A Brief Guide to Cognitive Therapy (www.mytherapist.co.nz)

The essential idea guiding cognitive therapy is that we experience our emotions as a result of the way that we interpret events in our lives. It is the meaning of events that triggers our emotions rather than the events themselves. The way that we evaluate or interpret an event depends on the context in which the event occurs, our mood at the time of the event and what we have learned from our past experiences. The type of emotions we will experience thus depends on our specific interpretation of what is happening around us. This means that the same event can produce totally different emotional experiences in different people, or even different emotions in the same person on different occasions. This can be seen in the following story:

This story shows how feelings of depression are associated with ideas of loss, feelings of anxiety are associated with ideas of personal danger, and feelings of anger are associated with ideas that someone has been unfair or broken one’s rules. In the story there is, of course, a cognitive therapist as well.

The cognitive therapist leaves his house (and it is important to note that expertise in this area doesn’t protect you from unpleasant events such as a foot in dog mess). However, the cognitive therapist’s reaction is quite different from that of the other three people. Looking down at his shoes, he smiled broadly, mopped his forehead, and said to himself, "Well….... lucky I had my shoes on!"

Cognitive therapy is not necessarily about thinking more positively, nor is it about thinking more rationally. The fundamental idea is that there may be several alternative ways of looking at a particular situation. People suffering from emotional problems are often trapped by particularly pessimistic or unhelpful ways of looking at their situation and tend only to see one way of interpreting it.

Read over the following list of ten cognitive distortions that form the basis for most emotional problems such as depression, anxiety and anger. Get a feel for them and when you are feeling upset, the list will be invaluable in making you aware of how you are fooling your

Common Cognitive Distortions

ALL-OR-NOTHING THINKING. This refers to a tendency we sometimes have to evaluate personal qualities in extreme, black-or-white categories. For example, an athlete might say, "Because I lost the race, I'm a zero." A straight-A student who receives a B on an exam might conclude, "Now I'm a total failure." All-or-Nothing thinking forms the basis for perfectionism. It makes people fear any mistake or imperfection because they will then see themselves as a complete loser, and then they feel inadequate and worthless. This way of evaluating things is irrational and unrealistic because life is rarely completely either one way or the other. No one is absolutely brilliant or totally stupid, no one is either completely attractive or totally ugly. Look at the floor of the room you are sitting in now. Is it perfectly clean? Is every inch piled high with dust and dirt? Or is it partially clean? Absolutes simply do not exist in our universe and when we try to force our experiences into absolute categories, we become emotionally distressed because our perceptions will just never conform to reality. We may put ourselves down endlessly because whatever we do will never measure up to our exaggerated expectations. Psychologists sometimes call this type of perceptual error "dichotomous thinking." Seeing everything as black or white when reality usually lies in the grey.

2. OVERGENERALIZATION. A common illusion: a magician takes a normal deck of cards in which every card is different and asks someone from the audience to choose a card at random. Let's assume the person picks the Jack of Spades. The card is returned to the deck without the magician knowing which card was chosen. The magician shouts "abracadabra"! Turns over the deck and every card has turned into the Jack of Spades.

When we over-generalise, we arbitrarily conclude that because something has happened to us once, this means that it will occur over and over again and there is no escape. Since what happened is invariably unpleasant, we feel emotionally upset. A depressed salesman noticed bird dung splattered across his car window and thought, "That's just my luck. The birds are always crapping on my window!" This is a perfect example of overgeneralization. When asked about this experience, he admitted that in twenty years of traveling, he could not remember another time when he found bird dung on his car window.

The pain of rejection is generated almost entirely from overgeneralization. In its absence, a personal affront is temporarily disappointing but cannot be seriously disturbing. A shy young man mustered up his courage to ask a girl for a date. When she politely declined because of a previous engagement, he said to himself, "I'm never going to get a date. No girl would ever want a date with me. I'll be lonely and miserable all my life." In his distorted cognitions, he concluded that because she turned him down once, she would always do so, and that since all women have 100 percent identical tastes, he would be endlessly and repeatedly rejected by any eligible woman on the face of the earth. Abracadabra!

