A cognitive distortion is an exaggerated or irrational thought pattern involved in the onset or perpetuation of
psychopathological states, such as
depression and
anxiety
Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
.
Cognitive distortions are thoughts that cause individuals to perceive reality inaccurately. According to
Aaron Beck
Aaron Temkin Beck (July 18, 1921 – November 1, 2021) was an American psychiatrist who was a professor in the department of psychiatry at the University of Pennsylvania. 's cognitive model, a negative outlook on reality, sometimes called ''negative
schemas'' (or ''schemata''), is a factor in symptoms of emotional dysfunction and poorer
subjective well-being
Subjective well-being (SWB) is a self-reported measure of well-being, typically obtained by questionnaire.
Ed Diener developed a tripartite model of subjective well-being in 1984, which describes how people experience the quality of their lives ...
. Specifically, negative thinking patterns reinforce negative
emotion
Emotions are mental states brought on by neurophysiological changes, variously associated with thoughts, feelings, behavioral responses, and a degree of pleasure or displeasure. There is currently no scientific consensus on a definition. ...
s and thoughts.
During difficult circumstances, these distorted thoughts can contribute to an overall negative outlook on the world and a depressive or anxious mental state. According to
hopelessness theory and
Beck's theory, the meaning or interpretation that people give to their experience importantly influences whether they will become depressed and whether they will experience severe, repeated, or long-duration episodes of depression.
Challenging and changing cognitive distortions is a key element of
cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (suc ...
(CBT).
Definition
Cognitive comes from the Medieval Latin , equivalent to Latin , 'known'. Distortion means the act of twisting or altering something out of its true, natural, or original state.
History
In 1957, American psychologist
Albert Ellis, though he did not know it yet, would aid
cognitive therapy
Cognitive therapy (CT) is a type of psychotherapy developed by American psychiatrist Aaron T. Beck. CT is one therapeutic approach within the larger group of cognitive behavioral therapies (CBT) and was first expounded by Beck in the 1960s. Cogn ...
in correcting cognitive distortions and indirectly helping
David D. Burns
David D. Burns (born September 19, 1942) is an American psychiatrist and adjunct professor emeritus in the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine and the author of bestselling books such as ...
in writing ''
The Feeling Good Handbook
''Feeling Good: The New Mood Therapy'' is a book written by David D. Burns, first published in 1980, that popularized cognitive behavioral therapy (CBT).
Origins
''Feeling Good'' grew out of dissatisfaction with conventional Freudian treatment o ...
''. Ellis created what he called the ABC Technique of rational beliefs. The ABC stands for the activating event, beliefs that are irrational, and the consequences that come from the belief. Ellis wanted to prove that the activating event is not what caused the emotional behavior or the consequences, but the beliefs and how the person irrationally perceive the events that aids the consequences. With this model, Ellis attempted to use
rational emotive behavior therapy (REBT) with his patients, in order to help them "reframe" or reinterpret the experience in a more rational manner. In this model Ellis explains it all for his clients, while Beck helps his clients figure this out on their own. Beck first started to notice these automatic distorted thought processes when practicing
psychoanalysis
PsychoanalysisFrom Greek: + . is a set of theories and therapeutic techniques"What is psychoanalysis? Of course, one is supposed to answer that it is many things — a theory, a research method, a therapy, a body of knowledge. In what might b ...
, while his patients followed the rule of saying anything that comes to mind. Aaron realized that his patients had irrational fears, thoughts, and perceptions that were automatic. Beck began noticing his automatic thought processes that he knew his patients had but did not report. Most of the time the thoughts were biased against themselves and very erroneous.
Beck believed that the negative schemas developed and manifested themselves in the perspective and behavior. The distorted thought processes lead to focusing on degrading the self, amplifying minor external setbacks, experiencing other's harmless comments as ill-intended, while simultaneously seeing self as inferior. Inevitably cognitions are reflected in their behavior with a reduced desire to care for oneself, to seek pleasure, and give up. These exaggerated perceptions, due to cognition, feel real and accurate because the
schemas, after being reinforced through the behavior, tend to become automatic and do not allow time for reflection. This cycle is also known as
Beck's cognitive triad
Beck's cognitive triad, also known as the negative triad, is a cognitive-therapeutic view of the three key elements of a person's belief system present in depression. It was proposed by Aaron Beck in 1967. The triad forms part of his cognitive th ...
