How Distorted Thinking Increases Stress and Anxiety

 

I learned about cognitive distortions in the 1990s from a book by David Burns called Feeling Good: The New Mood Therapy. I’d just moved from the faculty wing at U.C. Davis’ law school to serve as the dean of students. I knew how to teach law…but I didn’t feel competent to help students who were struggling emotionally.

When I shared my concerns with a friend who was a therapist, she recommended Feeling Good. She said it would help me recognize when a student was engaged in distorted thinking patterns that were increasing his or her stress and anxiety. I don’t know who benefitted more from the book: the students I was trying to help or me personally!

Many years later, after I became chronically ill, I found the notes I’d taken on ten cognitive distortions that Burns discusses in Feeling Good. I immediately realized that I had a new life challenge to apply them to. I’m indebted to him for this piece. I’ll describe each cognitive distortion and then include a suggestion or two for how to counter it.

Of course, before you can counter distorted thinking, you have to become aware that you’re engaging in it. To this end, it might be beneficial to make a list of the ten distortions and then look it over every few days. Or, you could write down some of your stressful and anxious thoughts and then look to see which of the ten distortions they fall under.

In my examples, I’ll focus on distortions that the chronically ill are prone to, but those of you who are in good health can substitute a word or two and I’m confident you’ll recognize yourself in these examples.

#1 All-or-Nothing Thinking

When you’re caught up in this cognitive distortion, if you fall short of perfect, you see yourself as a total failure. There’s no middle ground. An example: “Because I was in too much pain to do anything other than the dishes today, the house is a total mess.” (If you’re not struggling with your health, you could substitute “too busy” for “in too much pain.”)

To counter this cognitive distortion, start with a dose of self-compassion for the difficulty you’re encountering—in my example, the amount of pain you’re in. This is a circumstance of your life that simply makes it impossible for you to do everything you’d like to do. No blame! 

Then turn the thought around by focusing on what you did get done: “Given how much pain I was in today, it’s amazing that I managed to get the dishes done!”

#2 Overgeneralizing

When this cognitive distortion takes hold, if one thing is going wrong, you draw the general conclusion that everything will go wrong. Or, if something unpleasant happens, you conclude that it will happen over and over again.

I remember having an appointment with a doctor at which she wasn’t as attentive to me as usual. Instead of treating it as a single unpleasant experience (after all, she may have been having a really rough day), I jumped to the conclusion that she didn’t want to be my doctor anymore. This assumption on my part resulted in a lot of unnecessary stress and anxiety—unnecessary because, at subsequent appointments, she treated me with the care I’d become accustomed to receiving from her.

Here’s another example. You decide to take a short walk, but due to your symptoms, can only get half way around the block. You then overgeneralize by telling yourself, “I’ll never be able to get around the block.”

To counter overgeneralization, remind yourself that because an experience is unpleasant or doesn’t live up to your expectations one time doesn’t mean it will always be that way. It’s just your mind making a false assumption based one isolated experience.

It’s also helpful to keep in mind the phrase used by the well-known Zen monk and teacher, Thich Nhat Hanh. He suggests we ask ourselves, “Am I sure?” before jumping to a conclusion. “Am I sure the doctor doesn’t want me as a patient anymore?” (No!) “Am I sure I’ll never be able to make it around the block?” (No!) Questioning our tendency to overgeneralize keeps our minds open to the many possibilities that the future holds.

#3 Mentally Filtering Your Experience

Simply put, you filter out the positives of an experience and dwell on the negatives and on the disappointments. Repeatedly doing this can lead to a bleak vision of reality. Whether a person is chronically ill or not, almost all experiences in life are a mixture of positives and negatives; they have their pleasant aspects and their unpleasant aspects.

Here’s example from my life of how I can filter my experience to dwell on the negatives and the disappointments. When our son and his family come for Thanksgiving, I spend several hours visiting with them but invariably have to retire to my bedroom before the festivities are over. Unless I’m mindful of my tendency to engage in this cognitive distortion, once I’m in my bedroom, I dwell on what I couldn’t do instead of all that I was able to do. I’ll say to myself, “I couldn’t stay for the whole time they were here” instead of saying, “Wow, I was able to eat dinner with everyone!”

To counter this distortion, focus on the positive aspects of your experience, especially what you did do. If you still feel sad, that’s okay: treat yourself with compassion, perhaps by repeating a phrase that speaks directly to your disappointment, such as “It was so hard to leave the gathering while people were still here.”

#4 Disqualifying the Positive

Some of these cognitive distortions may sound similar, but there are subtle differences. When you disqualify the positive, you’re not just dwelling on the negatives by ignoring the positives, as in Mental Filtering. You go a step further and actively transform neutral or positive experiences into negative ones.

Here’s an example. You get a friendly message on your answering machine from someone you haven’t heard from in a long time, Instead of feeling good about it, you turn it into a negative experience: “She only called me because she felt obligated to, not because she wants to continue our friendship.”

Disqualifying the positive can have sad consequences, such as not returning the phone call of someone who really does want to keep in touch. I’ve found that it’s always best to give people the benefit of the doubt because their motives are almost always good. This is another example of where it’s helpful to ask yourself Thich Nhat Hanh’s “Am I Sure?” before turning a likely positive into a negative, such as deciding that a phone call was made out of obligation instead of out of simple friendship.

