Notes to Self

"For there is nothing either good or bad, but thinking makes it so." - William Shakespeare

An unhealthy self-esteem is often because of a warped self-identity which makes us more prone to stress, depression and anxiety. Cognitive therapy (also known as cognitive behavior therapy) is very effective in reducing depression and anxiety by providing us an amazing insight to all our actions and feelings. When applied consistently over a period, it also helps correct faulty perceptions about our personal identity thus increasing our self-esteem and making us more resilient.

What is Cognitive Therapy?

The basic premise of cognitive therapy is that your thoughts and attitudes - not external events - create your feelings.

An example: You are waiting for a friend who is late. If you are feeling annoyed, you might be thinking, "He is always late and makes me wait." If you are worried, you might be thinking, "It's not like him to keep me waiting. I wonder what's wrong?" The event is the same - the friend is late, but depending on your thoughts your feelings will differ.

Another example: If you just read the above and thought, "It's some trick. This guy is playing with words and imaginary situations to fool me ...", you might be feeling angry. On the other hand, if you thought, "Wow. That's profound ... This means I can change my feelings by just changing my thought!", you might be feeling very excited.

Based on this premise, cognitive therapists believe that "distorted" thinking patterns causes depression and unhealthy anxiety. A "distortion" in a thought means that while the thought might seem very truthful and realistic, it is actually clouded by faulty perceptions and not factually correct. And hence, correcting these "cognitive distortions" (a "cognition" is simply a thought) can help a person cope better with depression and anxiety.

The ten cognitive distortions

1. All-or-nothing thinking: All-or-nothing thoughts are characterized by absolutes. This distortion polarises a person's thinking into either extremes without any shades of grey. Perfectionist thoughts are often characterized by this distortion - they often feel if something is not perfect than it's a total failure.


2. Overgeneralization: A single negative event is seen as a never ending pattern of failure or defeat. These thoughts are characterized by words such as "always" or "never". For example, when John had a romantic rejection he thought, "Girls just don't like me. I'll always be alone."


3. Mental Filter: This is characterized by concentrating all efforts on a single negative details at the cost of other positive ones. Example: A teacher praises your essay a lot and adds in the end, "... but your handwriting is terrible, you really need to work on that." You obsess only on this negative comment for days, ignoring all the positive feedback you got.


4. Discounting the positive: You reject all positive outcomes by insisting that they "don't matter". Example: A designer, you create a great piece of art and everyone praises you. You discount it by saying, "These people have no idea. Any designer could have done this". This distortion takes the joy out of life and makes you feel frustrated and inadequate.


5. Jumping to conclusions: Without factual basis you assume things will go negatively. There are 2 formats of this distortion:
   
   Mind reading: Without any confirmation, you conclude that a person is reacting negatively to you. Example: "She must think I am idiot."
   
   Fortune telling: You predict a negative outcome; that "things will go bad". Example: Before an interview you might think, "I am going to mess this up and not get the job."


6. Magnification / Minimization: "Making a mountain out of a molehill" characterizes this thought pattern. You might exaggerate the importance of your problems and shortcoming and / or minimize your plus points.


7. Emotional reasoning: You assume your negative feelings reflect reality. Example: "I hate myself. This proves I am a rotten person." or "I feel angry. This means I am being treated unfairly."


8. "Should statements": You believe that things should be the way you hoped or expected. Example: "I shouldn't have scolded her." or "People should be nice to everyone." Should statements directed against yourself make you feel frustrated and guilty while those directed at other people make you feel frustrated and angry.


9. Labeling: Another form of all-or-nothing thinking, you attach a negative label to yourself or others. Example: Instead of saying you made a mistake, you label yourself a "loser". You may also label others - "He is a SOB". Labeling makes you think that the problem is with persons character, rather than his / her attitude or belief.


10. Personalization / Blame: Personalization is characterized by a tendency to hold yourself responsible for events that were beyond your control and leads to feelings of guilt, shame and inadequacy. Example: A child does something bad, and the mother thinks, "It's my fault, I am a bad mother." Blame is the opposite of personalization where you don't take any responsibility and blame other people. Example: "My girl friend is responsible for all the misery in our relationship."

Common misunderstanding about cognitive therapy

• Cognitive Therapy is all about changing your thinking, and does not involve behavioral change.
  Actually, Cognitive Therapy addresses your thinking, emotions, behaviors, and physiological symptoms (if applicable). Cognitive Therapy is called Cognitive Therapy because it is based on the premise that your underlying beliefs about yourself, others and the world influence the way you perceive situations, and prompt you to have certain thoughts, emotions, behavioral responses and physical symptoms.


• Cognitive Therapy only deals with surface layer problems, and it does not do much to change the root of people’s problems.
  Cognitive Therapy treatment starts by addressing present problems as a way to help patients gradually change their underlying problems. Cognitive Therapists work with patients to analyze what's happening in a given situation, come up with alternative responses, experiment with implementing new ways of thinking and acting, and gradually begin to change their responses to situations. When patients see how their reactions, mood and other symptoms can improve once they begin viewing situations in a more realistic light, they gradually begin to chip away at their ‘deep-seated’ core beliefs.

Continued » Cognitive Therapy - 2

(This article is incomplete and a work in progress.)