You can become more mindful of over-generalising whenever you find yourself using the words "Never"& "Always" 

3. MENTAL FILTER. Here we pick out a negative detail in any situation and dwell on it exclusively, thus perceiving that the whole situation as negative. For example, a depressed university student heard some other students making fun of her best friend. She became furious because she was thinking, "That's what the human race is basically like-cruel and insensitive!" She was overlooking the fact that in the previous months few people, if any, had been cruel or insensitive to her! On another occasion when she completed her first midterm exam, she felt certain she had missed approximately seventeen questions out of a hundred. She thought exclusively about those seventeen questions and concluded she would flunk out of university. When she got the paper back there was a note attached that read, "You got 83 out of 100 correct. This was by far the highest grade of any student this year. A+.

When we are depressed or anxious or angry, it is as if we wear a pair of eyeglasses with special lenses that filter out anything positive. All that we allow to enter our conscious mind is negative. Because we are generally not aware of this "filtering process," we conclude that everything is negative. Psychologists call this process "selective abstraction." It is a bad habit that can cause us to suffer much needless anguish.

4. DISQUALIFYING THE POSITIVE. An even more spectacular mental illusion is the persistent tendency that some individuals have to transform neutral or even positive experiences into negative ones. In this case we don't just ignore positive experiences, we cleverly and swiftly turn them into their nightmarish opposite. The medieval alchemists dreamed of finding some method for transmuting the common metal lead into precious gold. People who suffer with emotional may have developed the talent for doing the exact opposite. They have learned to instantly transform golden joy into emotional lead. This is rarely done intentionally, they are usually not even aware that they are doing this to themselves.

An everyday example of this is the way most of us have learned to respond to compliments. When someone praises our appearance or our work, we might automatically tell ourselves, "They're just being nice." With one swift blow we mentally disqualify their compliment. We do the same thing when we tell them, "Oh, it was nothing, really." If we constantly throw cold water on the good things that happen to us, life seems damp and chilly.

Disqualifying the positive is actually one of the most destructive forms of cognitive distortion. We act like scientists intent on finding evidence to support a pet theory. The theory that dominates emotionally disturbed thinking is usually some version of "I'm second-rate." Whenever we have a negative experience, we dwell on it and conclude, "That proves what I've known all along." In contrast, when we have a positive experience, we tell ourselves, "That was just a fluke. It doesn't count." Of course the price we pay for this tendency is intense misery and an inability to appreciate the good things that happen in our lives.

While this type of cognitive distortion is commonplace, it can also form the basis for some of the most extreme and intractable emotional problems. For example, a young woman hospitalised during a severe depressive episode lamented, "No one could possibly care about me because I'm such an awful person. I'm a complete loner. Not one person on earth gives a damn about me." When she was discharged from the hospital, many patients and staff members expressed great fondness for her. Can you guess how she negated all of this? "They don't count because they don't see me in the real world. A real person outside a hospital could never care about me." When asked her how she reconciled this with the fact that she had numerous friends and family outside the hospital who did care about her. She replied, "They don't count because they don't know the real me. You see, inside I'm absolutely rotten. I'm the worst person in the world. It would be impossible for anyone to really like me for even one moment!" By disqualifying positive experiences in this manner, the woman was able to maintain a negative belief that is clearly unrealistic and inconsistent with her everyday experiences.

While most people’s thinking is probably not as distorted as this young woman’s, there may be many times every day when we inadvertently ignore the genuinely positive things that happened us. This removes much of life's richness and makes things appear needlessly bleak.

5. JUMPING TO CONCLUSIONS. Here we arbitrarily jump to a negative conclusion that is not justified by the facts of the situation. Two examples of this are "mind reading" and "fortune telling.'