, focused on the theory that the person's negative schema applied to the self, the future, and the environment.
In 1972, psychiatrist, psychoanalyst, and cognitive therapy scholar
Aaron T. Beck published ''Depression: Causes and Treatment.''
He was dissatisfied with the conventional
Freudian treatment of
depression, because there was no empirical evidence for the success of Freudian psychoanalysis. Beck's book provided a comprehensive and empirically-supported theoretical model for depression—its potential causes, symptoms, and treatments. In Chapter 2, titled "Symptomatology of Depression", he described "cognitive manifestations" of depression, including low self-evaluation, negative expectations, self-blame and
self-criticism, indecisiveness, and distortion of the
body image
Body image is a person's thoughts, feelings and perception of the aesthetics or sexual attractiveness of their own body. The concept of body image is used in a number of disciplines, including neuroscience, psychology, medicine, psychiatry, ps ...
.
Beck's student
David D. Burns
David D. Burns (born September 19, 1942) is an American psychiatrist and adjunct professor emeritus in the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine and the author of bestselling books such as ...
continued research on the topic. In his book ''
Feeling Good: The New Mood Therapy'', Burns described personal and professional anecdotes related to cognitive distortions and their elimination. When Burns published ''Feeling Good: The New Mood Therapy'', it made Beck's approach to distorted thinking widely known and popularized.
Burns sold over four million copies of the book in the United States alone. It was a book commonly "prescribed" for patients who have cognitive distortions that have led to depression. Beck approved of the book, saying that it would help others alter their depressed moods by simplifying the extensive study and research that had taken place since shortly after Beck had started as a student and practitioner of psychoanalytic psychiatry. Nine years later, ''The Feeling Good Handbook'' was published, which was also built on Beck's work and includes a list of ten specific cognitive distortions that will be discussed throughout this article.
Main types
![Common Cognitive Biases](https://upload.wikimedia.org/wikipedia/commons/d/d0/Common_Cognitive_Biases.png)
John C. Gibbs and Granville Bud Potter propose four categories for cognitive distortions: ''self-centered'', ''blaming others'', ''minimizing-mislabeling'', and ''assuming the worst''. The cognitive distortions listed below
are categories of automatic thinking, and are to be distinguished from
logical fallacies.
All-or-nothing thinking
The "all-or-nothing thinking distortion" is also referred to as "splitting",
"black-and-white thinking",
and "polarized thinking."
Someone with the all-or-nothing thinking distortion looks at life in black and white categories.
Either they are a success or a failure; either they are good or bad; there is no in-between. According to one article, "Because there is always someone who is willing to criticize, this tends to collapse into a tendency for polarized people to view themselves as a total failure. Polarized thinkers have difficulty with the notion of being 'good enough' or a partial success."
* Example (from ''The Feeling Good Handbook''): A woman eats a spoonful of ice cream. She thinks she is a complete failure for breaking her diet. She becomes so depressed that she ends up eating the whole quart of ice cream.
This example captures the polarized nature of this distortion—the person believes they are totally inadequate if they fall short of perfection.
In order to combat this distortion, Burns suggests thinking of the world in terms of shades of gray.
Rather than viewing herself as a complete failure for eating a spoonful of ice cream, the woman in the example could still recognize her overall effort to diet as at least a partial success.
This distortion is commonly found in
perfectionists.
Jumping to conclusions
Reaching preliminary conclusions (usually negative) with little (if any) evidence. Three specific subtypes are identified:
Mind reading
Inferring
Inferences are steps in reasoning, moving from premises to logical consequences; etymologically, the word ''wikt:infer, infer'' means to "carry forward". Inference is theoretically traditionally divided into deductive reasoning, deduction and in ...
a person's possible or probable (usually negative) thoughts from their
behavior
Behavior (American English) or behaviour (British English) is the range of actions and mannerisms made by individuals, organisms, systems or artificial entities in some environment. These systems can include other systems or organisms as wel ...
and
nonverbal communication; taking precautions against the worst suspected case without asking the person.
