Cognitive Distortions

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]
 

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

The Definition of 'Trauma'

In the early versions of the primary manual of psychiatry, the Diagnostic and Statistical Manual of Mental Disorders (DSM), psychiatrists used the word “trauma” only to describe a physical agent causing physical damage, as in the case of what we now call traumatic brain injury.
 
In the 1980 revision, however, the manual (DSM III) recognized “post-traumatic stress disorder” as a mental disorder—the first type of traumatic injury that isn’t physical. PTSD is caused by an extraordinary and terrifying experience, and the criteria for a traumatic event that warrants a diagnosis of PTSD were (and are) strict: to qualify, an event would have to “evoke significant symptoms of distress in almost everyone” and be “outside the range of usual human experience.” The DSM III emphasized that the event was not based on a subjective standard. It had to be something that would cause most people to have a severe reaction. War, rape, and torture were included in this category. Divorce and simple bereavement (as in the death of a spouse due to natural causes), on the other hand, were not, because they are normal parts of life, even if unexpected. These experiences are sad and painful, but pain is not the same thing as trauma. People in these situations that don’t fall into the “trauma” category might benefit from counseling, but they generally recover from such losses without any therapeutic interventions. In fact, even most people who do have traumatic experiences recover completely without intervention.
 
By the early 2000s, however, the concept of “trauma” within parts of the therapeutic community had crept down so far that it included anything “experienced by an individual as physically or emotionally harmful . . . with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.” The subjective experience of “harm” became definitional in assessing trauma. As a result, the word “trauma” became much more widely used, not just by mental health professionals but by their clients and patients—including an increasing number of college students.
 
As with trauma, a key change for most of the concepts was the shift to a subjective standard. It was not for anyone else to decide what counted as trauma, bullying, or abuse; if it felt like that to you, trust your feelings. If a person reported that an event was traumatic (or bullying or abusive), his or her subjective assessment was increasingly taken as sufficient evidence. And if a rapidly growing number of students have been diagnosed with a mental disorder, then there is a rapidly growing need for the campus community to protect them. 

Concepts sometimes creep. Concepts like trauma and safety have expanded so far since the 1980s that they are often employed in ways that are no longer grounded in legitimate psychological research. Grossly expanded conceptions of trauma and safety are now used to justify the overprotection of children of all ages—even college students, who are sometimes said to need safe spaces and trigger warnings lest words and ideas put them in danger.

- Greg Lukianoff and Jonathan Haidt, The Coddling of the American Mind: 

How Good Intentions and Bad Ideas Are Setting Up a Generation, 2018

The Needs for Connection - Belonging & Intimacy

 The need for connection—to form and maintain at least a minimal number of positive, stable, intimate relationships—is a fundamental need that affects our whole being, permeating our entire suite of emotions, thoughts, and behaviors. While individuals differ in the strength of this need, connection is an irreducible, undeniable human need. The need for connection actually consists of two subneeds: (a) The need to belong, to be liked, to be accepted, and (b) The need for intimacy, for mutuality, for relatedness.
 
The Need for Belonging
 
As with all the other needs, the critical metric is the distance between your need for belonging and just how unmet this need is in your daily life. Research shows that those who report the highest levels of loneliness are those who have the highest unmet need to belong. The greater the discrepancy between a person’s need to belong and their satisfaction with their personal relationships, the higher the levels of loneliness and the lower the levels of life satisfaction in their daily lives.
 
This finding applies both to those who are living alone as well as those who are living with others. Simply living with someone does not guarantee that connection needs are being met. It’s the quality of the connections that matter for predicting loneliness, not the quantity of connections or even the proximity of the connections. Let’s take a closer look at this other essential component of connection.
 
The Need for Intimacy
 
While a secure attachment style serves as a critical foundation for connection, it does not assure intimacy. The essence of intimacy is a high-quality connection. What is a high-quality connection? Jane Dutton and Emily Heaphy define a high-quality connection as a “dynamic, living tissue that exists between two people when there is some contact between them involving mutual awareness and social interaction.”A high-quality connection makes both people feel especially vital and alive. A low-quality connection, on the other hand, can be downright depleting. As one business manager put it, “Corrosive connections are like black holes: they absorb all of the light in the system and give back nothing in return.”
 

- Scott Barry Kaufman, Transcend: The New Science of Self-Actualization, 2020

The Need for Attachment Security

The four adult categories of attachment style—secure, fearful, preoccupied, and dismissing—can be represented as a combination of just two dimensions: anxious and avoidant. The anxious-attachment dimension reflects a concern about being rejected and abandoned and is the product of beliefs about whether others will be there for you in times of need. The avoidant-attachment dimension has less to do with a sense of safety and more to do with how you regulate your emotions in response to stress—whether you use others as a secure base or pull away and withdraw from them.
 
