7 Ways Cognitive Distortion May Be Bending You Out of Shape

“My depression had grown on me as that vine had conquered the oak; a sucking thing that had wrapped itself around me, ugly and more alive than I,” describes best-selling author and psychologist Andrew Solomon in the Noonday Demon. Depression takes a serious and heartbreaking toll on people’s lives. In addition to being a risk factor for cognitive decline, disability, and mortality, depression robs people of the joy in their lives and depletes their vitality.

Cognitive Behavioral Therapy (CBT) is one of the most effective treatments we have in the arsenal to manage depression. There is even evidence that CBT may prevent depression by inoculating individuals against tendencies that increase mental distress.

CBT is based on the idea that our thought patterns and deeply held beliefs about ourselves and the world around us shape our experiences and behavior. According to the theory underlying CBT, when we distort meaning, make erroneous interpretations, and engage in illogical reasoning, we are putting ourselves on a potential on-ramp to depression. CBT shows us an exit by disrupting self-defeating behaviors and beliefs. If it were up to me, I would incorporate CBT into every high school and college curriculum.

A key component of classic CBT is learning how to identify and fight automatic negative thoughts. Automatic negative thoughts are those knee-jerk responses we have wherever something annoying or even ambiguous occurs. For instance, imagine your flight is canceled or traffic is bumper to bumper or your friend doesn’t respond to a text you sent 6 hours ago. How do you respond? Many of us interpret these situations using what psychologists call “cognitive distortions” — unhelpful unrealistic, and maladaptive thinking patterns.

Here are some classic examples of cognitive distortions in response to adverse or ambiguous events:

Cognitive distortions have consequences. If you believe things never work out for you, you might stop trying. If you believe someone dislikes you, you might avoid them in the future. If you believe something terrible has happened, you might go into full panic mode.

Operating on false assumptions can send us down a rabbit hole of unnecessary and exhausting negative emotions and behaviors. Moreover, habitually engaging in these counter-productive thinking patterns puts us at risk of developing more serious mental health issues. Learning how to catch yourself engaging in cognitive distortions can disrupt patterns of negative thinking and their consequences.

Here are 7 common cognitive distortions to look out for:

1. All or Nothing Thinking
Believing that things are either good or bad. There are no shades of gray. Complexity and nuance are ignored and overlooked.

Classic example: “I’m either succeeding or I’m failing. There is no in between.”

2. Fortune Telling
Based on little or no experience, believing one knows what will happen next.

Classic example: “My boss wants to meet with me on Friday. I know I am getting fired.”

3. Mental Filtering
Discounting anything positive that might have happened and only focusing on the negative.

Classic example: “That experience was a complete and utter waste of time.”

4. Mind Reading
Assuming that we know exactly what another person is thinking and that it is critical.

Classic example: “I know she hates me just from the way she looks at me.”

5. Castrophozing
Imagining the worst case scenario. Overestimating the likelihood or meaning of something and blowing it out of proportion. Ordinary worries become epic disasters.

Classic example: “I haven’t heard from her in two hours. Something terrible has happened.”

6. Labeling
Characterizing oneself or others in an overly simplified and negative way. These shorthand descriptions limit us from seeing ourselves and others with empathy and understanding.

Classic example: “I am completely useless.”

7. Personalization
Taking things personally or blaming oneself when things are beyond our control. Assuming that you are being personally targeted without evidence.

Classic example: “Why do bad things always happen to me?”

If you suspect you are engaging in unhelpful thinking patterns, identify the distortion, gather evidence to look for alternative explanations, and consider what advice you would give to a friend in a similar situation. More often than not, it is the interpretation that causes us distress more than the event itself. Questioning assumptions and disrupting knee-jerk responses helps us see ourselves and others more clearly.

As the great actor Alan Alda observed, “Your assumptions are your windows on the world. Scrub them off every once in a while, or the light won’t come in.”

I wish you all the best,

Dr. Samantha Boardman

How to Find a Therapist

May may be Mental Health Awareness Month but let’s be honest, mental health deserves the spotlight year round and every single day. The mental health toll of the pandemic has made this issue even more urgent. Rates of anxiety and depression among U.S. adults were about 4 times higher between April 2020 and August 2021 than they were in 2019. Some of the sharpest increases were among males, Asian Americans, young adults, and parents with children in the home, according to Centers for Disease Control and Prevention data.

 


The World Health Organization defines health as “a state of complete, physical, mental, and social wellbeing and not merely the absence of disease or infirmity.” Put simply, there is no health without mental health.

My goal with The Dose is to shine the spotlight on different aspects of mental health each week. Today’s newsletter provides a framework for finding a therapist that works for you.

