Cognitive distortions are exaggerated patterns of thought that are not based on facts and can result in people viewing things more negatively than they really are.
When a person experiences a mental health condition such as depression or anxiety disorders, they are often preceded by a number of unhelpful self-statements and thoughts.
People may attribute negative and unhelpful thoughts about themselves, others, and the world.
Often there will be a pattern for such thoughts, these being called cognitive distortions. In the 1960s, psychiatrist Aaron Beck pioneered research on cognitive distortion in his development of a treatment known as cognitive behavioral therapy (CBT).
Since then, researchers have identified many common cognitive distortions.
Many people can use cognitive distortions as an automatic habit without much awareness.
It is normal to fall into these thinking habits occasionally, especially when feeling down. But when a person consistently and repeatedly uses cognitive distortions, they can often cause themselves a great deal of emotional distress, and their mental health can suffer.
Cognitive distortions may be seen as a way to cope with adverse life events.
The more severe and prolonged these events are, the more likely that one or more cognitive distortions will form. These thoughts are usually not rational or healthy in the long term and can greatly impact how people feel and behave.
These thoughts are usually considered consistent errors in thinking, and people are likely to believe these thoughts without weighing up the evidence to the contrary.
Below will be some of the many types of identified cognitive distortions and how they can affect a person’s thoughts and behaviors.
Overgeneralization
This type of cognitive distortion involves making broad negative conclusions that are far beyond what the situation indicates. A person may take one instance that happened in either the past or present and impose this onto all current or future situations.
Someone may have started a new job and had an awkward first interaction with their co-worker. Someone who overgeneralizes may take this one interaction and believe that because of this, they will be terrible at the job as a whole.
They will irrationally believe broad conclusions at now being able to succeed based on one negative interaction.
With overgeneralization, words like ‘always,’ ‘never,’ ‘everything,’ and ‘nothing’ as frequently used in trains of thought.
For instance, a person who overgeneralizes may say, ‘I never accomplish anything,’ ‘Everyone hates me,’ or ‘I always clean up after you.’
If the individual took a step back and analyzed the evidence, they may find that these broad statements are far from the truth.
These thoughts may arise from a sense of learned helplessness, depression, or anxiety disorders.
Making generalized and global conclusions on the basis of only a little evidence can leave someone thinking that things are uncontrollable, inevitable, and out of control.
If this cognitive distortion ruminates, it could leave people frustrated, discouraged, depressed, and annoyed.
Mental Filters
This thinking style involves a ‘filtering in’ and ‘filtering out’ process, similar to tunnel vision. This involves a disproportionate amount of attention being given to small, negative details instead of seeing the larger picture, which often has more positive details.
All the positive aspects of a situation get ignored or are distorted due to what may be a single negative detail. A good way to think of this is as if someone is looking at the world through dirty glasses, and not seeing the whole picture.
An example of this cognitive distortion is imagining going out for a romantic meal with a partner. You may be having a really nice time together, but at the end of the dinner, you disagree about how much of a tip to leave.
If using mental filters, you may stew on this disagreement for the rest of the evening.
Although the rest of the evening may have been a positive experience, you may focus solely on the one negative thing that happened and exclude all other details that were enjoyable.
This means you may not remember the night as pleasant when looking back on it. Instead, you may keep experiencing the negative feelings associated with that event.
People may be more likely to remember negative parts of events, especially when feeling depressed.
If someone continues to dwell on all the negative details in every situation, this could make someone feel more depressed. This distortion can also contribute to problems, including anxiety, poor self-belief, and interpersonal problems.
Discounting The Positive
This cognitive distortion is similar to mental filtering; the difference is that the positive aspects of a situation are dismissed as something of little value.
This is common for people who are depressed in that they may only focus on the negatives of a situation and not give themselves credit for the positives.
They will usually explain away or have reasons for why they achieved something. For instance, when they pass an exam, they may say, ‘It was an easy exam’ or ‘It’s something I should have known anyway, so it doesn’t matter.’
Another example is if someone compliments the way you look, and you dismiss it as them only ‘being polite,’ or if you do well in a job interview, you may think this is because they didn’t realize that you’re not that good yet.