* Example 1: A student assumes that the readers of their paper have already made up their minds concerning its topic, and, therefore, writing the paper is a pointless exercise.
* Example 2: Kevin assumes that because he sits alone at lunch, everyone else must think he is a loser. (This can encourage
self-fulfilling prophecy
A self-fulfilling prophecy is a prediction that comes true at least in part as a result of a person's or group of persons' belief or expectation that said prediction would come true. This suggests that people's beliefs influence their actions. ...
; Kevin may not initiate social contact because of his fear that those around him already perceive him negatively).
Fortune-telling
Predicting outcomes (usually negative) of events.
* Example: A depressed person tells themselves they will never improve; they will continue to be depressed for their whole life.
One way to combat this distortion is to ask, "If this is true, does it say more about me or them?"
Labeling
Labeling occurs when someone overgeneralizes characteristics of other people. For example, someone might use an unfavorable term to describe a complex person or event.
Emotional reasoning
In the emotional reasoning distortion, it is assumed that feelings expose the true nature of things and experience reality as a reflection of emotionally linked thoughts; something is believed true solely based on a feeling.
* Examples: "I feel stupid, therefore I must be stupid".
Feeling fear of flying in planes, and then concluding that planes must be a dangerous way to travel.
Feeling overwhelmed by the prospect of cleaning one's house, therefore concluding that it's hopeless to even start cleaning.
Should/shouldn't and must/mustn't statements
Making "must" or "should" statements was included by
Albert Ellis in his
rational emotive behavior therapy (REBT), an early form of CBT; he termed it "musturbation". Michael C. Graham called it "expecting the world to be different than it is". It can be seen as demanding particular achievements or behaviors regardless of the realistic circumstances of the situation.
* Example: After a performance, a concert pianist believes he or she should not have made so many mistakes.
* In ''Feeling Good: The New Mood Therapy'', David Burns clearly distinguished between pathological "should statements",
moral imperatives, and
social norm
Social norms are shared standards of acceptance, acceptable behavior by groups. Social norms can both be informal understandings that govern the behavior of members of a society, as well as be codified into wikt:rule, rules and laws. Social normat ...
s.
A related cognitive distortion, also present in Ellis' REBT, is a tendency to "awfulize"; to say a future scenario will be awful, rather than to realistically appraise the various negative and positive characteristics of that scenario.
According to Burns, "must" and "should" statements are negative because they cause the person to feel guilty and upset at themselves. Some people also direct this distortion at other people, which can cause feelings of anger and frustration when that other person does not do what they should have done. He also mentions how this type of thinking can lead to rebellious thoughts. In other words, trying to whip oneself into doing something with "shoulds" may cause one to desire just the opposite.
Gratitude traps
A gratitude trap is a type of cognitive distortion that typically arises from misunderstandings regarding the nature or practice of
gratitude. The term can refer to one of two related but distinct thought patterns:
* A self-oriented thought process involving feelings of
guilt,
shame
Shame is an unpleasant self-conscious emotion often associated with negative self-evaluation; motivation to quit; and feelings of pain, exposure, distrust, powerlessness, and worthlessness.
Definition
Shame is a discrete, basic emotion, d ...
, or
frustration
In psychology, frustration is a common emotional response to opposition, related to anger, annoyance and disappointment. Frustration arises from the perceived resistance to the fulfillment of an individual's will or goal and is likely to inc ...
related to one's expectations of how things "should" be
* An "elusive ugliness in many relationships, a deceptive 'kindness,' the main purpose of which is to make others feel indebted", as defined by psychologist Ellen Kenner
Blaming others
Personalization and blaming
Personalization is assigning personal blame disproportionate to the level of control a person realistically has in a given situation.
* Example 1: A foster child assumes that he/she has not been adopted because he/she is not "loveable enough".
* Example 2: A child has bad grades. His/her mother believes it is because she is not a good enough parent.