1. How do you know if you need therapy?

You are experiencing any of the following:

🔲 Trouble regulating your emotions

🔲 Burnout

🔲 Performing less effectively at school or work

🔲 Turning to unhealthy behaviors such as excessive alcohol use

🔲 Thoughts of self-harm or harming someone else

🔲 People close to you are concerned about you

Keep in mind:

Therapy isn’t only for addressing mental health struggles or a crisis. It can be for anyone going through a transition and a tool to give yourself a boost or help you thrive. People don’t only workout because they want to lose weight, they also workout to build strength and feel good. Similarly, going to a therapist can be like going to a mind gym to increase emotional flexibility and resilience.

2. How do you go about finding a therapist?

🔲 Consider personal preferences such as background and gender

🔲 Ask about credentials, expertise, and experience

🔲 Consider the type of therapy you are interested in

🔲 Ask your primary care provider or another trusted professional for a recommendation (The APA’s Psychologist Locator is an excellent resource)

🔲 Determine your budget (does your health insurance provide mental health benefits? Does your employer offer an Employee Assistance Program?)

Keep in mind:

While convenient, asking friends and family for a recommendation is not always the best idea. Just because something worked for them does not mean it will work for you. Also, sharing a therapist with a close family member or friend can be awkward and create trust issues.

Do not spend too much time looking for the “perfect therapist.” Remember, you could always end therapy if you realize during later sessions you and your therapist are not a good match.

3. What are the goals of therapy?

🔲 Identify your goals during the initial consultation and evaluate progress with your therapist on a regular basis

🔲 Stay flexible — as therapy unfolds, new goals may arise. Don’t be afraid to “re-goal.”

Keep in mind:

Therapy is a process.

4. How do you know it’s working?

🔲 You start to feel better! (Good therapy is like emotional windshield wipers — you begin to find clarity and perspective)

🔲 You begin to make positive behavior changes

🔲 You feel more optimistic

🔲 You are living your values

🔲 You are taking better care of yourself

Keep in mind:

The most important predictor of a positive outcome is a good connection between you and your therapist. This is known as the therapeutic alliance. Feeling safe, comfortable and valued is essential. Research shows that the relationship between patient and therapist has a significant impact on progress. In fact, an APA task force found that the type of therapy matters less than a good therapeutic connection. It makes sense that you are more likely to make positive changes when you feel supported by your therapist. A good therapist will challenge you. If you feel frustrated or like skipping a session, treat those feelings as data. Talk to your therapist. Communicate how you’re feeling. Working through uncomfortable emotions can be a gateway to growth.

Therapy doesn’t only have to be about fixing what’s wrong, it can also be about building what’s strong.

Image: Chris Cater / The New Yorker

I wish you all the best,

Dr. Samantha Boardman

Self-Help Is Important. Other-Help Is Too.

One spring a patient named Margot came to my office feeling despondent. At the beginning of the year, she attended a seminar on the importance of self-care, which was titled, Make This Year All About You.” The two-hour workshop emphasized how prioritizing oneself was a must to achieve happiness. Margot was instructed to put herself at the top of her to-do list and begin each morning by looking in the mirror and asking, “What do I need today?” She was told to make regular “dates” with herself and treat herself with a slice of her favorite cake or a manicure. At the end of the seminar, the attendees signed a contract pledging to give more love, kindness, and attention to themselves.

When Margot returned home, she withdrew from her book club so she could read the recommended self-help books. (Plus, she told me, because the club didn’t always choose books she liked, she felt further justified in her decision.) The signed pledge gave Margot the license to decline invitations that weren’t convenient or to her liking. She decided not to attend a friend’s birthday dinner because it wasn’t being held at a vegan restaurant. When her sister came to town for a visit, Margot barely made time to see her.

The upside of Margot’s newly adopted self-care regimen was that she was getting lots of sleep, eating a healthy diet, reading a self-help book a week, meeting with a life coach every two weeks, meditating thirty minutes a day, and getting plenty of exercise. For her vacation, she canceled a visit to see her grandmother and opted instead for a silent retreat. Yet in spite of her efforts to give back to herself, Margot said that her efforts hadn’t provided the boost she had hoped for. If anything, she told me in almost a whisper, she felt worse.

As I write about in my book, Everyday Vitality, when taken too far, self-help can be self-sabotaging, especially when it greenlights self-focus and cuts us off from others. If self-help isn’t the answer, what actually helps? While it may sound counterintuitive, other-help is what reliably gives us an enduring boost.

I told Margot about an experiment published in Emotion, in which volunteers were asked to choose one of three acts to perform each week for a month: to show kindness to others, to humanity, or to themselves. The groups that performed acts of kindness towards others or humanity experienced a greater boost than those who focused on themselves. A massage is relaxing and enjoyable in the moment, but the positive feeling fades quickly. When acts of kindness are other-oriented, not self-oriented, people feel better for longer. The study concluded that when “people do nice things for others, they may feel greater joy, contentment, and love, which in turn promote greater overall well-being and improve social relationships.” In short, a cascade of uplifts follows other-oriented actions—and they linger.