People who have low self-esteem tend to use this cognitive distortion. This distortion is unhelpful as people may never feel proud of their accomplishments, can have a lower sense of self, or may push themselves to do better beyond what is realistically achievable.
Jumping To Conclusions
Although there are times when we can have gut feelings that turn out to be right, there are times when we are not right. People who jump to conclusions do so in two ways.
They can do this when they assume they know what someone else is thinking (mind reading) and when they make predictions about what is going to happen in the future (predictive thinking).
These conclusions are usually negative to the individual rather than positive conclusions.
Mind Reading
Mindreading involves the belief in knowing what others are thinking instead of considering more likely possibilities. Those who mindread tend to assume that they know what someone else is thinking or that they know the reasons behind someone else’s behavior.
For example, when spending time with a friend, they check their phone when you talk to them. Someone who mindreads may think, ‘they must think I am boring,’ whereas a more likely explanation could be that the friend is expecting an important phone call.
Another example is if your boss asks to see you in their office. You may think, ‘They must be mad at me. I am going to get fired,’ when there are countless other explanations that may be more likely.
Predictive Thinking
People can also jump to conclusions when they start making predictions about what is going to happen on some future occasion, which is called predictive thinking.
These are predictions where someone overestimates the negative emotions or experiences that are going to be encountered. For instance, when about to give a presentation for an assignment, you may have thoughts such as ‘I will mess up,’ ‘my voice will be shaky,’ and ‘I will do terribly.’
You may have succeeded at doing something many times before, but despite this, you may still predict things will go wrong.
This type of thinking is very common for people with anxiety disorders such as generalized anxiety and social anxiety disorder, and it is a way to increase anxiety and stress further.
People with anxiety disorders may be more likely to avoid situations where they predict something bad will happen, which in turn makes it harder for them to overcome their anxiety.
Magnification
This type of cognitive distortion involves unreasonably magnifying the negatives and unreasonably minimizing the positives. This is similar to discounting the positive, but instead of dismissing the positive attributes, they are minimized in themselves but magnified in other people.
Likewise, the negative attributes in themselves are magnified but minimized in others. People may often explain away their own positive characteristics or achievements as if they are not important.
This distortion can be thought of as looking through the world through either end of the same pair of binoculars.
An example of minimization is if you got a promotion at work, you might think, ‘I was just lucky.’ Or if you pass an exam, you might believe ‘it didn’t count, it wasn’t important.’
An example of magnification is if you made a mistake on a work assignment, you might think, ‘This is terrible’ or ‘I have failed at my job.’
Disqualifying one’s own attributes or achievements can have negative effects, such as lowering feelings of self-worth and sense of self. This type of thinking can also affect behavior in a variety of ways.
It can contribute to feelings of anxiety, fear, and panic because it causes people to exaggerate the importance of insignificant events.
People often believe that other people notice and judge their small mistakes when in reality, other people are probably more concerned with their own errors.
At the same time, they will minimize their own ability to cope with feelings of stress and anxiety, which can then contribute to increased anxiety and avoidance of many situations.
Emotional Reasoning
This cognitive distortion involves believing something to be true because the person feels that it is true. This is basing views of the situation, oneself, or others, on the way the person feels about them.
They will usually ignore or discount any evidence that doesn’t support their conclusion; the only evidence that something bad will happen is that they feel like something bad will happen.
People may experience emotional reasoning when they feel anxious about something. They may have a feeling that things will not work out, despite any evidence of this being true.
People who use emotional reasoning tend to take their emotions as being evidence of the truth. This thinking can contribute to a number of problems, including feelings of anxiety and depression.
Whilst this distortion is common in those who have anxiety or depression, it’s thought that emotional reasoning is a very common way of thinking that many people engage in.
‘Should’ And ‘Must’ Statements
‘Should’ and ‘must’ statements create precise and fixed ideas of how others should behave and overestimate how bad it is when these behavioral expectations are not met.
It is not necessarily unhelpful to have some shoulding and musting statements, such as ‘I should get to work on time’ or ‘I shouldn’t drink alcohol and drive home.’ These statements only become unhelpful when they put unreasonable demands or pressure on yourself and others.
