At Mountain Valley, we have sometimes questioned how much thoughts really matter and introduced the Acceptance and Commitment Therapy (ACT) strategy known as cognitive defusion. Today, we are going to be discussing a skill that involves actually engaging with distorted thinking that often accompanies anxiety or fear. This strategy is called cognitive restructuring and it is a classic skill from Cognitive Behavioral Therapy, which poses that if we change the way we think, we can change the way we feel and behave.

To understand cognitive restructuring, it’s important to understand cognitive distortions. Cognitive distortions are dysfunctional, often automatic thoughts patterns, that contain fallacies and bias in reasoning, leading to a “distorted” perception of one’s experience. For example, have you ever said, “no one ever wants to talk to me,” found yourself only noticing the bad things that happen in our day, or feel as though everyone is thinking about you? All of these are examples of different distorted thinking patterns that often function automatically in our everyday lives.

These thoughts often come from more deeply rooted “core beliefs,” or core “schema” that serve as a “lens” and “frame of reference” from we view and interpret the world. However, for the purposes of this article, we are going to stay more practical with how to deal with the surface level distorted thought, and we will save deeper core belief work for another day.

Here are 5 steps to working through the distorted thinking in a moment:

  1. Notice your thoughts – To change your thoughts as a way to change your mood and behavior, you have to be aware of what you are thinking. When you are feeling anxious, notice what you are thinking. Example: You walk into a room and the room is silent. You think “no one ever says hi to me. They must not like me very much.”
  2.  Write the thought down – Write the thought down on a piece of paper. This will help you begin to view the thought more objectively and become less emotional attached to the thought so you can see it for what it is.
  3.  Check for evidence that supports or does not support the thought – What evidence do you have that this thought is true? What evidence do you have that this thought is false? What evidence may be lacking or missing in order of us to draw any concrete conclusion? Example: Evidence for the thought could be that you walked in the room and its true, no one actually said hello to you. Counter evidence could be that when other people walked in the room, no one said hi to them either. People seem to be reading their books or on their phones not really paying attention. Also, there is no evidence that anyone has ever said that they didn’t like you.
  4.  Check for distortions – Check your thoughts against the pre-identified common cognitive distortions identified in CBT (see the list below). What distortions are present in this thought? Example: This thought includes the cognitive distortions such as personalizing, overgeneralizing, and fortune telling.
  5.  Re-write the thought – Now that you have looked at the evidence for and against the thought, and identified distorted thinking patterns within the thought, it’s time to rephrase the thought in a more balanced manner. Example: “No one said ‘hi’ to me today because people seem to be focused on themselves,” or, “people in the room are so focused on what they are doing that they aren’t saying hi to anybody.”

Cognitive restructuring doesn’t always get the best wrap in the therapeutic world. You often hear people say “just change the way I think? If only it were that easy.” And the truth is, it’s not that easy at all. Thinking is very much an automated process and our ability to have agency over our thinking and the core beliefs that drive those thoughts, is by no means a small challenge. It takes practice, consistency, and patience. Over time, as you continue to notice, question, and be intentional with your thoughts, you’re thinking patterns will change, your behavior will follow, and the anxious thoughts that once limited your life will no longer stand in the way.

Cognitive Distortions: 

  • Black-and-white (or all-or-nothing) thinking: I never have anything interesting to say.
  • Jumping to conclusions (or mind-reading): The doctor is going to tell me I have cancer.
  • Personalization: Our team lost because of me.
  • Should-ing and must-ing (using language that is self-critical that puts a lot of pressure on you): I should be losing weight.
  • Mental filter (focusing on the negative, such as the one aspect of a health change which you didn’t do well): I am terrible at getting enough sleep.
  • Overgeneralization: I’ll never find a partner.
  • Magnification and minimization (magnifying the negative, minimizing the positive): It was just one healthy meal.
  • Fortune-telling: My cholesterol is going to be sky-high.
  • Comparison (comparing just one part of your performance or situation to another’s, which you don’t really know, so that it makes you appear in a negative light): All my coworkers are happier than me.
  • Catastrophizing (combination of fortune-telling and all-or-nothing thinking; blowing things out of proportion): This spot on my skin is probably skin cancer; I’ll be dead soon.
  • Labeling: I’m just not a healthy person.
  • Disqualifying the positive: I answered that well, but it was a lucky guess.