“One more set. Just one more, to complete it to one dozen distortions, and then I will leave you alone,” Vladimir said to me, after I had told him, “We are done talking about cognitive distortions, let’s switch gears a bit.” Vladimir would not take no for an answer. Now, he is much more interested in CBT, and now that he is convinced it works, he wants to learn the “ins and outs” of it. Who I am to deter someone like this? You have met my friend, Vladimir in five previous articles in this series on CBT.
In three previous articles, I described and illustrated a total of nine cognitive distortions. The first set, Filtering, Polarized Thinking, and Overgeneralization. The second set, Jumping to Conclusions, Catastrophizing, and Personalization. And the third set, Should Statements, Emotional Reasoning, and Global Labeling. Below is the last set of cognitive distortions or errors that I described to Vladimir. And you can use them, especially, to help your patients and clients.
Everything is a big deal; nothing is small with this guy; he just takes something and blows it out of proportion; she just loves to make a mountain out of a molehill. Have you heard any of these types of statements before? If your patients and clients think this way or see and deal with the world from this perspective, it may certainly be causing them difficulty in their relationships, and it is worth looking into. How does it feel to be around someone who simply has to blow everything out of proportion? Do you dread that person; do you try to avoid him or her, if you can, or do you tend to feel anxious when around them? I always talk about how vital it is to have relationships and social support. Many of our patients and clients already have limited social support; so, helping them save the few healthy relationships they have, may be the single best way to touch their lives. And you can start by working with them on their tendency towards magnifying, in addition to other related cognitive errors.
Do you remember the last time you were in love? Your partner was either prince charming or the princess; he or she was perfect, exactly what you had been longing. This is a human phenomenon that most of us go through, if we are even that fortunate. We also know that we cannot stay in love like this forever. Nature, our life, and our brain were not designed this way. While in love, we often have one foot on the ground and the other floating in the air. We live in a world that is half fantasy and half reality. And that could not possibly go on forever. Once both feet are back on the ground, we start noticing all those imperfections in our prince charming or our princess, and “the decision to love or not love” needs to happen next. In other words, I decide to love you with all your imperfections and shortcomings of human nature, or I decide we are not as much of a fit, as we believed we were during the past months. During those past months, minimizing was used to help foster two people falling in love. This implies that minimizing cannot go on forever, otherwise, it starts causing problems, and the ramifications can be alarming.
One area where minimizing takes place is in domestic violence relationships. Malik, a war veteran once punched Andrea, resulting in physical dental trauma, loosening of one of her teeth. Andrea made sure to not seek medical attention until much later, because, “I know they are going to make this a big deal, and I just want to save them the show.” While Andrea’s perception was that people would be magnifying what had happened, the reality is that Andrea was minimizing what happened, something rather common in this type of relationship. The lives of abusive couples are rather complex, multidimensional, and minimizing is only one piece of the puzzle. However, this can be used as a subtle and noninvasive way to start the conversation with your patients and clients who are in abusive relationships.
Always Being Right
“I am right, you are wrong. I am always right, and I can’t be wrong, I cannot possibly be wrong; after all, I am perfect.” Are you either amused or tired by now? If so, I have reached my goal, “I am always right!” The truth is that we all love to be right; we all long to be right and strive to be right. The reality is that we just cannot be right all the time. We just don’t need to be right all the time, and we just don’t have to be right all the time. I personally love to argue, to stand for what I believe, and to use facts and science to back up my arguments. But, once new facts emerge that seem to contradict mine, I have to take one step back, reflect and have the courage to say, “I was wrong,” or “You were right.” Now, some people argue a lot, yet do recognize when they are wrong and could still be perceived by others as experiencing the cognitive distortion of “always being right,” and that would be an example of filtering. Filtering means, I pay attention only to the times when you stand for your beliefs, and I forget the times when you do acknowledge that you are wrong. Always Being Right means being wrong is always out of the question, by all means, and you will do whatever it takes to prove that you are right, regardless if it means disregarding everyone’s feelings. You will not stop until you prove that you are right. As you can see, there is an extremist aspect to this, and one associated cognitive distortion is polarized thinking. There is no in between, “I am right, I am always right, and you are just wrong and always wrong.” You can see how problematic this can be in the lives of your patients and clients. And a simple intervention that you may use lies in the Socratic method. “What is the worst that could possibly happen, if one day, you admitted that you were wrong this time?” How would your patients or clients respond to this?
Vladimir persisted, and so did you in reading up to this total of twelve cognitive distortions. Now, you can start by helping your patients and clients identify them, and collaboratively put a plan in place to help work on them and watch them grow and achieve recovery, which otherwise might have been elusive.
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, and management, experience. Some of his passions are public speaking, leadership, business, 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.
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