#5 Jumping to Conclusions

Here, you jump to a negative interpretation, even though it’s not supported by the facts. Sometimes this is called the “mind-reading error.” You conclude that someone is thinking negative things about you and then treat it as an established fact, even though that person has never given you cause to think this way.

I did this a lot when I first became chronically ill. I jumped to the conclusion that friends and colleagues thought I was a malingerer or that I didn’t want to work anymore. I had absolutely no evidence then or now that anyone was thinking this, yet I jumped to the conclusion that they were. This added tremendously to my emotional stress and mental suffering.

Again, the best way to counter this is with “Am I Sure?” Here’s another version of it from Korean Zen master Seung Sahn: Keep a “Don’t-Know Mind.” Am I Sure? and Don’t-Know Mind have been invaluable to me since I became chronically ill. In fact, I now rely on them to counter cognitive distortions that aren’t related to being sick.

#6 Catastrophizing (also known as Magnifying)

When you’re catastrophizing, you magnify the importance of something that’s happening or something that didn’t go the way you wanted it to. It’s as if you’re looking at the experience through binoculars, which blows it all out of proportion. An example. If my symptoms flare one day, instead of waiting to see if they subside by the morning, I magnify the experience and convince myself that this is my “new normal.” This can be the source of much stress and unhappiness.

I’d be surprised if anyone reading this hasn’t done this at some point, and it need not have been health-related. We can make ourselves miserable by magnifying our disappointments and frustrations. For example, I’ve been teaching myself the craft of Tunisian Crochet. One day a few months ago, when I didn’t do the second row correctly, this thought popped into my mind: “That’s it. You’ll never learn Tunisian Crochet.” Catastrophizing!

To counter the tendency to catastrophize, put your experience into perspective. I’m fortunate that I was able to do this fairly quickly with my Tunisian Crochet experience. I stopped the distorted thinking by saying to myself: “How silly! All I did was get one row wrong. Try again.” Now, Tunisian Crochet is easy for me; I’ve even made several scarves.

#7 Relying on Emotional Reasoning

This cognitive distortion has you believing that the way you feel is the way you are. “I feel like a failure at learning how to knit; therefore I am a failure.” “I feel stupid because I didn’t know the answer to his question; therefore I am stupid.“ “I feel as if I was boring at lunch; therefore I am boring.”

To counter this distortion, remind yourself that people often to jump to conclusions based on knee-jerk emotional reactions of the moment, but these conclusions do not reflect who they really are. Emotions arise in response to causes and conditions of the moment and are only temporary. Refuse to treat them as proof of who you are. Who you are is not only due to a complex combination of factors—it’s not even set in stone because you’re ever-changing!

#8 Using “Should” Statements

With this cognitive distortion, you try to motivate yourself and push yourself into shape—mentally and physically—by using “shoulds” and “shouldn’ts,” “oughts” and “musts.” These words are a set-up for negative self-judgment and self-blame (as I’ve written about before in this space and in all my books).

“I should exercise.” Well, maybe you shouldn’t! There are no hard and fast “shoulds” and “shouldn’ts” in life. It depends on your circumstances. Investigate what would be most beneficial for you and then do your best to act accordingly. If you’ve characterized your life in terms of “shoulds” and “shouldn’ts,” then when you come up short, you’ll feel guilty as if you deserve punishment when what you truly deserve is your compassion for having unfairly set impossible standards for yourself.

#9 Labeling Yourself and Others

When we label ourselves and others (“I’m incompetent,” “He’s irresponsible”), we’re engaging in a form of overgeneralization (#2 above) because no one is just one thing.

I suggest that you counter this distorted thinking by reminding yourself that labels do nothing but make us and other people feel bad. Find different ways to describe what happened—words that stick to the facts and don’t include labels. For example, instead of “I’m incompetent,” try “This is hard to learn; I’ll keep at it.” Instead of “He’s irresponsible,” try “I was expecting him at 4:00, but he didn’t come until 4:30.”

#10 Personalization

Personalization is a major trigger for self-blame. It occurs when you erroneously see yourself as the cause of some external negative event, even though you weren’t responsible for it. An example is when you feel responsible for whether people have a good time when you’re with them.

You can counter this cognitive distortion by putting in perspective what you actually control in this life. You certainly don’t control what other people are thinking or how they’re feeling or whether they’re having fun. It’s always been that way and always will be. All you can do is act with kindness and with care for yourself and others. The rest is out of your control.

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We shouldn’t be surprised that the mind is so adept at distorted thinking. As Buddhist teacher, Bhante Gunaratana said in a comment I quote in my book How to Wake Up: “Your mind is a shrieking, gibbering madhouse on wheels…No problem.” How nice to be told that it’s no problem! Bhante’s perspective enables me to hold these distortions more lightly and to not blame myself when they make an appearance in my mind.

In fact, I find it helpful to shake my head in amazement at the crazy stuff that goes on in my mind at times. I might say something to myself like, “This mind of mine is so unruly, so unreasonable!” This attitude helps me recognize that I’m engaging in a cognitive distortion, and this recognition alone opens the door to finding constructive ways to counter each of these ten distortions.