Episode 002: Cognitive Distortions and Practicing Truth

David Puder, MD

There are no conflicts of interest for this episode.

This week we discussed cognitive distortions with Adam Borecky, M.D. Usually, cognitive behavioral therapists deal with cognitive distortions by helping their clients identify habitual negative thoughts and putting those thoughts on trial. We don’t have to accept every thought that passes through our brains as truth. When we have distressing thoughts, it can be helpful to consider if we might be telling ourselves the full truth about a situation.

We refer to common cognitive distortions—depression, anxiety, feelings of failure, negative thoughts when interacting with people, social anxiety—and we see how they are applying to our thought process.

For a PDF of the cognitive distortions and an 8 days journal task towards better identifying them in your life, please see my resource page. In this 8 day journey, you will better identify your own troubling thoughts and move towards gratitude.

  • All or nothing thinking: things are black and white, completely without shades of gray.  For example, you may think, “If I am not perfect, I should not try at all, because then I would fail completely.” Or you might think, “My significant other is completely evil.” And then the next day, “My significant other is perfect.”  

  • Overgeneralization: generalizations are made without context, experience or evidence.  “I am always alone.”  Or “Everyone hates me.”  “I never win.” Always? Never?  Everyone? It happens absolutely all the time, without exceptions? In the moment, it can feel like that, but those statements are actually rarely true. Speaking truth to yourself, in this case, might look like: I am sometimes alone, several people are upset at me, I win sometimes, even if I didn’t this time.

  • Mental Filter: focusing on the negative rather than the whole picture. After receiving multiple positive statements and one negative statement, all you focus on is the negative statement.  

  • Disqualifying the positive: When you do something good like getting a compliment or award, you instantly find ways to make less of it! For example, if someone says, “You are looking good today,” but instantly you assume that person is giving you a false compliment.  

  • Jumping to conclusions (without evidence): reaching conclusions (usually negative) without little evidence.

    • Mind reading: assuming you know what the person is thinking about you. Connection occurs from accurately knowing another, and with mindreading you blind yourself without evidence.

    • Fortune telling: predicting negative things in the future. For example, you think “I am going to fail this test even if I study,” so you don’t try, don’t study, and don’t even show up.

  • Magnification or Minimization: you make some weakness of yours much larger than it is or a strength much less than it really is. For example, you see your friends as beautiful whereas you see your own beauty as very average.

    • Magnification of self and minimization of others (narcissism)

  • Emotional Reasoning: believe that your feelings reflect reality. For example, “I feel stupid, therefore I am.” or “I feel fearful of flying in planes, therefore, they must be dangerous,” or “I feel ugly therefore I am ugly despite what others tell me.”  

  • Shoulding: a thing that you believe you should or should not do, often created to try to maintain an image of yourself which is more in line with social pressures. For example, “I should be perfect,” “I should never cry,” “I should always win,” “I should be able to do this on the first try.”

  • Personalization: blaming oneself for a bad event without looking at external factors that contributed to the bad event. Attributing personal responsibility to things that you have no control over, or when you do not see all the things that caused something. For example, a friend is upset so you think it is something you caused or are responsible for.  

  • Error Messages: thoughts that are like obsessive compulsive disorder due to having thoughts that are repetitive, intrusive and not meaningful.

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Episode 003: Psychopathy with Michael A. Cummings M.D.

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Episode 001: The Basics of the Psychiatric Interview