CBT and Cognitive Distortions: The First 3
“Okay, you are convincing me. Now, I want to hear more about these automatic thoughts that you started talking about last week.” Vladimir is a colleague, with whom I meet on a regular basis. One day, he explained how CBT was like a cookbook and a mere reductionist view of the mind and the brain. After going over the history and background of CBT with him, he then said, “Hearing this is starting to change my perspective; how does this really work?”
In two previous articles on this topic, I explained that we have thousands of thoughts a day, that it would be unhealthy for us to even attempt to keep track of all of them, but that we needed to do something about the unhealthy thoughts that get us into trouble. These automatic thoughts that cause distress or get us into trouble are the negative automatic thoughts that stem from distortions in our own cognition. These distortions are also known as cognitive distortions, for which I prefer the term cognitive error, a term less pathologic in nature and more strength based. Regardless of the name, understanding these errors or distortions will help us address and correct our automatic thoughts.
There are over a dozen cognitive distortions. In this current article, I will describe three of them:
Have you ever received feedback that included both positive and negative elements, but you were only able to dwell on the negative aspects of the feedback? If so, this would be an example of filtering. It is a cognitive distortion that likely led to some negative automatic thoughts, which likely put you in a negative mood, and then affected your work, and your relationships, and the list goes on and on. The next time you find yourself or your patients and clients making the cognitive error of filtering, call attention to it; call yourself or your patient and client on it. You will be glad you did.
Also known as, “all or nothing” thinking or dichotomous reasoning, polarized thinking is a cognitive error that can get us or our patients and clients into big trouble and in a lot of distress. The work is either perfect, or not good at all. It either “always” or “never” happens.
Did you ever find yourself thinking that someone was no longer all that smart, because of one thing he or she did not know? While this may sound like an exaggerated example, you would be surprised how often it happens. Start correcting the cognitive error of polarized thinking and you will start appreciating life, yourself, and the people around you, seeing many things in a whole new, positive light.
Overgeneralization is similar to polarized thinking, but different in the sense that our patients and clients tend to make very broad conclusions based on a single observation. This cognitive distortion is close to the concept of cognitive fallacy, the tendency to look for and attempt to establish patterns where there are none. Nonetheless, the consequences of overgeneralizing are far more serious than those of cognitive fallacy, and they can at times cripple us.
Juan, who was Jane’s first boyfriend, broke up with her after dating for some time. Ever since, Jane has decided not to date because, “What is the point if they are going to end up dumping me, anyway?”
Do your patients and clients tend to overgeneralize when they talk about themselves, their relationships, and the world at large? Make a note, put on your clinical and coaching hat, use the Socratic method, and your Motivational Interviewing spirit, and work with them on the tendency to overgeneralize. You may end up needing your psychodynamic hat, too, but the point is that these cognitive errors have been causing your patients and clients a lot of distress, and they deserve the tools to address them. Given all of this, consider how much your patients and clients are so fortunate to have your help addressing these distortions.
Do you see how much of our distress derives from our cognitive distortions and how taking the time to address them can help us and our patients and clients live a more fulfilling life? Also, did you have an automatic thought that this was a useless article, because I presented only three of the cognitive distortions?
For more in this series of articles, check below!
Dr. Sidor is quadruple board certified in psychiatry, with board certification in General adult, Child and adolescent, Addiction, and Forensic, psychiatry. He also has additional training in public psychiatry, in several treatment modalities, in addition to his teaching, supervision, mentorship, coaching, and management, experience. Some of his passions are public speaking, leadership, entrepreneurship, and research, in addition to program development and project management. His overall goal is to empower all health care professionals throughout the United States and globally, towards ensuring the continuity of excellent patient care, while balancing the need to take care of themselves. Dr. Sidor is the main instructor for the SWEET Institute, and he is currently an Assistant Professor of Psychiatry at Columbia University. He is also the past-Medical Director for CASES (Center for Alternative Sentencing and employment Services), and he speaks and writes fluently in six (4) languages—French, English, Spanish, Creole, and has intermediate proficiency in Portuguese and Italian.
- Beck, A. T. (1976). Cognitive therapies and emotional disorders. New York: New American Library.
- Burns, D. D. (2012). Feeling good: The new mood therapy. New York: New American Library.
- Beck, Aaron T. (1972). Depression; Causes and Treatment. Philadelphia: University of Pennsylvania Press.
- Martin, Ryan C.; Dahlen, Eric R. (2005). "Cognitive emotion regulation in the prediction of depression, anxiety, stress, and anger". Personality and Individual Differences.39 (7): 1249–1260.