Speaker 1: Welcome back everyone, and today we're looking at cognitive distortions.
Speaker 1: So cognitive distortions are automatic thought patterns that are inaccurate,
Speaker 1: and they include catastrophizing, black and white thinking, personalization, over generalization,
Speaker 1: and emotional reasoning. We'll look at these in more detailed.
Speaker 1: These distortions are central to development and persistence of mood
Speaker 1: and anxiety disorders. There is cognitive assessments that identify the
Speaker 1: patterns through thought records, socratic questioning, and client self monitoring.
Speaker 1: One of the ways to work with them is cognitive restructuring,
Speaker 1: which modifies distorted thinking using evidence evaluation, alternative interpretations, and
Speaker 1: behavioral experiments. Schema theory explains how early cognitive templates shape
Speaker 1: perception and reinforced distortions. Neurobiologically distorted thinking links to pre
Speaker 1: funnel amignala dysregulation. Thoughts are not neutral. They shape perception, emotion,
Speaker 1: and behavior. So let's look at the first ones. Catastrophizing
Speaker 1: predicting the worst possible outcome and seeing it like it's inevitable.
Speaker 1: So if I make one mistake, I'll get fired and
Speaker 1: lose everything. And this is what you'll typically see in
Speaker 1: individuals with generalized anxiety disorder panic disorder. Another one is
Speaker 1: dichotomists thinking are all or nothing thinking. Here, you're seeing
Speaker 1: things in extremes. If I'm not the best, I'm a
Speaker 1: total failure. You can kind of relate to splitting the
Speaker 1: world of splitting in the psychodynamic world, so you'll see
Speaker 1: it a lot of borderline personality disorders, eating disorders, and perfectionism.
Speaker 1: Personalization is another one, believing one is responsible for events
Speaker 1: outside their control. My friend is upset, it must be
Speaker 1: something I did. Common in depression and social anxiety, reinforcing
Speaker 1: low self worth. Arbitrary inference is drawing conclusions without evidence,
Speaker 1: even if though there is evidence that's contradictory. For instance,
Speaker 1: they didn't say hi, they must hate me. This is
Speaker 1: seen in period paranoid ideation and social phobia, and it
Speaker 1: might even sound familiar to fundamental attribution error. Another one
Speaker 1: that's selective abstraction, focusing on one negative detail where ignoring
Speaker 1: the broader context. I got one critique of my work,
Speaker 1: so I'm terrible at my job. Another one is over generalization,
Speaker 1: making sweeping judgments from a single event. I failed once,
Speaker 1: so I always fail. It's a little bit different than
Speaker 1: the other ones. We just talked about selective abstraction for catastrophizing. Right,
Speaker 1: this is more of a predictive component. I'll always fail. Now,
Speaker 1: catastrophizing is also kind of predictive, but it's really the
Speaker 1: worst of the worst. You can think of emotional reasoning.
Speaker 1: Assuming feelings reflect facts. I feel anxious that something bad
Speaker 1: must be about to happen. This is a lot of
Speaker 1: today's society. We see this prominent panic disorder and OCD.
Speaker 1: A lot of these thought patterns are automatic. They hit
Speaker 1: us quickly and they feel really convincing the role they
Speaker 1: have in psychopathology, we see them a lot. Like I said,
Speaker 1: in anxiety disorders will have catastrophizing and tolerance of uncertainty
Speaker 1: emotional reasoning, and they amplify a perceived threat. So, for instance,
Speaker 1: in social anxiety, this leads clients to believe others are
Speaker 1: judging them negatively. And that's the cognitive distortion of personalization depression.
Speaker 1: You have something to call the cognitive cognitive triad. It's
Speaker 1: negative views of the self, the world, and the future.
Speaker 1: I'm worthless, nobody likes me, and there's no hope. So
Speaker 1: this is where you have worthlessness, helplessness, and hopelessness. Right,
Speaker 1: so worthlessness is I'm no good, helplessness, nobody can help me,
Speaker 1: the world isn't going to help me, and then the
Speaker 1: future is hopelessness. Nothing's going to get better. And this
Speaker 1: has ma constructed and maintained by distortions like selective abstraction
Speaker 1: on one detail, ignoring the whole context, overgeneralization, making sweeping
Speaker 1: judgments from a single event, and arbitrary influence drawing conclusions
Speaker 1: without evidence. These patterns, of course, reduce motivation and sustain
Speaker 1: a low mood personality disorders. We have a borderline personality disorder.
Speaker 1: You're going to see the cognitive distortion of the dichotomists thinking,
Speaker 1: which contributes to unstable relationships and shifting self image and
Speaker 1: paranoid personality to sort of have arbitrary inference. Remember drawing
Speaker 1: conclusions without evidence again narcissistic traits. You have selective attraction,
Speaker 1: which distorts self appraisal in both grandiose and vulnerable directions.
