Identifying Errors in Thinking with CBT (Cognitive Behavioral Therapy)

In Cognitive Behavioral Therapy (CBT), cognitive distortions are errors in thinking that lead to emotional distress. They are very common and are experienced at one time or another by almost everyone. These errors can be identified and corrected with CBT.

Cognitive Behavioral Therapy is a form of psychotherapy that is used as an evidence-based treatment for the symptoms of anxiety, depression, and other mental health disorders.

In CBT, clients work together with therapists on their thoughts, feelings, and behaviors so they can improve their relationships with others and themselves. Here are some common cognitive distortions to help you identify when your thoughts aren’t accurate or helpful:

Polarization

Also known as “all-or-nothing” or “black-and-white” thinking, this distortion manifests as an inability or unwillingness to see shades of gray. In other words, you see things in terms of extremes–something is either fantastic or awful, you are either perfect or a total failure.

Overgeneralization

When you overgeneralize something, you take a negative event and turn it into a pattern that this event “always” happens. Alternatively, it could be that positive events “never” happen. Overgeneralizing can lead to overly negative thoughts about oneself and one’s environment based on only one or two experiences.

Mental Filter

The mental filter distortion focuses on a single negative and filters out all the positives. It can result in a negative view of everything around you by focusing only on the negative while ignoring the positive.

Disqualifying the Positive

This distortion acknowledges positive experiences but rejects them instead of accepting them. It can facilitate the continuance of negative thought patterns even in the face of lots of evidence to the contrary.

Jumping to Conclusions

When you jump to conclusions, you interpret an event negatively without supporting evidence. This distortion can manifest as “mind-reading” and is the inaccurate belief that you know what another person is thinking. While it’s possible to have some idea of what other people are thinking, this distortion refers to the negative interpretations that you have that may be inaccurate.

Fortune Telling

Fortune telling refers to the tendency to make conclusions and predictions based on little or no evidence. There’s simply no way for you to know for certain how things will turn out. Your prediction may be one of several possible outcomes, rather than the one that will happen.

Catastrophizing

This distortion involves exaggerating the negative consequences of an event and can lead you to conclude the worst-case scenario will happen. While it’s possible the worst-case scenario can happen, you may be overestimating the likeliness that it will happen.

Minimization

This distortion involves minimizing the importance or meaning of events and can result in downplaying the positive. With this distortion, the importance of something significant– such as a personal achievement–is lessened.

Emotional Reasoning

Emotional reasoning refers to the acceptance of one’s emotions as fact. It leads you to believe that the way you feel is a reflection of reality. “I feel it, therefore it must be true,” defines this cognitive distortion.

Should Statements

Should statements are statements that you make to yourself about what you “should” do, what you “ought” to do, or what you “must” do. They can also be applied to others, imposing a set of expectations that will likely not be met by them.

Labeling and Mislabeling

Labeling or mislabeling refers to taking a single attribute and turning it into an absolute. It happens when you judge and then define yourself or others based on an isolated event.

Personalization

As the name implies, this distortion involves taking everything personally or assigning blame to yourself for no logical reason. It leads you to believe that you’re responsible for events that, in reality, are at least partially out of your control.

Control Fallacies

A control fallacy manifests as one of two beliefs: (1) that you have no control over your life, or (2) that you are in complete control of your life. Both beliefs are damaging, and both are equally inaccurate. No one is in complete control of what happens to them, and everyone has some control over their situation.

Fallacy of Fairness

While we would all probably prefer to operate in a fair world, this assumption is not based in reality and can result in negative feelings when we’re faced with proof that life isn’t always fair. It also refers to measuring every behavior and situation in terms of fairness and leads you to feel the need for everything to be fair.

Fallacy of Change

The fallacy of change has you expecting other people will change to suit your expectations or needs if you pressure them enough. This distortion is usually accompanied by a belief that your happiness depends on other people, leading you to believe that forcing those around you to change is the only way to get what you want.

Always Being Right

This distortion is the belief that you must always be right, correct, or accurate. With this distortion, the idea that you could be wrong is unacceptable and you will go to great lengths to prove you’re right.

Heaven’s Reward Fallacy

This fallacy manifests as a belief that one’s struggles, one’s suffering, and one’s hard work will result in a just reward. Sometimes no matter how hard you work or how much you sacrifice, you will not achieve what you hope to achieve. To think otherwise is a potentially damaging pattern of thought that can result in disappointment, frustration, anger, and even depression if the reward doesn’t happen.

Through the process of cognitive restructuring (or reframing), most cognitive distortions and negative thinking can be challenged or replaced with more accurate thoughts.