Studies show that these two dimensions are only weakly correlated with each other, which creates the possibility that people can score high on both dimensions. A further implication is that “secure attachment” doesn’t exist as a separate category; secure attachment is just the combination of low anxiety and low avoidance. Modern research suggests that there is no such thing as a completely securely attached person; all of us are at least a little bit anxious and avoidant when stress rears its head in our relationships.
 
Nevertheless, your particular placement on the anxious- and avoidant-attachment dimensions has important implications. Those who score lower on these dimensions tend to report more constructive ways of coping and regulating their emotions, thoughts, and behavior, and they report higher levels of relationship satisfaction, psychological adjustment, healthy self-esteem, and even heightened altruism, volunteerism, empathy, and increased tolerance of people who are in a different social group than those who are more insecurely attached. It’s clear that secure attachment doesn’t just set the stage for more satisfying relationships; it also sets the stage for many other aspects of growth.

- Scott Barry Kaufman, Transcend: The New Science of Self-Actualization, 2020

Healthy Self-esteem

All people in our society (with a few pathological exceptions) have a need or desire for a stable, firmly based, (usually) high evaluation of themselves, for self-respect, or self-esteem, and for the esteem of others. —Abraham Maslow, A Theory of Human Motivation (1943)
 
Maslow and other humanistic psychologists, such as Carl Rogers, have been blamed for inspiring the self-esteem movement in the United States, which reached its apotheosis in the 1980s and 1990s, with a focus on feeling good about oneself as the answer to all of life’s problems. But a close reading of the psychological literature suggests that the problem isn’t with self-esteem but the pursuit of self-esteem.
 
So what is a healthy self-esteem? Modern research has identified two distinct faces of healthy self-esteem: self-worth and mastery.
 
Self-worth
 
Maslow sometimes distinguished between the need for self-esteem and the need for esteem from others. However, modern research shows that the evaluation of others is often linked to our self-esteem. Like it or not, we are a social animal, and the judgments we formulate of our self frequently incorporate the judgment of others. Social psychologist Mark Leary’s research has shown that our feelings of self-worth strongly track our social value, or at least our perceptions of our social value. (Sometimes our perceptions are inaccurate.)
 
Leary and his colleagues Katrina Jongman-Sereno and Kate Diebels distinguish two forms of social value we can have in this world: relational social value (the degree to which we regard our relationship with others as personally valuable and important) and instrumental social value (the degree to which others perceive us as possessing resources and/or personal characteristics that are important for the benefit of the collective good). Those with a high sense of self-worth tend to like themselves, and view themselves as having high relational value.
 
Mastery
 
Your entire life history of successes and failures influence the attitude you have toward yourself as an intentional being capable of reaching your goals in life. The more successful you are at making progress toward your goals, the more confident you feel, and the two tend to spiral upward toward a stable sense of mastery. Vice versa, the more your goals are thwarted in life, the more you tend to spiral downward toward insecurity and feelings of incompetence. Since we are such a social species, mastery also tends to be linked to social value, but mastery tends to track instrumental social value more than relational social value. Those with high mastery tend to have traits that confer greater social status in their society due to their usefulness to others—not necessarily the characteristics that are valued in a friend, family member, or social group.
 
While both a healthy sense of self-worth and mastery are strongly related to each other—people tend to develop both forms of self-esteem in tandem—the two can come apart. It’s possible to view yourself as a willful agent in the world, capable of accomplishing your goals, but not really like or respect yourself. And vice versa, it’s possible to like yourself while not feeling very effective in reaching your goals. Tafarodi refers to these situations as “paradoxical self-esteem” and has shown that such variations have implications for how we process and remember social feedback from others.
 
This is why feelings of self-worth are so strongly linked to the need for belonging.
 

- Scott Barry Kaufman, Transcend: The New Science of Self-Actualization, 2020

The Two Faces of Narcissism (3) - Grandiose Narcissism

In fact, we found that grandiose narcissism is related to reports of greater life satisfaction. But we found that this increased life satisfaction is likely to come with a cost—disconnection from one’s own self. We found that those scoring high in grandiose narcissism reported high levels of imposter syndrome, a weak sense of self, self-alienation, a greater likelihood of accepting external influence, and higher levels of experiential avoidance.
 
Both forms of narcissism involve defense of a particular self-image. Vulnerable narcissists mount a vehement defense against being rejected and appearing unworthy of love and belonging. Grandiose narcissists fiercely defend a superior self-image. Both strategies can sometimes be helpful in achieving self-enhancing goals, but both incur the cost of others and a cost to one’s capacity to connect deeply with one’s most valued goals and desires.
 
We found that grandiose narcissism is also related to a black-and-white view of others, seen in the endorsement of statements such as “As far as I’m concerned, people are either good or bad,” as well as an extreme view of themselves, seeing themselves as fearless and bold.
 
One meta-analysis found that those scoring high in grandiose narcissism are more likely to impose harshly perfectionistic demands on others, showing perpetual dissatisfaction with their perceived flaws.
 
