Cognitive behavioral therapy was developed in the 1960s by Aaron Beck, a psychiatrist at the University of Pennsylvania. At the time, Freudian ideas dominated psychiatry. Clinicians assumed that depression and the distorted thinking it produces were just the surface manifestation of deeper problems, usually stretching back to unresolved childhood conflict. To treat depression, you had to fix the underlying problem, and that could take many years of therapy. But Beck saw a close connection between the thoughts a person had and the feelings that came with them. He noticed that his patients tended to get themselves caught in a feedback loop in which irrational negative beliefs caused powerful negative feelings, which in turn seemed to drive patients’ reasoning, motivating them to find evidence to support their negative beliefs. Beck noticed a common pattern of beliefs, which he called the “cognitive triad” of depression: “I’m no good,” “My world is bleak,” and “My future is hopeless.”
Many people experience one or two of these thoughts fleetingly, but depressed people tend to hold all three beliefs in a stable and enduring psychological structure. Psychologists call such structures schemas. Schemas refer to the patterns of thoughts and behaviors, built up over time, that people use to process information quickly and effortlessly as they interact with the world. Schemas are deep down in the elephant; they are one of the ways in which the elephant guides the rider. Depressed people have schemas about themselves and their paths through life that are thoroughly disempowering.
Beck’s great discovery was that it is possible to break the disempowering feedback cycle between negative beliefs and negative emotions. If you can get people to examine these beliefs and consider counterevidence, it gives them at least some moments of relief from negative emotions, and if you release them from negative emotions, they become more open to questioning their negative beliefs. It takes some skill to do this—depressed people are very good at finding evidence for the beliefs in the triad. And it takes time.
But it is possible to train people to learn Beck’s method so they can question their automatic thoughts on their own, every day. With repetition, over a period of weeks or months, people can change their schemas and create different, more helpful habitual beliefs (such as “I can handle most challenges” or “I have friends I can trust”). With CBT, there is no need to spend years talking about one’s childhood.
The list below shows nine of the most common cognitive distortions that people learn to recognize in CBT [based on a longer list in Robert Leahy, Stephen Holland, and Lata McGinn’s book, Treatment Plans and Interventions for Depression and Anxiety Disorders]
Many people experience one or two of these thoughts fleetingly, but depressed people tend to hold all three beliefs in a stable and enduring psychological structure. Psychologists call such structures schemas. Schemas refer to the patterns of thoughts and behaviors, built up over time, that people use to process information quickly and effortlessly as they interact with the world. Schemas are deep down in the elephant; they are one of the ways in which the elephant guides the rider. Depressed people have schemas about themselves and their paths through life that are thoroughly disempowering.
Beck’s great discovery was that it is possible to break the disempowering feedback cycle between negative beliefs and negative emotions. If you can get people to examine these beliefs and consider counterevidence, it gives them at least some moments of relief from negative emotions, and if you release them from negative emotions, they become more open to questioning their negative beliefs. It takes some skill to do this—depressed people are very good at finding evidence for the beliefs in the triad. And it takes time.
But it is possible to train people to learn Beck’s method so they can question their automatic thoughts on their own, every day. With repetition, over a period of weeks or months, people can change their schemas and create different, more helpful habitual beliefs (such as “I can handle most challenges” or “I have friends I can trust”). With CBT, there is no need to spend years talking about one’s childhood.
The list below shows nine of the most common cognitive distortions that people learn to recognize in CBT [based on a longer list in Robert Leahy, Stephen Holland, and Lata McGinn’s book, Treatment Plans and Interventions for Depression and Anxiety Disorders]
EMOTIONAL REASONING: Letting your feelings guide your interpretation of reality. “I feel depressed; therefore, my marriage is not working out.”
CATASTROPHIZING: Focusing on the worst possible outcome and seeing it as most likely. “It would be terrible if I failed.”
OVERGENERALIZING: Perceiving a global pattern of negatives on the basis of a single incident. “This generally happens to me. I seem to fail at a lot of things.”
DICHOTOMOUS THINKING (also known variously as “black-and-white thinking,” “all-or-nothing thinking,” and “binary thinking”): Viewing events or people in all-or-nothing terms. “I get rejected by everyone,” or “It was a complete waste of time.”
MIND READING: Assuming that you know what people think without having sufficient evidence of their thoughts. “He thinks I’m a loser.”
LABELING: Assigning global negative traits to yourself or others (often in the service of dichotomous thinking). “I’m undesirable,” or “He’s a rotten person.”
NEGATIVE FILTERING: You focus almost exclusively on the negatives and seldom notice the positives. “Look at all of the people who don’t like me.”
DISCOUNTING POSITIVES: Claiming that the positive things you or others do are trivial, so that you can maintain a negative judgment. “That’s what wives are supposed to do—so it doesn’t count when she’s nice to me,” or “Those successes were easy, so they don’t matter.”
BLAMING: Focusing on the other person as the source of your negative feelings; you refuse to take responsibility for changing yourself. “She’s to blame for the way I feel now,” or “My parents caused all my problems.
- Greg Lukianoff and Jonathan Haidt, The Coddling of the American Mind:
How Good Intentions and Bad Ideas Are Setting Up a Generation, 2018
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