Speaker 1: Is due to two different types of narcissism OCD and
Speaker 1: trauma and OCD intrusive thoughts are reinforced by emotional raising
Speaker 1: and catastrophizing and PTSD overgeneralization of a threat and the
Speaker 1: negative core beliefs maintain the hypervigilance and avoidance. So what
Speaker 1: can you do to identify these thought records where clients
Speaker 1: document triggering events, automatic thoughts, emotions, evidence for and against thought.
Speaker 1: Number two socratic questioning. Therapists use guided questions to challenge assumptions.
Speaker 1: This is where I think CBT looks like it's in
Speaker 1: a courtroom. You as a therapists are actually the defense
Speaker 1: attorney and the client as your client. The cognitive distortions
Speaker 1: are really the prosecution. So when you're in the defense,
Speaker 1: you can ask your client what's the evidence for that?
Speaker 1: Is there another way to view this? What would you
Speaker 1: say to a friend in the situation, or some of
Speaker 1: the challenges you can have as aquatic questioning, But at
Speaker 1: the same time you're also trying to dig into the
Speaker 1: clients to find all the contradictory evidence against what the
Speaker 1: prosecution has, and you're trying to build up a case
Speaker 1: for the client. Number three is behavioral experiments. Use the
Speaker 1: test beliefs in real world conditions. On example, be a
Speaker 1: socially anxious client predicts humiliation if they speak up in group.
Speaker 1: So here you can try to do is to do
Speaker 1: an experiment to disprove this. And lastly, it's self monitoring
Speaker 1: helping catch distortions in real time, so being really self aware.
Speaker 1: So this is where mindfulness comes in pretty handy. Some
Speaker 1: of the cognitive restructuring techniques is identifying the distortion, so
Speaker 1: labeling the pattern that's catastrophizing, which helps create distance, but
Speaker 1: really it helps create awareness. Once you create that awareness,
Speaker 1: you can create the distance from it and realize it's
Speaker 1: external from you. Challenge the thought of getting back to
Speaker 1: the court room. Replace I will always fail with I've
Speaker 1: succeeded before, even when it was difficult, So you have
Speaker 1: to get that contradictory evidence. Reframe the narrative, replace the
Speaker 1: distortive thought with a balance alternative that feels believable, and
Speaker 1: test it behaviorally. You see action will seal up or
Speaker 1: really solidify belief, so repeat it. This Confirming experiences will
Speaker 1: rewire your neuronal patterns in your brain. Lastly, schema and
Speaker 1: information processing biases, so cognitive distortions are downstream from schema,
Speaker 1: so deep cognitive structures formed by early experiences. This is
Speaker 1: where you see Aaron Beck's influence from psychoanalytic days. Schema shape, attention, memory,
Speaker 1: and interpretation. The rejection schema leads a client to interpret
Speaker 1: neutral clues a partner silence as evidence of abandonment. A
Speaker 1: failure schema filter success as luck and emphasizes mistakes. And
Speaker 1: these create information processing biases. So you have attentional bias
Speaker 1: noticing threat and more than safety, interpretation bias assuming negative intent,
Speaker 1: and memory bias recalling failures more than successes. So we
Speaker 1: also have what they call a neurobiological correlative negative thinking.
Speaker 1: So look at the neuroscience behind this, and in the
Speaker 1: pre funnel cortex it involves an executive function. If you're now,
Speaker 1: if you think about some of these cognitive thoughts are
Speaker 1: cognitive distortions, you can see that they are in the
Speaker 1: prefunnel cortex. Right, emotional regulation is going to be here.
Speaker 1: Lower activation leads to less cognitive control over automatic thoughts.
Speaker 1: Amigdal is heightened activity, especially in anxiety and depression, and
Speaker 1: increases emotional salience of negative stimuli. And finally, the default
Speaker 1: mode network associated with self referential thought thinking about yourself.
Speaker 1: Overactivity can support rumination and negative self focus. Therapies that
Speaker 1: are reduce to storarted thinking CBT mindfulness act also produce
Speaker 1: changes in these neural circuits. So really what you're doing
Speaker 1: is focusing on CBT by default. It's going to work
Speaker 1: on these areas biologically and hopefully seal up the corrected belief.
Speaker 1: Cognitive distortions again don't just restored perception. They actually can
Speaker 1: shape our identity, our relationships, whether you're working with a
Speaker 1: client of beliefs are unlovable. We're answering your question about
Speaker 1: how thoughts influenced anxiety. You're always tracing these patterns. What
Speaker 1: I have learned over the years is it almost always
Speaker 1: leads to worthlessness. And if you have a de client
Speaker 1: who's depressed, you'll see helplessness or hopelessness. But a lot
Speaker 1: of times rejection leads to worthlessness. They don't want to
Speaker 1: be rejected, they don't want to feel like they're not
Speaker 1: good enough. It doesn't provide security and safety. So that's
Speaker 1: it for now.