Some example statements which are unhelpful include ‘I should always get things right,’ ‘I must be the best,’ and ‘they should know better than that.’
Someone who repeatedly uses these kinds of statements may feel guilty or disappointed in themselves. Likewise, they may leave someone feeling frustrated, angry, or disappointed in others, resulting in interpersonal issues.
Labeling
This type of cognitive distortion involves assigning labels to the self, others, and the world. These are often negative labels that make global statements based on behavior in specific situations.
People may use negative labels even though there are many more examples that aren’t consistent with that label.
For example, you may knock over a hot drink onto the carpet and say, ‘I am such an idiot.’ Or, if a friend appears to ignore you when you pass them in the street, you may think, ‘They are inconsiderate.’
These labels essentially generalize people and ignore all the other positive characteristics and actions. When stepping back from the situation, you may realize that one action does not define someone.
The friend you saw on the street may have had a lot on their mind and truly did not see you. Labeling people in this way based on only one situation can result in interpersonal issues.
Likewise, labeling the self in a negative way can impact self-esteem and self-worth.
Personalization and Blame
Personalization and blame involve beliefs that others are behaving negatively because of them, without giving any consideration for more likely explanations for this behavior. They may take others’ behaviors personally and take total responsibility for external events occurring.
The person may take 100% of the responsibility for the occurrence of external events, usually when something hasn’t gone quite as wanted or expected.
People can blame themselves for everything that goes wrong or could go wrong, even when they may only be partly responsible or not responsible at all.
Example statements of this cognitive distortion are ‘this is all my fault’ and ‘I’m to blame.’ Carrying all the responsibility for something that the person probably had little control over is a large burden and one that’s likely to leave them feeling discouraged or overwhelmed.
Personalization and blaming are found to be common for people who have experienced trauma or have been in abusive relationships. People who have depressive or anxiety disorders are also likely to blame themselves for external events.
Catastrophizing
Catastrophizing is also thought of as making mountains out of molehills. When something negative happens, no matter how small, a person who catastrophizes blows the situation out of proportion and will view the situation as terrible or dreadful, even though the reality is that the problem itself is quite small.
An example of catastrophizing thinking could occur when you are home alone at night and you hear a noise that startles you.
You may think, ‘Someone has broken into my house. They are going to kill me.’ Another example is if you wake up feeling depressed in the morning and think, ‘What if I always stay depressed?’
These thoughts can relate to other cognitive distortions, such as predictive thinking and jumping to conclusions.
Even though the reality of the problem itself may be small, when someone catastrophizes, things can get very big very quickly, and individuals may get to a point where it all seems out of control.
People with anxiety disorders often experience this thinking where they believe things are going to be a lot worse than they really are.
Black And White Thinking
This is also known as all-or-nothing thinking, as people who use this distortion tend to see only one extreme or the other. They may view things as either right or wrong and good or bad without seeing the shades of grey in between.
An instance of this is if a student does not achieve straight As in all of their classes, they may believe they are a failure. They may think, ‘If I am not the best at what I do, then I am worthless.
This type of thinking is very unhelpful as it can lead to extremely unrealistic standards, you’re the self and others and can affect motivation and relationships.
It can also set you up for failure if you quit something that you think you will not be perfect at. This type of polarized thinking can also make people miss the complexity of most people and situations.
How Can You Manage These Distortions?
Below are some ways to manage these cognitive distortions:
Identify the thought
When you realize that a thought is causing anxiety or affecting your mood, it is important to figure out which type of cognitive distortion you are experiencing.
Most irrational patterns of thought can be shifted once you are made aware of them.
Reframe the situation
Try to look for alternative explanations or shades of grey which may explain the situation better. This may provide you with a more realistic or positive interpretation to expand your thinking.
It may be helpful to write down the original thought followed by alternative interpretations. You may not be able to change the events, but you can work on redirecting the thoughts.
Perform a cost-benefit analysis
It might be helpful to determine how the thought patterns have helped you cope in the past. Do they give a sense of control or allow you to avoid taking responsibility or necessary risks?
