Because thoughts and feelings are interdependent, thoughts are a key part of emotional distress. Normal situations can turn negative based on how they are interpreted—often through the lens of inaccurate or distorted thinking.
Unresolved cognitive distortions—thought patterns that create a biased or unhealthy view of reality—can worsen anxiety and depression, as well as a range of other mental health issues. There are two kinds of distortion:
Tangible Distortion: An individual believes he cannot complete a task despite evidence to the contrary. Someone else believes her health is declining despite getting a doctor’s clean bill of health.
Abstract Distortion: An individual believes he is disliked by his friends and family. Another believes they have lost a core aspect of their identity or personality.
Examples of cognitive distortions:
Black-and-white or “polarizing” thinking: A tendency to think in extremes, either good or bad, without seeing nuance or complexity. For example, an individual can have a feeling of being either perfect or a total failure, or rely on such words as “always,” “never,” “impossible” or “disaster.” Negative polarizing thinking can become a habit; it can:
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- Hurt physical and mental health
- Sabotage school or work
- Disrupt relationships
Catastrophizing: A tendency to assume the worst possible outcome in a stressful situation or to exaggerate the difficulties to be faced. For example, worry over failing an exam can lead to thoughts of being a bad student who will never succeed in life. Because it is often not intentional, catastrophizing is not simply over-exaggeration and can result in high frustration and anger.
Overgeneralizing: A tendency to rely on overly broad thinking and language—words like “always,” “never,” “everybody” and “nobody”—in evaluating events or people, despite the inaccuracy of such words. Once something “always” happens, the individual responds to the pattern of events, instead of just the one event. For example, an individual who states he is stopped at “every” red light grows more frustrated every time he drives. People who overgeneralize tend to get angrier than others, express anger in less healthy ways and suffer greater consequences as a result.
Personalizing: A tendency to automatically blame oneself, despite evidence an event or action is not one’s fault or beyond one’s control. For example, when there’s no response to her group text, the teenager thinks “no one wants to be friends with me anymore”—when they are actually busy at that moment.
The goal of cognitive therapy is to pursue accurate thinking and to do this through problem solving. Shifts in thinking and in style of interpretation take time and practice to accomplish. But first, clients need to form a clear sense of where the change must take place to reach their goals by:
1 – Identifying key (or “hot”) thoughts that create emotional distress
2 – Determining whether or not key thoughts are accurate—and taking steps that aim to:
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- Make them more accurate, if inaccurate
- Problem solve, if accurate
- Accept the distress and refocus attention to keep distress in perspective, if accurate but without solution
