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Cognitive Distortions

8/31/2022

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  Cognitive distortions are automatic thought patterns that are inaccurate and reinforce negative thinking or emotions. These automatic thoughts “distort” our thinking by leading us to believe something that is both unhelpful and untrue (Bollen et al., 2021). Psychiatrist and researcher Dr. Aaron Beck is known for first proposing the theory behind cognitive distortions in the 1960s. He would then form the central part of his cognitive theory and, later, cognitive behavioral therapy (CBT). 

  In his book (1963), he lists five types of cognitive distortions. 
  • Arbitrary interference: the process of forming an interpretation of a situation, event, or experience when there is no factual evidence to support the conclusion or where the decision is contrary to the evidence
    • Example: “Everyone can tell I’m awkward” or “My friends probably think I’m annoying and weird”
  • Selective abstraction: the process of focusing on a detail taken out of context, ignoring other more salient features of the situation, and conceptualizing the whole experience on the basis of this element
    • Example: Focusing on one mistake during your speech or presentation without noticing the praise or applause
  • Overgeneralization: drawing a general conclusion about their ability, performance, or worth on the basis of a single incident
    • Example: "Things always go wrong" or "I can never succeed”
  • Magnification and minimization: errors in evaluation that are so extreme as to constitute distortions
    • Example: "My friend is late for our meeting. What if they had a car accident?" or "It’s not a big deal. It was nothing”
  • Inexact labeling: the affective reaction is proportional to the descriptive labeling of the event rather than to the actual intensity of a traumatic situation
    • Example: Believing someone is an “idiot” and calling them so when they accidentally bump into you on the sidewalk

  Dr. David Burns was an early student of Dr. Beck and helped popularize CBT. In his book (1980), he included more unhealthy thinking styles while also re-wording some of Beck’s distortions:
  • All-or-nothing thinking: tendency to evaluate your personal qualities in extreme, black-or-white categories
    • Example: "I have no good qualities" or “If I don’t plan, everything will be a disaster”
  • Overgeneralization: believing that one thing that happened to you once will occur over and over again
    • Example: "Things always go wrong" or "I can never succeed”
  • Disqualifying the positive: an extreme form of all-or-nothing thinking in which we filter out all the positive evidence about our performance, and only attend to the negative
    • Example: "He only complimented me to be nice” or “Anyone else could have done that"
  • “Should” statements: attempting to motivate ourselves in this way can, paradoxically, lead to apathetic and unmotivated feelings
    • Example: “I should have said this instead of that" or "I should have been less nervous"
  • Mental filter: the process of picking out a negative detail in any situation and dwelling on it, causing you to perceive the whole situation as negative
    • Example: "The party was going smoothly until we ran out of cups. It was a disaster"
  • Mind reading: arbitrarily jumping to a negative conclusion that is not justified by facts
    • Example: “Everyone can tell I’m awkward” or “My friends probably think I’m annoying and weird”
  • Emotional reasoning: emotional reasoning is where emotions are taken as evidence of the truth
    • Example: “I feel anxious so I know something dangerous is going to happen”
  • Personalization and blame: when you assume responsibility for a negative even when there is no basis for doing so and arbitrarily conclude that what happened was your fault or reflects your inadequacy, even when you were not responsible for it
    • Example: “It’s my fault that you got a bad grade”

  The theory underlying CBT states that cognitive distortions are associated with certain mental health disorders. These conditions include anxiety and depression. One anxiety disorder that’s largely affected by cognitive distortions is social anxiety disorder. Social anxiety disorder (SAD) occurs when individuals fear and endure discomfort or avoid social situations, such as social interaction or performances that may involve social scrutiny (Cook et al., 2019). These individuals are more likely to have negative thinking patterns that overestimate the probability and severity of negative social events and interactions. With depression, cognitive distortions were found to have a positive relationship, meaning as depression increased, cognitive distortions increased with helplessness and self-blame being the top two predictors of mental well-being (Yüksel & Bahadir-Yilmaz, 2019). Cognitive distortions were also found to mediate the relationship between trauma and suicide ideation (Whiteman et al., 2019). Researchers (2019) revealed that negative cognitions about the world and about the self were strong predictors of suicide ideation. These findings support the routine assessment of cognitive distortions and suicide ideation in survivors of trauma and of those who are experiencing anxiety and depressive symptoms. 

