Techniques to identify the maladaptive thoughts that influence behaviors and emotions were discussed in the two previous blog entries. Mere awareness of such thoughts can reduce unpleasant emotions and redirect unhealthy behaviors. Often times, people require more than just identifying these maladaptive thoughts in order to change them. Numerous ways exist to challenge thoughts. The current blog entry will focus on three: (a) Socratic questioning, (b) identifying cognitive distortions, and (c) accepting reality while committing to change. Each one of these techniques takes time to master, so consider focusing on one at a time.
Socrates used questions to encourage his students to arrive at the answers they sought. Instead of simply responding to students’ questions or providing lectures, he systematically asked questions that encouraged deep thought which allowed students to gain knowledge through critical thinking. Cognitive therapists often use Socratic questioning to help people challenge maladaptive, unrealistic, and/or unbalanced thoughts. People can learn to challenge their own thoughts through Socratic questioning as well.
At times, clients and students find the technique frustrating because they “just want an answer.” With maladaptive thoughts, most people need to do some work to believe new thoughts. For instance, a person who thinks “I’m a failure” will likely not believe the thought “I’m good just as I am” because a therapist told him/her it is truer than “I’m a failure.” Socratic questions encourage people to apply logic to their thoughts in order to understand that the ways they think of themselves and others may not actually be true. Eventually through Socratic questioning a person can arrive at adaptive, more realistic beliefs.
Examples of questions that can be used to challenge thoughts include:
· Is this thought realistic?
· What is the evidence for and against this idea?
· Might this belief be a habit, rather than something based on facts?
· How long have I been thinking this?
· What possible misinterpretations might I be making?
· Am I thinking in all-or-none/black-and-white terms?
o Is there any room for “grey” with
· Am I using words or phrases that are extreme or exaggerated (i.e., always, forever, never, need, should, must, can’t, ever time, etc.)?
· Is extreme and/or exaggerated language implied in this thought?
· In what way might I be focusing only on one aspect of the event (possibly negative)?
· Who has given me this message before?
o Other people in my life?
o A younger version of myself?
o Is that person a reliable source
of information when it comes to
· What are the odds that this thought is true? Am I overestimating the likelihood that this thought is true? Am I overestimating the odds that something bad will happen?
· Are my judgments based on feelings rather than facts?
· In what way might I be focused on irrelevant factors?
· What are the costs and benefits of this thought?
o How might I arrive at similar
benefits with different thoughts?
Remembering that the word “cognitive” refers to thoughts, “cognitive distortions” reflect distorted patterns of thought. Generally speaking, when a thought fits the pattern(s) of any of the cognitive distortions listed below, it is likely unrealistic. If you notice yourself using any of these patterns, it may be useful to employ the Socratic questioning technique discussed above.
The cognitive distortions and examples listed below come from The Worry Cure: Seven Steps to Stop Worry from Stopping You by Robert L. Leahy.
Future-Telling: You predict the future – that things will get worse or that there’s danger ahead. “I won’t get that job.”
Catastrophizing: You believe that what happened or will happen will be so awful and unbearable that you won’t be able to stand it. “It would be terrible if I failed.”
Labeling: You assign global negative traits to yourself and others. “I’m disgusting.” “He’s horrible.”
Discounting Positives: You claim that the positives that you or others attain are trivial. “That’s what I’m supposed to do, so it doesn’t count.” “Those successes were easy so they don’t matter.”
Negative Filter: You focus almost exclusively on the negatives and seldom notice the positives. “Look at all the terrible things on the news.”
Overgeneralizing: You perceive a global pattern of negatives on the basis of a single incident. “I fail all the time.”
All-or-None Thinking: You view events or people in all-or-none/black-and-white terms. “It was a waste of time.” “I get rejected by everyone.”
Shoulds: You interpret events in terms of how things should be rather than simply focusing on what is. “I should do well; if I don’t, I’m a failure.”
Personalizing: You attribute a disproportionate amount of the blame to yourself for negative events and fail to see that certain events are also caused by others. “The marriage ended because I failed.”
Blaming: You focus on the other person as the source of your negative feelings and refuse to take responsibility for changing yourself. “She’s to blame for the way I feel.” “My parents caused all my problems.”
