A cognitive distortion is a thought that causes a person to perceive reality inaccurately due to being exaggerated or irrational. Cognitive distortions are involved in the onset or perpetuation of psychopathological states, such as depression and anxiety. Cognitive distortions are negative or biased thought patterns that distort one’s perception of reality, often leading to unnecessary stress, anxiety, or self-doubt. These distortions, such as mind reading, fortune telling, and emotional reasoning, warp the way individuals interpret situations and themselves, reinforcing negative emotions and behaviors. Understanding and challenging these distortions is crucial in cognitive-behavioral therapy (CBT) to help individuals overcome them and improve their mental well-being.
According to Aaron Beck'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. Specifically, negative thinking patterns reinforce negative emotions 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.
Etymology
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, and comes from Latin dis- ("reverse, apart") and torquēre ("to twist").
History
In 1957, American psychologist Albert Ellis, though he did not know it yet, would aid cognitive therapy in correcting cognitive distortions and indirectly helping David D. Burns in writing The Feeling Good Handbook. 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 beliefs. 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 perceives the events which aid 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 to 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, while his patients followed the rule of saying anything that comes to mind. He 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 led 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, reduced desire to seek pleasure, and finally give up. These exaggerated perceptions, due to cognition, feel real and accurate because the schemas, after being reinforced through the behavior, tend to become 'knee-jerk' automatic and do not allow time for reflection. This cycle is also known as Beck's cognitive triad, 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. 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 with 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
thumb|upright=1.8|Examples of some common cognitive distortions seen in depressed and anxious individuals. People may be taught how to identify and alter these distortions as part of cognitive behavioural therapy.
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 negative self-talk.
All-or-nothing thinking
The "all-or-nothing thinking distortion" is also referred to as "splitting", "black-and-white thinking", Someone with the all-or-nothing thinking distortion looks at life in black and white categories.
Suggested ways to combat this distortion include examining the evidence for and against a particular conclusion, testing its validity by challenging it in a real-world context, and reflecting on whether its importance to the person is actual or exaggerated, were it correct.
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.. For example, "I am a failure" or "My meeting will go badly." They might use an unfavorable term to describe a complex person or event, such as assuming that a friend is upset with them due to a late reply to a text message, even though there could be various other reasons for the delay. It is a more extreme form of jumping-to-conclusions cognitive distortion where one speaks in extremes and makes unfounded conclusions.
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". 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 they should not have made so many mistakes.
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 they have not been adopted because they are not "loveable enough".
- Example 2: A child has bad grades. Their mother believes it is because they are not a good enough parent.
Fallacy of change
Relying on social control to obtain cooperative actions from another person.
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 is a form of magnification where one gives greater weight to the worst possible outcome, however unlikely, or experiences 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 generalizations from insufficient evidence. Such as seeing a "single negative event" as a "never-ending pattern of defeat",
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.
Mental filtering
Filtering distortions occur when an individual dwells only on the negative details of a situation and filters out the positive aspects. 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 tend, unrealistically, to view themselves as superior, overemphasizing their strengths and understating their weaknesses.
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 Major features of these disorders are the subjective report of being overwhelmed by life circumstances and the incapability of affecting them.
Criticism
Common criticisms of the diagnosis of cognitive distortion relate to epistemology 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".