Through this, you can consider what engaging in the distortion is costing you. Weighing up the costs and benefits of the thought patterns could motivate you to change them.
Replace absolutes
Instead of using statements that use words such as ‘always’ and ‘everyone,’ try to replace these words such as ‘sometimes’. For example, instead of ‘I always get things wrong,’ this could be replaced with ‘Sometimes I make mistakes.’
This can stop you from generalizing statements to every situation and changing the statements to more realistic ones.
Label the behavior
Instead of labeling yourself with negative terms, it is more helpful to label the behavior instead in a factual way.
For instance, instead of saying, ‘I am lazy,’ you could say, ‘I didn’t clean today.’ Labels such as ‘lazy’ cannot be applied to every situation, but labeling behaviors are more accurate.
Find the evidence
Before concluding with a cognitive distortion, consider asking yourself if there is any evidence to back up your claim. You can do some detective work to write down all the evidence for and against the claim about yourself being true.
You may find that there is a lot of evidence to dispute your negative thought or statement and that there may be a lot of facts you are overlooking or ignoring.
Finding evidence encourages people to find alternative explanations and consider how realistic their thoughts are.
Search for positive aspects
Even if this proves challenging at first, it may be useful to find some positive examples in each situation where you find yourself using cognitive distortions.
For every negative aspect, challenge yourself to find at least three positive aspects to counter the negative. Eventually, searching for the positives should become a spontaneous habit, and the negative thoughts should lessen.
Evaluation of CBT
Reversing cognitive distortions is often at the heart of CBT, among other types of psychotherapy.
CBT helps people recognize these distortions and shift towards more helpful, realistic thoughts.
Benefits of CBT
CBT is recognized as one of the most effective and broadly applicable therapeutic approaches. This type of therapy is based on the cognitive model of emotional response.
This model tells us that our feelings and behaviors stem from our thoughts as opposed to external stimuli. CBT is goal-orientated and problem-focused, unlike other therapies such as psychoanalysis.
As a result, CBT focuses on the present rather than on a lengthy analysis of the individual’s history.
CBT is known for its quick results and the number of sessions depending on the needs of the client, but it usually ranges between 5 to 20 sessions. However, it is worth noting that this is not the case for everyone, and some clients may eventually relapse.
The cognitive distortions are often discussed in CBT so that the clients can identify their negative thought patterns.
Once identified, together with the therapist, the individual can learn to approach situations with more realistic thinking rather than reaching for those negative automatic thoughts.
CBT aims to teach people that while they cannot control every aspect of the world around them, they can take control of how they interpret and deal with situations.
CBT allows the individual to engage in healthier thinking patterns by becoming more aware of their thoughts which affect their mood and feelings. There are usually homework assignments for the client to complete outside of therapy sessions.
These allow the individual to apply what they have learned to situations that may arise and build their confidence to cope with these situations.
Research into CBT has consistently found effectiveness in treating different mental health conditions and finding that the relapse rate for these individuals is significantly lower compared to medicative treatments, especially for those with depression (DeRubeis et al., 2008).
A meta-analysis in 2012 reviewed CBT’s efficacy in treating various conditions.
The researcher’s findings revealed overwhelming support for CBT as an effective treatment option for anxiety disorders, personality disorders, depression and bipolar disorders, eating disorders, anger control problems, and general stress (Hofmann et al., 2012).
Likewise, other meta-analyses have found that CBT helped to improve the symptoms of people with anxiety and anxiety-related disorders, including obsessive-compulsive disorder and posttraumatic stress disorder (Carpenter et al., 2018).
Limitations of CBT
CBT may not be effective for everyone. Some research has found that response rates to CBT for anxiety and depression vary, with between 13% and 62% of individuals failing to show significant reductions in their symptoms (Hofmann et al., 2012).
Despite a lot of positive support for CBT, other evidence suggests that this type of therapy may not be suitable for other conditions.
Reportedly, CBT has shown ineffectiveness against the negative symptoms associated with schizophrenia (Velthorst et al., 2015). A meta-analysis found that CBT was also ineffective in preventing the relapse of bipolar disorder symptoms (Lam, 2000; Scott, 2001).