Unfair Comparisons: You interpret events in terms of standards that are unrealistic. “Others did better than I did on the test.” “People my age are more successful than I am.”
Regret Orientation: You focus on the idea that you could have done better in the past, rather than on what you can do better now. “I could have had a better job if I had tried harder.” “I shouldn’t have said that.”
What if? You keep asking a series of questions about what if something happens, and fail to be satisfied with any of the answers. “Yeah, but what if I get anxious, and I can’t catch my breath.”
Emotional Reasoning: You let your feelings guide your interpretation of reality. “I feel depressed, therefore my marriage isn’t working.” “I feel anxious, therefore I must be in danger.”
Inability to Disconfirm: You reject any evidence or arguments that might contradict your negative thoughts. “I’m unlovable – my friends hang out with me only because they must feel sorry for me.” “I’m a bad person – I only help others because it makes me feel better about myself.”
Judgment Focus: You view yourself, others, and events in terms of evaluations of “good” and “bad” or “right” and “wrong” or “superior” and “inferior,” rather than simply describing, accepting, or understanding. “I didn’t perform well.” “I tried it, and I just kept doing it wrong.” “Look how successful she is, I’m not that successful.”
In The Worry Cure, Leahy titles one of the chapters “Accept Reality, Commit to Change.” The contents of this chapter seem to epitomize the power of acceptance, and the title serves as a good reminder to practice. Acceptance refers to seeing things as they really are, and not as you think they are or as you think they should be. In Dialectical Behavior Therapy, Marsha Linehan speaks of “radical acceptance,” which refers to recognizing reality so that you identify the place from where you must start in order to change.
For instance, consider a person who recently lost his job and believes “I’m a failure.” He may initially think, “I lost my job, I’m such a failure. I’m never going to get another job. This is horrible.” Consequently, he may find himself thinking in circles and feeling hopeless. Radical acceptance may appear as follows: “I lost my job. That is the reality. I don’t like it. I feel sad because of it. The thought about me being a failure keeps entering my head. That’s where I have to start from.”
By practicing radical acceptance, a person can recognize reality and then commit to the next step in order to move in a desired direction. Reality includes external as well as internal events (i.e., thoughts and feelings). When the man in the example above practices radical acceptance, he acknowledges and accepts the fact he lost his job just as he acknowledges and accepts the fact that he does not like it, that he feels sad about it, and that he has thoughts about failure. He does not treat the thoughts as true or conclude he can do nothing as result of his feelings; he merely acknowledges their existence.
Emotions and thoughts are part of reality in that they exist. Emotions are important to feel, but they do not have to dictate behavior. Regarding thoughts, we can think anything; the mere act of having a thought does not make it true. If the man thinks “I will never get another job” he is not predicting the future, he is having a thought. The reality is that he thinks he will never get another job, not that he will be unemployed forever. Consider another example. I can have the thought that “someone will call me in five seconds to tell me that I’ve won $1,000,000.00.”
I am not a million dollars richer. The fact remains that I had the thought that I would win the money, and if I truly believed that thought you could imagine my disappointment when the phone did not ring. The man in the example faces a dilemma when he believes the thought “I am a failure” rather than acknowledging it as an event that occurred in his mind.
Committing to change often requires people to take difficult steps in the presence of contradictory thoughts or feelings. It also involves recognizing the values by which a person wants to live. The ability to commit to change arises when a person can gain distance from the thoughts or feelings that impede growth. Gaining distance means recognizing that thoughts are merely thoughts and do not dictate behavior. Many times, the distance allows people to realize their maladaptive thoughts about reality have been wrong. As previously mentioned, the man above may at times have the thought “I will never get another job,” and later realize the prediction was false when he actually receives an offer.
When people gain distance from their thoughts, they can recognize that thoughts can be experiences they observe and then let go. The man above can recognize “I just had the thought that I’m a failure,” and then continue applying for jobs in the presence of that thought. As long as he has some idea about what he wants and/or what he values, that man can make decisions in the presence of any thought.
The skill of gaining distance can be harder to develop than Socratic questioning or identifying cognitive distortions. It takes practice and patience.
One way of gaining distance involves labeling internal experiences so that instead of thinking a thought, one identifies I am having a thought. The internal experience people generally label include:
· I am having the feeling that
· I am having the memory that
· I am having the urge to
· I am just noticing