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<v Speaker 1>Welcome back everyone, and today we're looking at cognitive distortions.

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<v Speaker 1>So cognitive distortions are automatic thought patterns that are inaccurate,

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<v Speaker 1>and they include catastrophizing, black and white thinking, personalization, over generalization,

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<v Speaker 1>and emotional reasoning. We'll look at these in more detailed.

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<v Speaker 1>These distortions are central to development and persistence of mood

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<v Speaker 1>and anxiety disorders. There is cognitive assessments that identify the

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<v Speaker 1>patterns through thought records, socratic questioning, and client self monitoring.

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<v Speaker 1>One of the ways to work with them is cognitive restructuring,

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<v Speaker 1>which modifies distorted thinking using evidence evaluation, alternative interpretations, and

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<v Speaker 1>behavioral experiments. Schema theory explains how early cognitive templates shape

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<v Speaker 1>perception and reinforced distortions. Neurobiologically distorted thinking links to pre

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<v Speaker 1>funnel amignala dysregulation. Thoughts are not neutral. They shape perception, emotion,

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<v Speaker 1>and behavior. So let's look at the first ones. Catastrophizing

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<v Speaker 1>predicting the worst possible outcome and seeing it like it's inevitable.

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<v Speaker 1>So if I make one mistake, I'll get fired and

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<v Speaker 1>lose everything. And this is what you'll typically see in

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<v Speaker 1>individuals with generalized anxiety disorder panic disorder. Another one is

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<v Speaker 1>dichotomists thinking are all or nothing thinking. Here, you're seeing

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<v Speaker 1>things in extremes. If I'm not the best, I'm a

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<v Speaker 1>total failure. You can kind of relate to splitting the

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<v Speaker 1>world of splitting in the psychodynamic world, so you'll see

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<v Speaker 1>it a lot of borderline personality disorders, eating disorders, and perfectionism.

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<v Speaker 1>Personalization is another one, believing one is responsible for events

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<v Speaker 1>outside their control. My friend is upset, it must be

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<v Speaker 1>something I did. Common in depression and social anxiety, reinforcing

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<v Speaker 1>low self worth. Arbitrary inference is drawing conclusions without evidence,

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<v Speaker 1>even if though there is evidence that's contradictory. For instance,

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<v Speaker 1>they didn't say hi, they must hate me. This is

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<v Speaker 1>seen in period paranoid ideation and social phobia, and it

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<v Speaker 1>might even sound familiar to fundamental attribution error. Another one

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<v Speaker 1>that's selective abstraction, focusing on one negative detail where ignoring

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<v Speaker 1>the broader context. I got one critique of my work,

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<v Speaker 1>so I'm terrible at my job. Another one is over generalization,

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<v Speaker 1>making sweeping judgments from a single event. I failed once,

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<v Speaker 1>so I always fail. It's a little bit different than

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<v Speaker 1>the other ones. We just talked about selective abstraction for catastrophizing. Right,

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<v Speaker 1>this is more of a predictive component. I'll always fail. Now,

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<v Speaker 1>catastrophizing is also kind of predictive, but it's really the

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<v Speaker 1>worst of the worst. You can think of emotional reasoning.

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<v Speaker 1>Assuming feelings reflect facts. I feel anxious that something bad

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<v Speaker 1>must be about to happen. This is a lot of

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<v Speaker 1>today's society. We see this prominent panic disorder and OCD.

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<v Speaker 1>A lot of these thought patterns are automatic. They hit

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<v Speaker 1>us quickly and they feel really convincing the role they

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<v Speaker 1>have in psychopathology, we see them a lot. Like I said,

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<v Speaker 1>in anxiety disorders will have catastrophizing and tolerance of uncertainty

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<v Speaker 1>emotional reasoning, and they amplify a perceived threat. So, for instance,

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<v Speaker 1>in social anxiety, this leads clients to believe others are

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<v Speaker 1>judging them negatively. And that's the cognitive distortion of personalization depression.

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<v Speaker 1>You have something to call the cognitive cognitive triad. It's

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<v Speaker 1>negative views of the self, the world, and the future.

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<v Speaker 1>I'm worthless, nobody likes me, and there's no hope. So

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<v Speaker 1>this is where you have worthlessness, helplessness, and hopelessness. Right,

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<v Speaker 1>so worthlessness is I'm no good, helplessness, nobody can help me,

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<v Speaker 1>the world isn't going to help me, and then the

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<v Speaker 1>future is hopelessness. Nothing's going to get better. And this

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<v Speaker 1>has ma constructed and maintained by distortions like selective abstraction

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<v Speaker 1>on one detail, ignoring the whole context, overgeneralization, making sweeping

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<v Speaker 1>judgments from a single event, and arbitrary influence drawing conclusions

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<v Speaker 1>without evidence. These patterns, of course, reduce motivation and sustain

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<v Speaker 1>a low mood personality disorders. We have a borderline personality disorder.

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<v Speaker 1>You're going to see the cognitive distortion of the dichotomists thinking,

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<v Speaker 1>which contributes to unstable relationships and shifting self image and

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<v Speaker 1>paranoid personality to sort of have arbitrary inference. Remember drawing

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<v Speaker 1>conclusions without evidence again narcissistic traits. You have selective attraction,

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<v Speaker 1>which distorts self appraisal in both grandiose and vulnerable directions.