According to research published in Science, people also tend to feel better when they buy a gift for someone else than they do when they buy it for themselves. Plus, the happiness derived from giving things does not wear off in the same way as purchasing something for oneself does. Having can get boring, but the “warm glow” of doing something for someone sustained itself over the course of the study. A study published in Motivation and Emotion found that altruistic behavior can even dial down anxiety. People who are socially anxious were able to override feelings of insecurity and feel more confident after actively leading a helping hand, such as by mowing a neighbor’s lawn or doing a favor for a roommate. During the pandemic, graduate students who tutored high-school students reported improved mental health and reduced stress according to a study in Nature.


To be clear, I am not promoting self-neglect or martyrdom. Nor am I recommending a life that rivals that of a doormat. It is important to take care of yourself. All I am saying is that too much self-focus can become an excuse to shut ourselves away from the rest of the world.
There is nothing wrong with doing good things for yourself, but taken to the extreme, it can turn into a justification for self-absorption.

Bottom Line: self-help might be all the rage, but it’s important not to forget other-help as a source of vitality and resilience.

I wish you all the best,

Dr. Samantha Boardman

What Happy Couples Do Differently When Tensions Arise

Life often feels like a game of Wac-A-Mole or, as one patient put it, like an endless wave of attention-requiring energy-draining drudgery: “I basically crisis-surf all day.” Not surprisingly, when people report a lot of stress outside their romantic relationship, they also report more stress inside their romantic relationship. This “spillover stress” takes the form of harsh words, criticism, less forgiving behavior, fewer positive interactions and no doubt, more eye rolls.

Anyone who has ever had a bad day can relate. The moment we get home, we unzip that bursting-at-the-seams emotional backpack, filled with all the annoyances and hassles accumulated over the course of the day, and dump its contents on our partner’s lap. Venting, finger pointing, and laying blame typically follow. All too often, we cannot resist holding them responsible for the empty tank of gas, the broken dishwasher and the sick dog (“Weren’t you the last one to feed him?”).

Over time, this behavior functions like relationship anthrax—it poisons good will, asphyxiates intimacy, and propagates contempt. A study entitled “Under Pressure: The Effects of Stress on Positive and Negative Relationship Behaviors” published in the Journal of Social Psychology found that people gave 15% fewer compliments to their partner and were also more likely to want to flirt with someone else when experiencing “high stress.” In other words, not only do we roll our eyes more at the other person and interpret their behavior through a less glamorous lens when feeling flattened by the daily grind, we also tend to have more of a roving eye.

Unloading pent up frustrations on those closest to us erodes the quality of the relationship and usually ends up leaving us feeling even more stressed out. Research suggests an alternative more helpful strategy: instead of blaming the other person for your woes, focus on the big picture instead. For instance, during the 2007-2009 financial crisis, people who blamed the economy for their problems rather than the other person reported feeling happier than couples who blamed each other for their day-to-day money issues. Similarly, as described in a recent Scientific American Mind article entitled “It’s Not You, It’s COVID,” a study found that couples who blamed the pandemic for tension rather than each other stayed happier. Attributing stress to the coronavirus enabled them to cope more effectively together.

The research suggests that couples who present a united front against a stressor are better equipped to navigate tough times. Reframing obstacles as a shared challenge makes it easier to tackle as a team. As the researchers observe, when faced with a great deal of stress, “the ability to shift blame for relational distress away from each other and onto the stressor may inspire partners to unite in the face of a common threat.”

Bottom Line: Stress can tear us apart. It can also bring us closer.

 

I wish you all the best,

Dr. Samantha Boardman

How To Calm Your Eco-Anxiety

Angry, terrified, and in despair.

These three words capture how many people are feeling because of climate change according to a recent report by the American Psychological Association, “Mental Health and Our Changing Climate: Impacts, Inequities, and Responses.” A global study published in the Lancet found that nearly 6 in 10 people aged 16 to 25 were very or extremely worried about the fate of the planet, nearly half of them reported climate distress or anxiety affecting their daily lives, three-quarters agreed that “the future is frightening,” and over half are convinced that “humanity is doomed.”

The health of the planet is deeply connected to our mental health. While people who are directly affected by environmental disasters and climate change are at the greatest risk of developing mental-health issues, many who aren’t in the line of fire are suffering as well. Increased awareness of the looming threats to the environment and bearing witness to the current changes is psychologically distressing. Watching the toll of these irreversible changes on the planet can lead to what is known as eco-anxiety: the ongoing worry, fear, and frustration about the future for oneself and for future generations.