Mind Reading: We make the assumption that other people are looking down on us, and we are so convinced about this that we  don't even bother to check it out. We may be giving an excellent lecture to a group of people, and we notice that someone in the front row is nodding off. This person may have been up most of the night on a wild fling, but we of course don't know this. We might have the thought, "This audience thinks I'm a bore." Perhaps a friend passes us on the street and fails to say hello because they are so absorbed in their own thoughts that they don’t notice us. We might mistakenly conclude, "They are ignoring me so they must not like me anymore." Perhaps our spouse is unresponsive one evening because they were criticised at work and are too upset to want to talk about it. Our heart sinks because of the way we interpret the silence: "He (or she) is mad at me….What did I do wrong? We may then respond to these imagined negative reactions by withdrawal or counterattack. This self-defeating behaviour pattern may act as a self-fulfilling prophecy and set up a negative interaction in our relationship when none exists in the first place.

Fortune Telling Error: It’s as if we have a crystal ball that foretells only misery for us. We imagine that something bad is about to happen, and we take this prediction as a fact even though it is irrational. A high-school librarian repeatedly told herself during anxiety attacks, "I'm going to pass out or go crazy." These predictions were unrealistic because she had never once passed out (or gone crazy!) in her entire life. Nor did she have any serious symptoms to suggest impending insanity. During a therapy session an acutely depressed physician explained that her was giving up his practice because "I realise that I'll be depressed forever. My misery will go on and on, and I'm absolutely convinced that this or any treatment will be doomed to failure." This negative prediction about his prognosis caused him to feel helpless. His symptomatic improvement soon after initiating therapy indicated just how mistaken his fortune telling had been.

It’s easy to find ourselves jumping to conclusions like these? Suppose we telephone a friend who then fails to return our call after a reasonable time. We might then feel depressed if we tell ourselves that our friend probably got the message but wasn't interested enough to call you back. We are fooled into the cognitive distortion of mind reading. We then feel bitter, and may not call back and check this out because we say to ourselves, "They will think I'm being obnoxious if I call him back again. I'll only make a fool of myself." Because of these negative predictions (the fortune teller error), we avoid our friend and feel put down. Sure enough, we later learn that our friend never got our message at all. In the meantime we have made ourselves very miserable.

6. CATASTROPHISATION AND MINIMISATION. Another thinking trap people commonly fall to is known as "Catastrophisation and minimisation" sometimes called the "binocular trick" because we are either blowing things up out of proportion or shrinking them. We catastophise when we look at your own errors, fears, or imperfections and exaggerate their importance: "My God I made a mistake. How terrible! How awful! The word will spread like wildfire! My reputation is ruined!" It’s as if we see our faults through the end of the binoculars that makes them appear gigantic and grotesque. We turn commonplace negative events into nightmarish monsters.

When we think about our strengths, we may do the opposite look through the wrong end of the binoculars so that things look small and unimportant. When we magnify our imperfections and minimise our good points and strengths, we fool ourselves into feeling inferior.

7. EMOTIONAL REASONING. This occurs when we take our emotions as evidence for the truth. The irrational reasoning: "I feel like a failure, therefore 1 am a failure," "I feel frightened this means there is something to be frightened of." This kind of reasoning is very misleading because our feelings reflect our thoughts and beliefs but may not reflect the evidence of what it happening at the moment. Examples of emotional reasoning include "I feel guilty therefore, I must have done something bad"; "I feel overwhelmed and hopeless, therefore, my problems must be impossible to solve"; "I feel inadequate, therefore, I must be a worthless person"; "I'm not in the mood to do anything, therefore, I might as well just lie in bed"; "I'm feel angry at you, this proves that you've been acting nasty and trying to take advantage of me.

Emotional reasoning plays a strong role in nearly all emotional problems. Things feel so negative to us, that we assume they really are. Tricked by this type of thinking, it generally doesn't occur to us to challenge the validity of our perception that creates our feelings.