Collective Narcissism: Defensive Form of In-group Positivity
 
In recent years, psychologists have been scientifically investigating “collective narcissism,” a defensive form of in-group positivity. People who score high on tests of collective narcissism believe that their in-group deserves special treatment and insist that their in-group gets the recognition it deserves. Just like individual narcissism, collective narcissism stems from the frustration that comes from the need for control and self-esteem and is an attempt to compensate for such insecurity.
 
In contrast, self-esteem has been linked to healthy in-group positivity, which is more likely to foster both in-group and out-group love. This is ultimately an uplifting message: just as it’s possible to have a heathy self-esteem, it’s possible to have healthy in-group love—where it feels good to be a member of your in-group and in which you have great pride for the genuine accomplishments of your group without constantly experiencing hypersensitivity to intergroup threat and hostility.
 
Addicted to Self-esteem
 
At the end of the day, I believe we shouldn’t ignore the seduction of power or pretend that this pull is not a part of our common humanity. But striving for power does not necessarily have to lead to destruction. Almost all humans strive for mastery and to make a difference in the world, but as Adler noted, we also have a striving for social interest. We have both strivings within us. Therefore, the question remains: How can we satisfy our self-esteem needs in the most authentic, healthy, and growth-fostering way?
 

- Scott Barry Kaufman, Transcend: The New Science of Self-Actualization, 2020

The Two Faces of Narcissism (2) - Vulnerable Narcissism

The research on vulnerable narcissism suggests that high levels of uncertainty about one’s worth as a human being often bring along with it hairpin triggers of shame and reactive hostility, avoidance of situations that may activate such triggers, grandiose fantasies of receiving validation and respect from others, a constant need for validation and attention from others (including feeling entitled to the attention of others and constant resentment for not being appreciated), a hiding of one’s felt needs and perceived weaknesses, an excessive need to help others in order to feel good about oneself, and distrust and cynicism about people’s true intentions.
 
While features of vulnerable narcissism may help in managing the overwhelmingly painful feelings of low self-worth and shame generated by rejection and early childhood abuse and can help minimize the chances that the abuse will ever happen again, vulnerable narcissism is linked to a host of beliefs, coping strategies, and attachment styles that ultimately inhibit health, growth, and integration. In our research, we found that vulnerable narcissism was associated with lower levels of life satisfaction, autonomy, authenticity, mastery, personal growth, positive social relationships, purpose, and self-acceptance in life, as well as a lack of trust in one’s thoughts and feelings, and a profound lack of a sense of self.
 
We also found an extremely strong relationship between vulnerable narcissism and reports of imposter syndrome. Those scoring high in vulnerable narcissism scored high on statements such as “I tend to feel like a phony,” and “Sometimes I am afraid I will be discovered for who I really am.” It’s less likely that such individuals actually feel fraudulent and more likely that they engage a “self-presentation strategy” that serves as another way of protecting themselves against the potential pain of rejection. By adjusting the expectations of others, they won’t feel as intensely ashamed if they do fail.
 
We also found that those scoring high in vulnerable narcissism have great difficulty reining in their strong impulses and taking constructive action on their own behalf. The defense mechanisms they tend to employ—harboring infantile and unrealistic fantasies, projecting responsibility onto others, being passive-aggressive in expressing their needs, apologizing for asserting their needs, experiencing somatic symptoms, isolating themselves from those who could offer support, suppressing emotions, reacting with anger when hurt or stressed, and engaging in impulsive behaviors such as eating to feel better and regain control—make sense for a vulnerable child trying to cope with intense pain and fear. But in adulthood, they prevent growth of the whole person.
 
From Vulnerability to Growth
 
Vulnerable narcissism need not be a barrier to growth. Any of us, regardless of our levels of these characteristics, can take charge of our lives and start to build a coherent and stable sense of self. A key way of overcoming severe self-esteem uncertainty is to shed the perfectionistic self-presentation. As one meta-analysis of the literature found, vulnerable narcissism is significantly linked to an obsessive concern over whether one is coming across as imperfect to others, as well as perceiving others as demanding perfection of oneself.
 
Cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), and acceptance and commitment therapy (ACT) can be immensely helpful in learning to regulate the intense feelings of rejection and shame we often feel and the irrational, negative thoughts that are floating around constantly in our heads. You really can “retrain your brain.” Steven Hayes, founder of the ACT approach to psychotherapy, has stated that an important outcome of ACT is “the ability to contact the present moment more fully as a conscious human being, and to change or persist in behavior when doing so serves valued ends.
 
Changing your self-limiting narratives about your worthiness, asserting needs in a healthy way, overcoming your avoidance of fearful experiences, and taking responsibility for your behaviors—these actions strengthen and stabilize the vulnerable self. The great irony is that the less you focus on whether you are worthy and competent, and take that as a given, the greater the chances you will consistently accept your inherent worth.
 

- Scott Barry Kaufman, Transcend: The New Science of Self-Actualization, 2020