CBT and Cognitive Distortions: 3 more

“Talking about these cognitive distortions has been helpful. What are some of the other ones?” Vladimir, a colleague who previously did not think much about CBT, has now become a believer.

After providing the background on CBT and an overview of cognitive restructuring and automatic thoughts, I then started to talk with him about cognitive distortions. And I described three types with examples, and, still, Vladimir wanted to learn more, and so we continued.

Jumping to Conclusions

You pretend to know what the other person is feeling and the reason behind his or her actions. You pretend that your friend’s intention was to just hurt you. You think about it and hypothesize on it, without waiting for the “experimentation phase,” in order to prove it definitively; you just conclude what you think or hypothesize is factual and nothing less.

The danger here, once you draw your conclusion, it becomes even harder for the other person to prove otherwise. Worse still, the more your friend, or your spouse, or your staff try to prove his or her true intention, that it was totally different from what you concluded, then the closer to your heart and mind you hold your previously determined conclusion. As this happens, both you and your friend continue to experience hurt, and it becomes more and more challenging to reconcile the different points of view.

Lastly, mind reading and fortune telling are two subtypes of cognitive distortions that go along with Jumping to Conclusions. The next time you catch your patients and clients jumping to conclusions, ask them, “When did you start believing you could read minds?”  While some may be convinced they really can read minds, most will likely laugh, and this humorous moment may be the start of an opportunity to work with them on abandoning this dangerous cognitive error.

When an action takes place, several types of reactions may ensue. And, some may be more bearable than others. When you assign the most weight and the highest probability to the worst possible reaction, you are catastrophizing. In this case, the problem is that you feed yourself as much anxiety as possible, to the point that it may become incapacitating.

Have you seen individuals with so many somatic and debilitating symptoms that get better once the stressor is no longer present? Once it becomes clear that their spouse did not leave them, or they did not get fired, as previously believed, to the point of illness, somatic symptoms tend to suddenly disappear. While these associated core beliefs are rather complex and deeply rooted, there are things you can do about them. As you will see in subsequent articles, the use of the Socratic method can be rather life saving, as it helps with thinking things through, as patients and clients go through the process of answering a series of questions.

Personalization

Amaris was four-years-old when her father yelled at her. Amaris’ mother told him that it was wrong for him to yell at her. This was the trigger for the biggest fight they ever had, leading Amaris’ father to leave the house, spending weeks away before returning home. During these weeks, Amaris developed certain beliefs. Her words to her mother were, “Mommy, I am sorry I made daddy go. I am so sorry.”

At that age, Amaris believed she was responsible for whatever happened in her life, because, “she holds the magical power to make things happen.” By the time she turned age seven, Amaris can be expected, in the way we could also be expected, to transition from magical thinking to logical thinking. This also means that as long as we continue to personalize everything, believing that we are responsible for everything and anything that may have happened, or believing that anything that someone says or does has to do with us, we are back to being that 4-year-old Amaris, using magical thinking.

The next time we catch our patients and clients personalizing, just ask them, “When did you start believing that you were so magical that everything said or done has to do with you?” You may get a confusing look from some and a big laugh from others. Regardless of the reaction you observe, you will be able to use either the power of confusion or that of humor to start helping your patients live a happier life, by helping them attend to their negative, automatic thoughts and also by helping them correct their cognitive errors.

References:

1. Rush, A.; Khatami, M.; Beck, A. (1975). “Cognitive and Behavior Therapy in Chronic Depression”. Behavior Therapy. 6 (3): 398–404.
2. Beck AT. Cognitive therapy: Nature and relation to behavior therapy. Behavior Therapy. 1970; 1:184–200.
3. Beltman MW, Oude Voshaar RC, Speckens AE. Cognitive-behavioural therapy for depression in people with a somatic disease: meta-analysis of randomised controlled trials. The British Journal of Psychiatry. 2010; 197:11–19.
4. Butler AC, Chapman JE, Forman EM, Beck AT. The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review. 2006; 26:17–31.