Blaming is the opposite of personalization. In the blaming distortion, the disproportionate level of blame is placed upon other people, rather than oneself.
In this way, the person avoids taking personal responsibility, making way for a "
victim mentality
Victim mentality is an acquired personality trait in which a person tends to recognize or consider themselves a victim of the negative actions of others, and to behave as if this were the case in the face of contrary evidence of such circumstances ...
".
* Example: Placing blame for marital problems entirely on one's spouse.
Always being right
In this cognitive distortion, being wrong is unthinkable. This distortion is characterized by actively trying to prove one's actions or thoughts to be correct, and sometimes prioritizing
self-interest
Self-interest generally refers to a focus on the needs or desires (''interests'') of one's self. Most times, actions that display self-interest are often performed without conscious knowing. A number of philosophical, psychological, and economi ...
over the feelings of another person.
In this cognitive distortion, the facts that oneself has about their surroundings are always right while other people's opinions and perspectives are wrongly seen.
Fallacy of change
Relying on
social control to obtain cooperative actions from another person.
The underlying assumption of this thinking style is that one's happiness depends on the actions of others. The fallacy of change also assumes that other people should change to suit one's own interests automatically and/or that it is fair to pressure them to change. It may be present in most abusive relationships in which partners' "visions" of each other are tied into the belief that happiness, love, trust, and perfection would just occur once they or the other person change aspects of their beings.
Minimizing-mislabeling
Magnification and minimization
Giving proportionally greater weight to a perceived failure, weakness or threat, or lesser weight to a perceived success, strength or opportunity, so that the weight differs from that assigned by others, such as "
making a mountain out of a molehill". In depressed clients, often the positive characteristics of ''other people'' are exaggerated and their negative characteristics are understated.
*
Catastrophizing
Exaggeration is the representation of something as more extreme or dramatic than it really is. Exaggeration may occur intentionally or unintentionally.
Exaggeration can be a rhetorical device or figure of speech. It may be used to evoke stron ...
– Giving greater weight to the worst possible outcome, however unlikely, or experiencing a situation as unbearable or impossible when it is just uncomfortable.
Labeling and mislabeling
A form of overgeneralization; attributing a person's actions to their character instead of to an attribute. Rather than assuming the behaviour to be accidental or otherwise extrinsic, one assigns a label to someone or something that is based on the inferred character of that person or thing.
Assuming the worst
Overgeneralizing
Someone who overgeneralizes makes
faulty generalization
A faulty generalization is an informal fallacy wherein a conclusion is drawn about all or many instances of a phenomenon on the basis of one or a few instances of that phenomenon. It is similar to a proof by example in mathematics. It is an exampl ...
s from insufficient evidence. Such as seeing a "single negative event" as a "never-ending pattern of defeat",
and as such drawing a very broad conclusion from a single incident or a single piece of evidence. Even if something bad happens only once, it is expected to happen over and over again.
* Example 1: A young woman is asked out on a first date, but not a second one. She is distraught as she tells her friend, "This always happens to me! I'll never find love!"
* Example 2: A woman is lonely and often spends most of her time at home. Her friends sometimes ask her to dinner and to meet new people. She feels it is useless to even try. No one really could like her. And anyway, all people are the same; petty and selfish.
One suggestion to combat this distortion is to "examine the evidence" by performing an accurate analysis of one's situation. This aids in avoiding exaggerating one's circumstances.
Disqualifying the positive
Disqualifying the positive refers to rejecting positive experiences by insisting they "don't count" for some reason or other. Negative belief is maintained despite contradiction by everyday experiences. Disqualifying the positive may be the most common fallacy in the cognitive distortion range; it is often analyzed with "always being right", a type of distortion where a person is in an all-or-nothing self-judgment. People in this situation show signs of depression. Examples include:
*"I will never be as good as Jane"
*"Anyone could have done as well"
*"They are just congratulating me to be nice"
Mental filtering
Filtering distortions occur when an individual dwells only on the negative details of a situation and filters out the positive aspects.
* Example: Andy gets mostly compliments and positive feedback about a presentation he has done at work, but he also has received a small piece of criticism. For several days following his presentation, Andy dwells on this one negative reaction, forgetting all of the positive reactions that he had also been given.