A sense of hopelessness and helplessness often accompany eco-anxiety and may even result in eco-paralysis. Resignation, guilt, and fatalism set in when we lose hope. Threats to the environment are so complex and widespread, sometimes it’s hard to imagine that one person’s actions can make a difference. Watching the devastation of a violent storm hundreds of miles away or seeing piles of trash in your neighborhood can feel equally intimidating. Where to begin? There isn’t a simple answer.

Eco-anxiety is not something to be medicated or treated in the traditional sense. Unlike irrational worry that is characteristic of anxiety disorders, eco-anxiety is a perfectly rational response to a very real threat. Just because it is unpleasant doesn’t mean it should be minimized or medicated.

On the contrary, it’s a signal that we need to be paying attention and taking action. Negative emotions can be uncomfortable, but when we treat them as data and information, they can be a gateway to positive change.

While a lot may be beyond your personal control, look for everyday ways to contribute to the health of the environment. A report by the APA entitled “Mental Health and Our Changing Climate” recommends taking positive actions like walking or biking to work and using public transportation instead of driving. Not only are these actions good for the earth, they are also good for you. Whatever you do, make sure you are walking the walk. If you say you care about the planet, let your lifestyle reflect it. Use clean energy, buy local food when possible, use green products, and, last but not least, get to the voting booth.

The key is to balance hope and worry. As Christiana Figueres, an internationally recognized leader on global climate change argues, we must remain “stubbornly optimistic.”

3 Strategies to Master the Art & Science of Asking for a Favor

“Just thinking about it gives me hives,” explained my patient. Like many people I know, she doesn’t like asking for favors. Most people prefer doing a favor for someone else to asking for one. There are many reasons we are reluctant to request help including not wanting to feel beholden to someone, not wanting to seem vulnerable or needy, dreading the awkwardness of the interaction, and the possibility the person will say “no.” Indeed, fear of rejection looms especially large.

While people won’t always come through, here are 3 strategies to maximize your chances of getting a “yes.”

1. Give The Person A Shout Out

Nobody wants to feel put upon or pressured. In fact, people are more likely to agree when offered a choice in the matter. Saying something along the lines of “I completely understand if you are too busy” or “No worries if this is bad timing for you” conveys understanding and appreciation regardless of the outcome. Plus, by providing an escape clause, you give them an opportunity to graciously decline and smooth over the possibility of future awkwardness.

2. Provide A Reason, Any Reason

No need to launch into a lengthy explanation but a quick sentence about why you are asking for the favor can be persuasive. People like to have a “why” and appreciate a little background. Interestingly, Harvard psychologist Ellen Langer found that simply using the word “because” is enough to convince people to comply with a request. In a well known experiment demonstrating this principle in action, she approached people who were standing on line to use a library photocopy machine. She asked if she could cut the line using one of the requests listed below:

  1. “Excuse me, I have 5 pages. May I use the xerox machine?”
  2. “Excuse me, I have 5 pages. May I use the xerox machine, because I’m in a rush?”
  3. “Excuse me, I have 5 pages. May I use the xerox machine, because I have to make copies?”

In the first scenario, 60% agreed to let her use the photocopying machine ahead of them. In the second scenario, 94% allowed her to jump ahead. She provided a “legitimate” reason—she was in a rush. What is striking is the result of the third scenario. An astonishing 93% agreed to let her go ahead of them. The request is absurd: “because I have to make copies.” Everyone on the line needs to make copies. Simply by providing a reason, even a ridiculous one, people mindlessly allowed her to go ahead.

3. Ask In Person

If you really need a favor, arrange a face to face meeting. A study entitled Should I Ask Over Zoom, Phone, Email, or In-Person? Communication Channel and Predicted Versus Actual Compliance published November 2021 in Social Psychological and Personality Science found that we consistently underestimate the value of an in-person interaction. Participants expected there to be a small difference between asking for a favor via text message, over the phone, or on Zoom versus in person but did not realize how significant it would be. “When we are the ones asking for something, we think what matters is what we are asking for, rather than how we are asking for it,” explained co-author of the study Vanessa Bohns. In other words, the “how” matters as much if not more than the “what” and the “why.” While it’s certainly easier to send a text, pick up the phone, or write an email, we are less likely to get a “yes” from those modes of communication than if we made the effort to show up in person.

On a final note, next time you are reluctant to ask for a favor consider this: there is plenty of evidence to suggest that asking for a favor makes you more likable and can even improve your relationship with the “requestee.” Instead of being a burden, doing a favor for someone is more often a pleasure than a pain.

“When we give cheerfully and accept gratefully, everyone is blessed.” ― Maya Angelou

I wish you all the best,

Dr. Samantha Boardman