If you’re having difficulty with negative thought patterns and would like to explore how CBT and cognitive restructuring may help you, please reach out to me for a free consultation.

Online Therapy and COVID-19

People often start psychotherapy because they’re facing unprecedented challenges and are feeling overwhelmed.

If you’re feeling this way now, you’re not alone.

The outbreak of coronavirus disease 2019 (COVID-19) may be stressful for you and your loved ones. Fear and anxiety about a disease can be overwhelming and cause strong emotions. Stress during an infectious disease outbreak can include:

  • Fear and worry about your own health and the health of your loved ones
  • Changes in sleep or eating patterns
  • Difficulty sleeping or concentrating
  • Worsening of chronic health problems
  • Worsening of mental health conditions
  • Increased use of alcohol, tobacco, and other drugs

The coronavirus pandemic has created a paradox in mental health care.

Social distancing means that more people are in need of support for anxiety and depression and that more of those resources are harder to access in person. Mental health services might be inaccessible through traditional means, but never before have they been so accessible through our phones and computers.

What is online therapy and how does it work?

Online therapy, also known as teletherapy, e-therapy, e-counseling, distance counseling, etc. involves providing mental health services and support via the internet. It can be a safe and effective way of getting support during COVID-19.

Teletherapy can occur through email, text messaging, videoconferencing, online chat, phone, and mobile device apps. It utilizes the convenience of the internet to allow real-time (such as in phone conversations and text messaging) and time-delayed (such as through email messages) communication between client and therapist.

It works much like face-to-face therapy by providing you with the comfort and privacy to discuss your problems in a safe space.

In an online therapy modality, you are able to utilize everyday ways of communicating, such as phone calls, text messages, emails, and videoconferencing to talk to your therapist at your convenience about the challenges you’re facing.

There is no better time than now to take care of your mental health. Problems will not go away on their own, and challenges will only be made greater during the COVID-19 pandemic. You can begin to take charge of your life and create an increased sense of certainty and well-being during these tough times.

Online therapy can be a powerful tool for your mental health, especially during such an isolating, stressful time.

Online therapy during a global pandemic such as COVID-19 has become the norm for therapy under the social restrictions that we are currently experiencing. It enables you to get the support and help you may need with your problems from the safety of your own home during self-quarantine or shelter-in-place orders.

The majority of clients I’ve treated through teletherapy, seem to find that it goes smoothly. It might take a bit longer to feel connected if you’ve never met your therapist in person, but given a little time I’ve found that a close alliance can develop that supports the work of therapy.

If you generally like Skyping and FaceTiming with people, you’ll probably be comfortable with teletherapy.

Consider giving it a try for a few sessions if you’re on the fence about it. It could be a safe and convenient way to get the support you need during this challenging time.

Feel free to contact me for a free phone consultation to see if we’re a good fit or if you have any questions about online therapy and whether or not it’s right for you.

 

Want to learn more?

Here’s a great Psychology Today article about online therapy, which I was recently quoted in.

What is Peter Pan Syndrome?

Peter Pan Syndrome was coined in 1983 by Dr. Dan Kiley, in his book, The Peter Pan Syndrome: Men Who have Never Grown Up. This “syndrome” is not a recognized disorder by the American Psychiatric Association in the DSM 5, but rather is a collection of symptoms recognized by Dr. Kiley.

Dr. Kiley refers to the “victim” of this syndrome as a man-child. He states, “The man wants your love; the child wants your pity. The man yearns to be close; the child is afraid to be touched. If you look past his pride, you’ll see his vulnerability. If you defy his boldness, you’ll feel his fear.” (Kiley, 1983).

Peter Pan Syndrome has origins in Greek mythology and is referred to as the archetype of the eternal child by Carl Jung.

Though Dr. Dan Kiley was the first to popularize this phenomenon in 1983, Carl Jung and other post-Jungian psychologists had written about the puer aeternus (Latin for “eternal child”) as an archetype—a recurrent symbol or motif in mythology—prior to J.M. Barrie and Dr. Kiley. The name puer aeternus was first written of in Metamorphoses, the epic work by Ovid.

Examples of the puer in Greek mythology include the gods Dionysus, Eros, and Adonis. The puer aeternus is characterized as having two poles: the positive side embodies newness, potential for growth, and hope for the future, while the negative side (what we typically think of as Peter Pan Syndrome) consists of the aforementioned man-child who refuses to grow up and meet the challenges of life head on, instead waiting for his problems to be solved for him.

 

There tends to be a disparity between the person’s age and their level of maturity.

The term usually refers to a man whose emotional life has remained at an adolescent level.

