entirely.

Should statements

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Doing, or expecting others to do, what they morally should or ought to do irrespective of the particular case the person is faced with. This involves conforming strenuously to ethical categorical imperatives which, by definition, "always apply," or to hypothetical imperatives which apply in that general type of case. Albert Ellis termed this "musturbation". Psychotherapist Michael C. Graham describes this as "expecting the world to be different than it is".[8]

  • Example: After a performance, a concert pianist believes he or she should not have made so many mistakes. Or, while waiting for an appointment, thinking that the service provider should be on time, and feeling bitter and resentful as a result.[7]

Splitting (All-or-nothing thinking or dichotomous reasoning)

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Seeing things in black or white as opposed to shades of gray; thinking in terms of false dilemmas. Splitting involves using terms like "always", "every" or "never" when this is neither true, nor equivalent to the truth.

  • Example: When an admired person makes a minor mistake, the admiration is turned into contempt.

Cognitive restructuring

Cognitive restructuring (CR) is a popular form of therapy used to identify and break down maladaptive cognitive distortions. It is typically used with individuals with depression.[9] CR therapies aim to eliminate “automatic thoughts” which create dysfunctional or negative views for individuals. Cognitive restructuring is the main component of Beck’s and Burns's cognitive behavioral therapy (CBT).[10]

As narcissistic defense

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Exaggeration and minimization are commonly adopted by narcissists to manage and defend against psychic pain.[11][12]

Decatastrophizing

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In cognitive therapy, decatastrophizing or decatastrophization is a cognitive restructuring technique to treat cognitive distortions, such as magnification and catastrophizing, commonly seen in psychological disorders like anxiety[13] and psychosis.[14]

See also

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3

References

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