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<v Speaker 1>Is due to two different types of narcissism OCD and

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<v Speaker 1>trauma and OCD intrusive thoughts are reinforced by emotional raising

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<v Speaker 1>and catastrophizing and PTSD overgeneralization of a threat and the

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<v Speaker 1>negative core beliefs maintain the hypervigilance and avoidance. So what

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<v Speaker 1>can you do to identify these thought records where clients

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<v Speaker 1>document triggering events, automatic thoughts, emotions, evidence for and against thought.

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<v Speaker 1>Number two socratic questioning. Therapists use guided questions to challenge assumptions.

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<v Speaker 1>This is where I think CBT looks like it's in

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<v Speaker 1>a courtroom. You as a therapists are actually the defense

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<v Speaker 1>attorney and the client as your client. The cognitive distortions

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<v Speaker 1>are really the prosecution. So when you're in the defense,

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<v Speaker 1>you can ask your client what's the evidence for that?

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<v Speaker 1>Is there another way to view this? What would you

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<v Speaker 1>say to a friend in the situation, or some of

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<v Speaker 1>the challenges you can have as aquatic questioning, But at

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<v Speaker 1>the same time you're also trying to dig into the

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<v Speaker 1>clients to find all the contradictory evidence against what the

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<v Speaker 1>prosecution has, and you're trying to build up a case

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<v Speaker 1>for the client. Number three is behavioral experiments. Use the

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<v Speaker 1>test beliefs in real world conditions. On example, be a

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<v Speaker 1>socially anxious client predicts humiliation if they speak up in group.

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<v Speaker 1>So here you can try to do is to do

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<v Speaker 1>an experiment to disprove this. And lastly, it's self monitoring

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<v Speaker 1>helping catch distortions in real time, so being really self aware.

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<v Speaker 1>So this is where mindfulness comes in pretty handy. Some

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<v Speaker 1>of the cognitive restructuring techniques is identifying the distortion, so

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<v Speaker 1>labeling the pattern that's catastrophizing, which helps create distance, but

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<v Speaker 1>really it helps create awareness. Once you create that awareness,

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<v Speaker 1>you can create the distance from it and realize it's

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<v Speaker 1>external from you. Challenge the thought of getting back to

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<v Speaker 1>the court room. Replace I will always fail with I've

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<v Speaker 1>succeeded before, even when it was difficult, So you have

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<v Speaker 1>to get that contradictory evidence. Reframe the narrative, replace the

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<v Speaker 1>distortive thought with a balance alternative that feels believable, and

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<v Speaker 1>test it behaviorally. You see action will seal up or

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<v Speaker 1>really solidify belief, so repeat it. This Confirming experiences will

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<v Speaker 1>rewire your neuronal patterns in your brain. Lastly, schema and

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<v Speaker 1>information processing biases, so cognitive distortions are downstream from schema,

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<v Speaker 1>so deep cognitive structures formed by early experiences. This is

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<v Speaker 1>where you see Aaron Beck's influence from psychoanalytic days. Schema shape, attention, memory,

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<v Speaker 1>and interpretation. The rejection schema leads a client to interpret

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<v Speaker 1>neutral clues a partner silence as evidence of abandonment. A

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<v Speaker 1>failure schema filter success as luck and emphasizes mistakes. And

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<v Speaker 1>these create information processing biases. So you have attentional bias

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<v Speaker 1>noticing threat and more than safety, interpretation bias assuming negative intent,

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<v Speaker 1>and memory bias recalling failures more than successes. So we

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<v Speaker 1>also have what they call a neurobiological correlative negative thinking.

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<v Speaker 1>So look at the neuroscience behind this, and in the

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<v Speaker 1>pre funnel cortex it involves an executive function. If you're now,

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<v Speaker 1>if you think about some of these cognitive thoughts are

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<v Speaker 1>cognitive distortions, you can see that they are in the

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<v Speaker 1>prefunnel cortex. Right, emotional regulation is going to be here.

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<v Speaker 1>Lower activation leads to less cognitive control over automatic thoughts.

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<v Speaker 1>Amigdal is heightened activity, especially in anxiety and depression, and

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<v Speaker 1>increases emotional salience of negative stimuli. And finally, the default

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<v Speaker 1>mode network associated with self referential thought thinking about yourself.

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<v Speaker 1>Overactivity can support rumination and negative self focus. Therapies that

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<v Speaker 1>are reduce to storarted thinking CBT mindfulness act also produce

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<v Speaker 1>changes in these neural circuits. So really what you're doing

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<v Speaker 1>is focusing on CBT by default. It's going to work

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<v Speaker 1>on these areas biologically and hopefully seal up the corrected belief.

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<v Speaker 1>Cognitive distortions again don't just restored perception. They actually can

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<v Speaker 1>shape our identity, our relationships, whether you're working with a

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<v Speaker 1>client of beliefs are unlovable. We're answering your question about

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<v Speaker 1>how thoughts influenced anxiety. You're always tracing these patterns. What

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<v Speaker 1>I have learned over the years is it almost always

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<v Speaker 1>leads to worthlessness. And if you have a de client

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<v Speaker 1>who's depressed, you'll see helplessness or hopelessness. But a lot

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<v Speaker 1>of times rejection leads to worthlessness. They don't want to

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<v Speaker 1>be rejected, they don't want to feel like they're not

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<v Speaker 1>good enough. It doesn't provide security and safety. So that's

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<v Speaker 1>it for now.