This “man-child” is not incapable of functioning in society, but often is unhappy and camouflages his sadness with fun and cheerfulness, much like J.M. Barrie’s character, Peter Pan. The individual has symptoms of irresponsibility, anxiety, loneliness, and immaturity in social and relational roles.

 

Who is most affected by Peter Pan Syndrome?

The Peter Pan Syndrome is found more often in men than women. The men who characterize these symptoms are usually single, rarely finish college or are dissatisfied with their lives though they have made some achievements. They typically come from a traditional family, where the parents have stayed together and are middle to upper class.

They were often sensitive children who received covert messages from parents over marital frustration.

Rather than clearing the air with private conversations, the parents kept their frustration bottled up until it leaked out onto the child. The child then finds themselves in the middle of marital discord.

According to Kiley (1983), the types of messages they received as children from parents include the mother/son theme of “Don’t be close to your father” and the father/son theme of “You’re mother is a weakling and you’re hurting her.” This can lead to thoughts as a child of:

“I hurt my mom because I’m like my dad, who can’t stand to have me hurt Mom. Dad doesn’t love us like his work because he doesn’t have feelings. Mom can’t understand me, and I make her pick on Dad. I’m supposed to protect her, but that means I have to use my feelings to do what Dad doesn’t do. To protect my dad, I have to shape up and not be like him.” (Kiley, 1983)

 

The individual’s negative self-image becomes a self-fulfilling prophecy.

He believes he has the ability to hurt and/or protect his parents and to save them from emotional grief and condemns himself when he fails to do so. They are unable to realize the vicious cycle created by their negative self-image. They try to escape their emotional pain, which results in relational problems with both their mother and father (see below).

The individual’s relationship with their parents never matures and many people with this “syndrome” spend their lives trying to get close to their father without feeling panic and to pull away from their mother without feeling guilty.

They believe they have the power to save their parents from pain, but this power doesn’t exist.

Individuals with this “syndrome” are rarely self-supporting in their twenties, depending on parents or other resources. Older individuals may be financially secure, but often do not feel as though they are and tend to spend their money on their own indulgences.

 

What are some signs that someone has Peter Pan Syndrome?

The puer aeternus leads a provisional life due to the fear of finding themselves caught in a situation from which it might be impossible to escape. They protect their independence and freedom, oppose boundaries and limits, and tend to find restriction intolerable. Someone with “Peter Pan Syndrome” as defined by Dr. Dan Kiley (1983) has seven psychological traits that dominate their lives:

  1. Emotional paralysis (difficulty expressing emotions): Their emotions are not expressed in the same way they are experienced. For example, anger may present as rage, disappointment as self-pity, sadness as nervous laughter or forced cheerfulness. They may say they love or care for you, but can’t seem to express their love. It would seem that they have lost touch with their emotions and don’t know what they feel.
  2. Procrastination: These individuals tend to put things off until they are forced to do them. Their life goals are somewhat unclear or poorly defined. “I don’t know” and “I don’t care” are often the defense against criticism.
  3. Social impotence (difficulty in social situations): They cannot seem to make true friends. Seeking friends and being friendly are of more importance than deeper connections as these individuals desperately need to belong and are often lonely and afraid of being alone.
  4. Magical thinking: They tend to think things like “If I don’t think about it, it will go away” or “If I think it will be different, then it will be.” This tends to be easier than admitting mistakes or taking responsibility. Individuals who fit the Peter Pan motif often blame others for their problems and try to escape their reality to make their problems disappear.
  5. Mother hang-up (problems with maternal relationship): People with this “syndrome” feel ambivalence toward their mother, vacillating between anger and guilt. They want to be free of her influence, but also tend to elicit pity from their mother to get their needs met.
  6. Father hang-up (problems with paternal relationship): These individuals tend to be estranged or distant from their fathers. They long to be close, but have decided that they can never receive their father’s love and approval. This tends to lead to problems with authority figures in general.
  7. Sexual hang-up (problems in romantic relationships): These people search desperately for a partner, however their immaturity tends to drive most people away. They tend to have a fear of rejection, which causes them to hide their sensitivity behind a persona of self-confidence.

 

Overcoming Peter Pan Syndrome

Individuals who experience “Peter Pan Syndrome” or issues related to the puer aeternus archetype need to develop awareness around the issue to begin the work of overcoming their problems. These people tend to enter individual therapy due to anxiety, loneliness, or other symptoms of the Peter Pan Syndrome.

It is important to focus on integrating parts of the senex (Latin for “old man”) archetype into the individual’s daily life. These types of things include discipline, control, rationality, and responsibility for one’s actions. This helps to balance the opposites of the two archetypes and create a more sustainable lifestyle.