  Cognitive distortions can be combatted with CBT, which has been known to help redirect negative thought patterns into more positive ones (Beck, 1963). It can also help you challenge your negative thoughts and emotions, and encourage you to find the source of those thoughts. Fortunately, there are many resources to help you challenge your cognitive distortions and identify their root cause.
  • Therapist Aid Cognitive Distortions Worksheet
    • We recommend using worksheets like this with a therapist
  • Checklist of Cognitive Distortions
  • Cognitive Distortions + Reframing Tips

References
  • Beck, A. T. (1963). Thinking and depression: I. Idiosyncratic content and cognitive distortions. Archives of General Psychiatry, 9(4), 324-333.
  • Bollen, J., ten Thij, M., Breithaupt, F., Barron, A. T., Rutter, L. A., Lorenzo-Luaces, L., & Scheffer, M. (2021). Historical language records reveal a surge of cognitive distortions in recent decades. Proceedings of the National Academy of Sciences, 118(30). https://doi.org/10.1073/pnas.2102061118 
  • Burns, D. D. (1980). Feeling Good: The New Mood Therapy.
  • Cook, S. I., Meyer, D., & Knowles, S. R. (2019). Relationships between psychoevolutionary fear of evaluation, cognitive distortions, and social anxiety symptoms: A preliminary structural equation model. Australian Journal of Psychology, 71(2), 92–99. https://doi.org/10.1111/ajpy.12215  
  • Whiteman, S. E., Kramer, L. B., Petri, J. M., & Weathers, F. W. (2019). Trauma type and suicidal ideation: The mediating effect of cognitive distortions. Traumatology. http://dx.doi.org/10.1037/trm0000192 
  • Yüksel, A., & Bahadir‐Yilmaz, E. (2019). Relationship between depression, anxiety, cognitive distortions, and psychological well‐being among nursing students. Perspectives in Psychiatric Care, 55(4), 690–696. https://doi.org/10.1111/ppc.12404 ​
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Uncommon Anxiety

2/10/2021

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Many people will experience anxiety at some point in their lives. It’s a normal response to stressful life events that can boost efficiency at healthy levels. However, when symptoms of anxiety become larger than the events that triggered them and begin to interfere with your life, they could be signs of an anxiety disorder. Anxiety disorders can be debilitating, but they can be managed with proper help from a medical professional. Recognizing the symptoms is the first step. Unfortunately, there are also symptoms that are subtle and are not as common. Let’s dive into what these may look like. 

Psychologists have developed seven categories of anxiety disorders. They are:
  • Generalized Anxiety Disorder (GAD)
  • Social Phobia
  • Panic Disorder
  • Agoraphobia
  • Phobias
  • Post-Traumatic Stress Disorder (PTSD)
  • Obsessive-Compulsive Disorder (OCD)

Each category is complex with a wide range of symptoms. Common anxiety symptoms include rapid heartbeat, excessive trembling and sweating, nausea and dizziness, chest pain and headaches, and weakness and tingling in the limbs. Other physical symptoms such as rash, leg pain, and feelings of choking are less common but may appear in some cases. In regards to psychological signs of anxiety, these include worrying, agitation, restlessness, fatigue, difficulty concentrating, and avoidance of social situations. 

Subtle signs that don’t really scream “anxiety” can manifest as well. One example is jaw pain. This can stem from anxiety because it causes you to clench and grind your teeth while you are both awake and asleep. This can then lead to headaches which exacerbates feelings of anxiety. Having intrusive thoughts can also be a sign of anxiety, especially in people with OCD. Also known as ruminating, it can make you less present and imagining the worst. This can lead to unnecessary stress and headaches as well. Other uncommon symptoms of anxiety include hoarding, scattered thinking, overspending, impulsivity, indecisiveness, and disorganization. I have personally seen hoarding situations in my family and my friends’ families that were directly linked to mental health and anxiety. Many may see this as an easy issue to fix when in reality, it’s extremely difficult for hoarders to part with their stuff. I’ve learned that we can never really know the root cause of these behaviors and may assume that these are easy fixes. We may wonder, “Well why don’t you just organize your room?” or “Why can’t you ever remember things?” We have to understand their side of the story. If we ever encounter our loved ones in these situations exhibiting these types of behaviors, we should first ask ourselves why they act this way and how we can figure out what is the root of their anxiety. Anxiety can be a vicious circle of signs and symptoms that if not fixed, can cause even more anxiety down the line. Fortunately for us, anxiety disorders are completely controllable with the help of friends, family, and mental health professionals. 
​

Reference
Abraham, M. (2020). The 6 main types of anxiety: which do you have? Calm Clinic. Retrieved from https://www.calmclinic.com/anxiety-guide/main-types
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