Confronting Cognitive Distortions with DBT

Adrian Acevedo, MHC

What is a cognitive distortion?

Cognitive distortions are irrational thought patterns that influence our beliefs and behaviors. They tend to reflect strong personal bias and negative or critical beliefs about self and others. Most importantly, they are thought patterns that do not accurately reflect reality. Cognitive distortions can have a powerful impact on the way we move through the world, contributing to anxiety, depression, low self-esteem, and relationship difficulties. Examining cognitive distortions is a central practice of cognitive behavioral therapy, with the goal of restructuring these thought patterns and in turn, decreasing inappropriate or unwanted emotional responses and behavioral patterns.

How can DBT help me manage cognitive distortions?

Dialectical Behavior Therapy (DBT) is a skills-based therapy designed to help individuals understand and manage overwhelming emotions. DBT skills can help address the emotional responses associated with cognitive distortions by encouraging mindfulness and more flexible thinking. DBT also challenges us to suspend judgment and personal bias in communication and relationships, which is also useful when we are confronting cognitive distortions. If you are recognizing cognitive distortions in your own life, and finding yourself emotionally overwhelmed, consider integrating DBT skills in your therapeutic practice. Below are some common cognitive distortions, and corresponding DBT skills that may help you manage them:

All-Or-Nothing Thinking: All-or-nothing thinking is thinking in absolutes. You may be able to identify very binary or black-and-white language in your own thought and communication patterns. All-or-nothing thinking is generally irrational and not factual, and this rigidity can negatively shape our beliefs about ourselves, others, and the world. Dialectical Behavior Therapy challenges us to think dialectically, which means to be able to hold two seemingly contradictory truths at once. 

When you notice yourself thinking in absolutes, stop and examine the thoughts, from a position of curiosity. Is this really always true? When has something contradictory been true? Can I hold that tension, even if it feels more complex and challenging?

Jumping to Conclusions and Emotional Reasoning: These two cognitive distortions are closely related in that they involve shaping our beliefs and behaviors without factual evidence. DBT tells us that this is our Emotion Mind at work. When we allow our emotions to dictate what is true to us, we behave in ways that are irrational and ineffective. We may find ourselves becoming isolated, avoidant, and disempowered by our own thoughts. 

When you recognize these cognitive distortions, slow down and connect to Wise Mind. DBT teaches us that the Wise Mind is the integration of our Rational Mind and our Emotion Mind, our centered, grounded state of being and knowing. Consider also using Check the Facts skill to determine if your beliefs are grounded in reality, or being shaped by emotions and personal biases.

“Should” Statements: “Should” statements reflect an irrational belief that everything (our life circumstances, ourselves, others’ behaviors) should be a certain way and can be expected to be a certain way. We become distressed when things and people are not the way we believe they ought to be, and we can become resistant and resentful.

DBT emphasizes the importance of mindfulness. When we are mindful, we suspend judgmental thinking. The next time you notice yourself clinging to a belief that things “should” be different, consider a shift in language that is less rooted in judgment. When you are resistant or resentful towards a person or a set of circumstances that is outside your control, practice Radical Acceptance.

Catastrophizing: Catastrophizing is the irrational focus on the worst possible outcomes of a situation, and the belief that they are the most likely to come to fruition. Catastrophizing can exacerbate our existing emotions about events, particularly fear and panic. By expecting the worst-case scenario, we may find ourselves unable to be present, engaged, and effective.

If you find yourself stuck catastrophizing, and you believe your Emotion Mind is fueling this response, consider using Check The Facts skill and Cope Ahead skill. Checking the facts can help reframe the irrational thought itself by clarifying whether it is emotionally based. Coping ahead is the process of envisioning yourself moving through the difficult event you’re imagining, with an opportunity to make plans for both practical steps and self-soothing/emotional processing.

Reference
Linehan, M., M., (2014). DBT Training Manual. New York, NY: The Guilford Press.