Emotional reasoning frequently leads to procrastination. We might avoid cleaning up our desk because we tell ourselves, "I feel so depressed when I think about that messy desk, cleaning it will be impossible." Months later when finally give ourselves a little push and do it, it turns out to be quite gratifying and not so tough at all. We fool ourselves all along because we are in the habit of letting our negative feelings guide the way we act.

8. SHOULD STATEMENTS. Here we try to motivate ourselves by saying, "I should do this" or "I must do that." These statements cause us to feel pressured and resentful. Paradoxically, we end up feeling apathetic and unmotivated.

When we direct should statements toward others, we similarly usually feel frustrated. When an emergency caused a therapist to be five minutes late for the first therapy session, the new patient thought, "He shouldn't be so self-centered and thoughtless. He ought to be prompt." This thought caused her to feel sour and resentful.

Should statements generate a lot of unnecessary emotional turmoil in our daily life. When the reality of our own behaviour falls short of our standards, our shoulds and shouldn'ts create self-loathing, shame, and guilt. When the all-too-human performance of other people falls short of our expectations, as will inevitably happen from time to time, we feel bitter and self-righteous. We either have to change our expectations to approximate reality or always feel let down by human behaviour.

9. LABELLING AND MISLABELLING. Personal labelling means creating a completely negative self-image based on our errors. It is an extreme form of overgeneralization. The philosophy behind labelling is generally "The measure of a man is the mistakes he makes." There is a good chance we use personal labelling whenever we describe our mistakes with sentences beginning with "I'm a . . .

For example, when we fall short of our own self-expectations and we think "I’m a loser" of "I’m a failure" instead of "I slipped up on this occasion" or "I made a mistake".

Labelling ourselves is not only self-defeating, it is irrational. We simply can’t equate who we are with any one thing that we do. Our lives are a complex and ever-changing flow of thoughts, emotions, and actions, more like a river than a statue. We don’t think of ourselves exclusively as an "eater" just because we eat, or a "breather" just because we breathe?

Similarly, when we label other people, we invariably generate unnecessary hostility. When the boss sees his occasionally irritable secretary as "an uncooperative bitch." His labelling then leads him to resent her, and he is likely to jump at every chance to criticise her. She, in turn, labels him an "insensitive chauvinist" and complains about him at every opportunity. So, around and around they go at each other's throats, focusing on every weakness or imperfection as proof of the other's worthlessness.

Mislabelling involves describing an event with words that are inaccurate and emotionally heavily loaded. For example, a woman on a diet ate a dish of ice cream and thought, "How disgusting and repulsive of me, "I’m a pig." These thoughts made her so upset she ate the whole tub of ice cream!

10. PERSONALIZATION. This distortion is the mother of guilt! Here we assume responsibility for a negative event when there is no basis for doing so. We arbitrarily conclude that what happened was our fault or reflects our inadequacy, even when it is obvious to those about us that we can not be held responsible. For example, when a patient didn't do a self-help assignment suggested by the therapist, the therapist then felt guilty because of their thought, "I must be a lousy therapist. It's my fault that she isn't working harder to help herself… It's my responsibility to make sure she gets well." When a mother saw her child's report card, there was a note from the teacher indicating the child was not working well. She immediately decided, "I must be a bad mother. This shows how I've failed".

Personalization can trick us a crippling guilt. We suffer from a paralysing and burdensome sense of responsibility that forces us to carry the whole world on our shoulders. When we find ourselves doing this we have simply confused influence with control over others. In our role as a parent, spouse, teacher, counselor, parent, physician, salesman, executive, we will certainly influence the people we interact with, but no one could reasonably expect us to control them. What the other person does is ultimately his or her responsibility, not ours.

       Feelings are not Facts

We might accept then that distorted thoughts and interpretations about ourselves, other people and the world around us cause our emotional distress, depression, anxiety, anger etc. This explains why our outlook on life can change so dramatically with our mood. But if our thoughts are so obviously distorted, how do we continually get fooled? If what we are telling ourselves is irrational, why does it seem so right?"