Focusing on mundane tasks with mindfulness, working toward becoming more responsible, and following through with commitments are key to becoming more aware of the problems associated with being stuck in the puer archetype.

It is beneficial for the individual to work toward distancing him- or herself from their thoughts and feelings, instead of identifying with them. In this way, one can start to ask questions such as “Is this what I really feel?” “Is this what I want?” “What are the consequences and can I live with them?” “How does what I do affect others?”

When working with finding the balance between puer and senex it is important to realize that swinging too far in one direction or the other can both have detrimental effects on one’s life.

The goal is to integrate the positive aspects of both archetypes so that the individual can live a responsible and aware life with a sense of child-like wonder, rather than silencing the inner child with the inner old man (as Captain Hook would have it in J.M. Barrie’s Peter Pan). The truth is Peter Pan and Captain Hook need each other for their lives to be meaningful.

 

How should I approach this subject with someone I’m dating?

There is hope for Peter Pan and the Lost Boys. It is a sensitive subject to approach with a partner. It is important to have compassion for someone who is dealing with the symptoms of “Peter Pan Syndrome” while being able to confront the issues in the relationship that are impacting them.

Remember that what you do is not as important as what you don’t do.

One should not try to “fix” their partner or tell them what they should do, but rather help lead them to possible sources of help for symptoms such as anxiety, loneliness, and social/relational problems such as a psychotherapist who specializes in these types of problems so the person can begin to take responsibility for themselves.

 

Want to learn more?

Here’s a great article about Peter Pan Syndrome, which I was recently quoted in.

What is Individuation?

In Jungian psychology, also called analytical psychology, individuation is the process in which the individual self develops out of an undifferentiated unconscious—seen as a developmental psychic process during which innate elements of personality, the components of the psyche, and the experiences of the person’s life become integrated over time into a well-functioning whole.

One’s unique self-identity, which is separate from that of any other individual, develops through the process of individuation. Individuation is ongoing and can be considered both a goal and a lifelong process.

Carl Jung believed the process of individuation is an important life goal. In Jungian psychology, individuation describes a process of self-realization—the discovery of one’s life purpose or what one believes to be the meaning of life, for example.

According to Jungian psychology, when individuals lose touch with certain aspects of their selves, they may be able to reintegrate these aspects of their nature through individuation.

The process of individuation is considered essential to the development of a healthy identity and the formation of healthy relationships with others. A person who does not adequately individuate may lack a clear sense of self and feel uncomfortable pursuing goals.

Feelings of depression and anxiety may result. Difficulty individuating may also lead to increased dependence on others, challenges in romantic or professional relationships, poor decision-making skills, and a general sense of not knowing who one is or what one wants from life.

Individuals seeking help with individuation often find therapy a safe place to share thoughts and feelings and express desires without worrying about judgment or societal acceptance.

In addition, a therapist can provide support as people work toward being better able to set healthy boundaries, communicate assertively, and develop other skills that allow for the expression of personal identity.

By learning to listen and following your inner voice, you will be able to direct your journey toward a unique and self-actualized life. If you don’t follow group consciousness, but rather your own destiny, you will be able to unlock your true potential and discover, at last, a sense of personal wholeness.

Am I Depressed?

Clinical depression can manifest as feeling sad and depressed for weeks or months on end—not just a passing depressed mood for a day or two. This feeling is most often accompanied by a sense of hopelessness, a lack of energy, and taking little or no pleasure in things that once gave you joy in the past.

Depression symptoms take many forms, and no two people’s experiences are exactly alike. A person who has clinical depression may not seem sad to others. They may instead complain about how they just “can’t get moving,” or are feeling completely unmotivated to do just about anything.

Clinical depression is different from normal sadness—like when you lose a loved one or experience a relationship breakup—as it usually consumes a person in their day-to-day living. It doesn’t stop after just a day or two—it will continue for weeks on end, interfering with social, occupational, or other life functions.

The symptoms of depression include the majority of the following signs, experienced nearly every day over the course of two or more weeks:

  • a persistent feeling of loneliness or sadness
  • lack of energy
  • feelings of hopelessness
  • difficulties with sleeping (too much or too little)
  • difficulties with eating (too much or too little)
  • difficulties with concentration or attention
  • loss of interest in enjoyable activities or socializing
  • feelings of guilt and worthlessness
  • and/or thoughts of death or suicide

Most people who are feeling depressed don’t experience every symptom, and the presentation of symptoms varies in degree and intensity from person to person. If you feel you may be experiencing depression, feel free to contact me for a free consultation.