''The Feeling Good Handbook'' notes that filtering is like a "drop of ink that discolors a beaker of water".
One suggestion to combat filtering is a
cost–benefit analysis
Cost–benefit analysis (CBA), sometimes also called benefit–cost analysis, is a systematic approach to estimating the strengths and weaknesses of alternatives. It is used to determine options which provide the best approach to achieving benefits ...
. A person with this distortion may find it helpful to sit down and assess whether filtering out the positive and focusing on the negative is helping or hurting them in the long run.
Conceptualization
In a series of publications, philosopher Paul Franceschi has proposed a unified conceptual framework for cognitive distortions designed to clarify their relationships and define new ones. This conceptual framework is based on three notions: (i) the reference class (a set of phenomena or objects, e.g. events in the patient's life); (ii) dualities (positive/negative, qualitative/quantitative, ...); (iii) the taxon system (degrees allowing to attribute properties according to a given duality to the elements of a reference class). In this model, "dichotomous reasoning", "minimization", "maximization" and "arbitrary focus" constitute general cognitive distortions (applying to any duality), whereas "disqualification of the positive" and "catastrophism" are specific cognitive distortions, applying to the positive/negative duality. This conceptual framework posits two additional cognitive distortion classifications: the "omission of the neutral" and the "requalification in the other pole".
Cognitive restructuring
Cognitive restructuring (CR) is a popular form of therapy used to identify and reject maladaptive cognitive distortions, and is typically used with individuals diagnosed with depression.
In CR, the therapist and client first examine a stressful event or situation reported by the client. For example, a depressed male college student who experiences difficulty in dating might believe that his "worthlessness" causes women to reject him. Together, therapist and client might then create a more realistic cognition, e.g., "It is within my control to ask girls on dates. However, even though there are some things I can do to influence their decisions, whether or not they say yes is largely out of my control. Thus, I am not responsible if they decline my invitation." CR therapies are designed to eliminate "automatic thoughts" that include clients' dysfunctional or negative views. According to Beck, doing so reduces feelings of worthlessness, anxiety, and anhedonia that are symptomatic of several forms of mental illness.
CR is the main component of Beck's and Burns's CBT.
Narcissistic defense
Those diagnosed with
narcissistic personality disorder
Narcissistic personality disorder (NPD) is a personality disorder characterized by a life-long pattern of exaggerated feelings of self-importance, an excessive need for admiration, a diminished ability or unwillingness to empathize with other ...
tend, unrealistically, to view themselves as superior, overemphasizing their strengths and understating their weaknesses.
Narcissists use
exaggeration and
minimization this way to shield themselves against
psychological pain
Psychological pain, mental pain, or emotional pain is an unpleasant feeling (a suffering) of a psychological, non-physical origin. A pioneer in the field of suicidology, Edwin S. Shneidman, described it as "how much you hurt as a human being. It ...
.
Decatastrophizing
In cognitive therapy, decatastrophizing or decatastrophization is a cognitive restructuring technique that may be used to treat cognitive distortions, such as magnification and catastrophizing, commonly seen in psychological disorders like
anxiety
Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
and
psychosis
Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior ...
. Major features of these disorders are the subjective report of being overwhelmed by life circumstances and the incapability of affecting them.
The goal of CR is to help the client change their perceptions to render the felt experience as less significant.
Criticism
Common criticisms of the diagnosis of cognitive distortion relate to
epistemology
Epistemology (; ), or the theory of knowledge, is the branch of philosophy concerned with knowledge. Epistemology is considered a major subfield of philosophy, along with other major subfields such as ethics, logic, and metaphysics.
Episte ...
and the theoretical basis. If the perceptions of the patient differ from those of the therapist, it may not be because of intellectual malfunctions but because the patient has different experiences. In some cases, depressed subjects appear to be "sadder but wiser".
See also
References
{{Defence mechanisms
Cognitive therapy
Defence mechanisms
Cognitive biases
Anxiety
Barriers to critical thinking
Depression (mood)
Error
Narcissism
Deception