The problem is that even though our thoughts may be distorted, they nevertheless create a powerful illusion of truth. In short, our feelings simply mirror the way we are thinking. If our perceptions make little sense, the feelings they create will be equally as absurd. Never the less our distorted emotions feel just as valid and realistic as the feelings created by undistorted thoughts, so we automatically attribute truth to them.

When we invite emotional distress by viewing the world through our habitual or "automatic" use of cognitive distortions, our feelings and actions begin to reinforce each other in a self-perpetuating vicious cycle. Because we believe whatever our depressed, anxious, guilty or angry thinking tells us, we find ourselves feeling negative about almost everything. Because our thinking has become habitual and largely out of our immediate conscious awareness we end up living a life of unconsciousness. At the mercy of our own habitual and instantaneous distorted thinking. The subsequent unpleasant and destructive emotions certainly feel realistic and in turn they lend credibility to the distorted thoughts that created them. The cycle repeats and we are trapped. The mental prison we create however is merely an illusion, a deception we unconsciously create. But it seems real because it feels real.

So how do we escape this emotional prison? Well first we need to recognise that they way we habitually think impacts on the way we habitually feel, the sort of emotions we have. Knowing this, we need to recognise that our emotions are hardly proof that what we think and believe is accurate. Unpleasant feelings may merely indicate that we are thinking something that is psychologically destructive and being hoodwinked into believing it.

The ten forms of cognitive distortions cause many, if not all, of our emotionally distressed states. They are summarised below and it is important to study them and master the concepts they contain.

1. ALL-OR-NOTHING THINKING: When we see things in simple black-and-white categories. If our performance falls short of perfect, we see ourselves as a total failure.

2. OVER-GENERALIZATION: When we see a single negative event as a never-ending pattern of defeat. We need to be aware of overgeneralising whenever we find ourselves using the words "Never", "Always" and "All the time".

3. MENTAL FILTER: When we pick out a single negative detail and dwell on it exclusively so that our vision of all reality becomes darkened, like the drop of ink that dis-colours an entire glass of water.

4. DISQUALIFYING THE POSITIVE: When we reject positive experiences by insisting they "don't count for some reason or other. In this way we can maintain a negative or harmful belief that is contradicted by our everyday experiences.

5. JUMPING TO CONCLUSIONS: When we make a negative interpretation even though there are no definite facts that convincingly support our conclusion. There are two major types of the distortion:

Mind reading. When we arbitrarily conclude that someone is reacting negatively to us, and we don't bother to check this out.

Fortune Telling. When we anticipate or predict that things will turn out badly, and feel convinced that our prediction is an already-established fact.

6. CATASTROPHISING OR MINIMIZATION: when we exaggerate the importance of things (such as our mistakes or someone else's achievements), or when we inappropriately shrink things until they appear tiny (our own desirable qualities or the other person's imperfections). This is also called the "binocular trick."

7. EMOTIONAL REASONING: When we assume that our negative emotions necessarily reflect the way things really are: "I feel it, therefore it must be true."

8. SHOULD STATEMENTS: When we try to motivate ourselves with shoulds and shouldn'ts, as if we had to be whipped and punished before we could be expected to do anything. Musts and Oughts are also offenders. The emotional consequence is guilt. When we direct should statements toward others, we feel anger, frustration, and resentment.

9. LABELING AND MISLABELING: This is an extreme form of overgeneralisation; Instead of describing our error, we attach a negative label to ourselves: "I'm a failure, loser etc." When someone else's behaviour irritates us, we attach a negative label to that person: "He’s a bastard". Mislabelling involves describing an event with language that is highly coloured and emotionally loaded.

10. PERSONALIZATION: When we see ourselves as the cause of some negative external event that we are not primarily responsible for.