It is also suggested that CBT is less effective for those with Autism Spectrum Disorders (ASD). While CBT may help decrease comorbid symptoms from other conditions people with ASD struggle with, there is little evidence that CBT can help with social and communicative functioning in these individuals (Binnie & Blainey, 2013).
Alternative therapies
Although CBT is often thought to be effective in many respects, alternative therapies may work just as well or better, depending on the condition and symptom severity.
A clinical trial found that when comparing CBT with narrative therapy, there was a significant reduction in depression symptoms in both of these therapies (Lopes et al., 2014). This suggests that narrative therapy may be as effective at managing depression as CBT.
A systematic review of the literature found that exposure therapy and cognitive therapy were equally effective to CBT in the treatment of PTSD (Mendes et al., 2008).
Likewise, Mindfulness-Based Stress Reduction (MBSR) has been shown to be associated with a reduction in anxiety and depressive symptoms among adults with ASD, comparable to CBT (Sizoo & Kuiper, 2017).
There were also indicators that MBSR was preferred over CBT for a reduction in measures of irrational beliefs and an increase in positive mood.
Do you or a loved one need mental health help?
USA
Contact the National Suicide Prevention Lifeline for support and assistance from a trained counselor. If you or a loved one are in immediate danger: https://suicidepreventionlifeline.org/
1-800-273-8255
UK
Contact the Samaritans for support and assistance from a trained counselor: https://www.samaritans.org/; email jo@samaritans.org .
Available 24 hours a day, 365 days a year (this number is FREE to call):
116-123
Rethink Mental Illness: rethink.org
0300 5000 927
References
Binnie, J., & Blainey, S. (2013). The use of cognitive behavioural therapy for adults with autism spectrum disorders: a review of the evidence. Mental Health Review Journal, 18(2), 93-104.
Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta‐analysis of randomized placebo‐controlled trials. Depression and anxiety, 35(6), 502-514.
DeRubeis, R. J., Siegle, G. J., & Hollon, S. D. (2008). Cognitive therapy versus medication for depression: treatment outcomes and neural mechanisms. Nature Reviews Neuroscience, 9(10), 788-796.
Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive therapy and research, 36, 427-440.
Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive therapy and research, 36(5), 427-440.
Lam, D. H., Bright, J., Jones, S., Hayward, P., Schuck, N., Chisholm, D., & Sham, P. (2000). Cognitive therapy for bipolar illness—a pilot study of relapse prevention. Cognitive therapy and research, 24, 503-520
Lopes, R. T., Gonçalves, M. M., Machado, P. P., Sinai, D., Bento, T., & Salgado, J. (2014). Narrative Therapy vs. Cognitive-Behavioral Therapy for moderate depression: Empirical evidence from a controlled clinical trial. Psychotherapy Research, 24(6), 662-674.
Mendes, D. D., Mello, M. F., Ventura, P., de Medeiros Passarela, C., & de Jesus Mari, J. (2008). A systematic review on the effectiveness of cognitive behavioral therapy for posttraumatic stress disorder. The International Journal of Psychiatry in Medicine, 38(3), 241-259.
Nathan, P., Rees, C., Lim, L., & Correia, H. (2003). Back from the Bluez. Perth, Western Australia: Centre for Clinical Interventions
Scott, J., Garland, A., & Moorhead, S. (2001). A pilot study of cognitive therapy in bipolar disorders. Psychological medicine, 31(3), 459-467.
Sizoo, B. B., & Kuiper, E. (2017). Cognitive behavioural therapy and mindfulness based stress reduction may be equally effective in reducing anxiety and depression in adults with autism spectrum disorders. Research in developmental disabilities, 64, 47-55.
Velthorst, E., Koeter, M., Van Der Gaag, M., Nieman, D. H., Fett, A. K., Smit, F., Staring, ABP, Meijer, C. & De Haan, L. (2015). Adapted cognitive–behavioural therapy required for targeting negative symptoms in schizophrenia: meta-analysis and meta-regression. Psychological medicine, 45(3), 453-465.
Further Information
Information Sheets on the Unhelpful Thinking Styles – Centre For Clinical Interventions (CCI)
