In order to have psychological abnormality the identified pt’s psychological presentation must be characterized by 3 (potentially 4) elements: (1) distress (2) dysfunction and (3) deviance. The forth element is danger and may or may not be present. The basis of cognitive behavioral therapy (CBT) is that psychological abnormality, indicated by a person’s suffering is caused by illogical thinking. This illogical thinking often occurs in the form of cognitive distortions, identified patterns of illogical thinking that often center around negative core beliefs that the pt has developed about the self throughout his or her lifetime. These core beliefs can be thought of as a person’s story about his or herself or what he or she sees when they look in a mirror. As someone who has experience a lot of psychological distress throughout her life, which has resulted in several different clinically diagnosed abnormalities, I am a repeat offender of using cognitive distortions. And while I find CBT to be the most annoying form of therapy (cue the phrase “what evidence do you have of that”), I can’t deny the relatability of these concepts.
The following is a non-exhaustive list of cognitive distortions:
- Filtering- only allowing yourself to hear/see negative aspects of a situation while ignoring any positives
- Black or white thinking- things are either perfect or a complete failure
- Overgeneralization- assuming that one performance in one area of your life says something greater about who you are as a person
- Jumping to conclusions- making assumptions about other people’s perceptions about you
- Catastrophizing- “what if…”
- Personalization- assuming you are responsible for another person’s actions
- Control fallacies- assuming you have control over things you don’t
- Fallacy of fairness- making the very false assumption that life is fair
- Blaming- saying other people caused our feelings w/o realizing that no one can cause a person’s feelings, not even themselves
- Should’s- having inflexible ideas about how life should be
- Emotional reasoning- assuming our feelings and thoughts are always true
- Fallacy of change- believing that things will be this way forever
- Global labeling- name calling
- Always being right- confirmation bias
- Reward fallacy- assuming we will always be rewarded for doing what is right
*Definitely comment below if you have a distortion that you would like me to talk more about. I have experienced pretty much all of these so I could give you endless examples of all of them.
But today I want to talk about black and white/all or none thinking because this is the distortion that causes me the most psychological distress and pain and causes me to not feel the way I want to feel.
All or nothing thinking is basically how I fell into my eating disorder. In high school, I wanted to lean up for sports. While I did have negative body image and thoughts and wanted to look more attractive and like my classmates, a lot of my eating disorder was focused around athletic performance. I was obsessed with sports, to the point that my perspective of myself as a basketball player was overgeneralized to what I thought about myself as a person (see what I did there). If I had a good practice that day I was a good person. If I had a bad practice that day I was a bad person. If I was a good player everyone would like me. If I was a bad player I would have no friends. I was obsessive about my practices. Everything had to be just right so I was prepared and ready to go. I had to have enough sleep the night before. I had to be well fed enough so that I wouldn’t run out of energy. My hair had to be slicked back and I had to be wearing clothes I was comfortable in so I wouldn’t be distracted. I would come home and sleep until practice started in the afternoon because I couldn’t bear the anxiety. Obviously this was not sustainable as a college athlete with multiple practices during a day which often led me to mental breakdown and poor performance. I ultimately just stopped caring about my performance when my eating disorder got bad enough and there was nothing left for me to do. I couldn’t obsess anymore. I had moved every barrier there was to move and I still wasn’t enough for my coach who could care less about me as a person. That’s when things got really bad because if there was no athlete, there was no person for me, no reason to live. There was that all or nothing thinking again.
All or nothing thinking still gets me today. It often is in the form of disordered eating. Due to negative body thoughts and daily triggers, I often restrict my eating, especially around certain food groups. Tracking my food is a strong behavior of mine and I feel successful when I am able to eat less food than I need. However, if I “mess up” in my mind and eat something bad or eat too much I often think “screw it” and eat whatever I want in whatever amount I want, which makes me feel like absolute dog crap. I am working on not marking my days as good or bad, but just being ok with having days. Nothing is the same forever and this includes the way our body’s look. While I can control the amount and type of food that I eat and the exercise that I do, I cannot control my hunger levels or my metabolism that has been destroyed through the severe anorexia I developed several years ago. Furthermore, I do not have a body that no one will find attractive or anyone will find attractive. It is most likely that there will be some of both. I just have to find some people on the side that fills my soul and makes me feel good about myself. And while my mental health battle seems never ending and it is hard not to label myself as forever anxious and a lost cause I cannot believe in the change fallacy. I must press on and hope that one day my thinking will be logical again and I can let go of the negative core beliefs that drag me down everyday. It seems like a day, but believing that things can change is the first step in a more logical direction.