Cognitive Distortions
Understanding and Addressing Them
Presented by: Dr. Dawn-Elise Snipes
Executive Director, AllCEUs
Objectives
~ Define Thinking Errors
~ Explore the different types of thinking errors
~ Cognitive distortions
~ Irrational Thoughts
~ Evaluate how thinking errors can play into our basic fears: Rejection, isolation, the unknown, loss of control, failure
~ Identify ways to
~ Increase awareness of thinking errors
~ Address thinking errors
~ Address basic fears
Why I Care/How It Impacts Recovery
~ Thinking errors, or stinkin’ thinkin’ plays a large part in keeping people miserable
~ Addiction, depression, anxiety, anger and guilt often stem or are made worse by faulty thinking
~ Addressing these thought patterns will help clients:
~ Not make a mountain out of a molehill
~ Focus on the things they can change
~ Identify and eliminate thought patterns that are keeping them stuck
What are Thinking Errors
~ Cognitive Distortions take a thought and manipulate it to
~ Fulfil people’s expectations of a situation
~ Conform to their current head space (negative sees negative)
~ Irrational Thoughts are beliefs/thoughts that you may hold that
~ Are usually extreme (I must have love and approval from everyone all the time)
~ Are unrealistic
~ Create feelings of failure, inadequacy, disempowerment
Causes of Thinking Errors
~ Information-processing shortcuts
~ Using outdated, dichotomous schemas
~ Mental noise
~ The brain's limited information processing capacity
~ Age
~ Crisis
Causes of Thinking Errors
~ Emotional causes
~ I feel bad, therefore it must be bad
~ Moral causes
~ It was the right thing to do
~ Social causes
~ Everyone is doing it
Impact of Thinking Errors (Fight or Flee)
~ Emotional upset
~ Depression
~ Anxiety
~ Behavioral
~ Withdrawal
~ Addictions
~ Sleep problems/changes
~ Eating changes
~ Physical
~ Stress-related illnesses
~ Headaches
~ GI Distress
~ Social
~ Irritability/impatience
~ Withdrawal
Thinking Errors & Interventions
~ Emotional Reasoning –Feelings are not facts
~ Learn to effectively identify feelings and separate facts
~ I am terrified
~ About what are you terrified?
~ What is the evidence that you are in danger now?
~ In what ways is this similar to other situations?
~ How have you dealt with those situations?
~ Develop distress tolerance skills
~ Develop emotional regulation skills
Thinking Errors & Interventions
~ Cognitive Bias/Negativity/Mental Filter– Focus on the negatives and worry about the future
~ Questions
~ What is the benefit to focusing on the negative?
~ What are the positives to this situation?
~ What are all the facts?
~ Coin toss activity
Thinking Errors & Interventions
~ Disqualifying or minimizing the positive
~ Questions
~ Would you minimize this if it was your best friend’s experience?
~ What is scary about accepting the positive?
~ Sometimes we disqualify the positive because it fails to meet someone else’s standards, might that be true here?
~ Availability Heuristic: Remembering what is most prominent in your mind
~ Questions
~ What are the facts
Thinking Errors & Interventions
~ Egocentrism– My perspective is the only perspective
~ Question: What are some alternate perspectives
~ Personalization/Mindreading
~ Questions
~ What are some alternate explanations for the event that did not involve you
~ How often is it really about you?
Thinking Errors & Interventions
~ Magnification
~ Questions
~ Are you confusing high and low probability outcomes?
~ How much will this matter 6 months from now?
~ What have you done in the past to tolerate events like these?
~ All-or-Nothing
~ Questions
~ Love vs Hate
~ Perfection vs. Failure
~ All good intentions vs. All bad intentions
Thinking Errors & Interventions
~ Availability Heuristic: Remembering what is most prominent due to (frequency, intensity or duration) in your mind
~ Questions
~ What are the facts
~ How often does it really happen
~ How long has it been since you have seen that behavior
~ The good times are amazing, but how frequent are they compared with the bad times?
Thinking Errors & Interventions
~ Belief in a just world/fallacy of fairness
~ Question: Identify 4 good people who have had bad things happen.
~ Attributional Errors (Labeling yourself not a behavior)
~ Global vs. Specific
~ I am stupid vs. I do not have good math skills
~ Stable
~ I am (and always will be stupid) vs. I can learn math skills
~ Internal
~ It is about me as a person vs. It is about a skill/skill deficit
Questions for Clients
Belief = Thought/Fact + Personal Interpretation
~ What are the facts for and against my belief
~ Is the belief based on facts or feelings?
~ Does the belief focus on one aspect, or the whole situation?
~ Does the belief seem to use any thinking errors?
~ What are alternate explanations?
~ What would you tell your child/best friend if they had this belief?
~ What do you want someone to tell you about this belief?
~ How is this belief
~ Moving you toward what and who is important to you?
~ Moving you away from what or who is important to you?
Cognitive Distortions Review
~ Evaluate how thinking errors can play into our basic fears: Rejection, isolation, the unknown, loss of control, failure
~ Personalizing
~ Mindreading
~ All-or-Nothing/Polarized
~ Catastrophizing
~ Overgeneralization
~ Shoulds
~ Recency/Availability Heuristic
ABC-DEF
~ Activating Event (What happened)
~ Beliefs
~ Obvious
~ Negative self-talk//Past tapes
~ Consequences
~ Dispute Irrational Thoughts
~ Evaluate the Most Productive Outcome
~ Is this worth my energy?
~ How can I best use my energy to deal with or let go of the situation?
Triggers—Coping Skills
~ Distract don’t react
~ Talk it through to:
~ Identify the distortions
~ Find the middle path
~ Urge surf
~ Notice how you are feeling
~ Remind yourself it increases and decreases like a wave
~ Notice changes as the urge goes out
Constructive Self Talk
~ Have clients pinpoint what they tell themselves about an urge that makes it harder to cope with the urge
~ Use empowering self-talk constructively to challenge that statement. An effective challenge will make them feel better (less tense, anxious, panicky)
~ What is the evidence?
~ What is so awful about that?
~ You are a regular human being and have a right to make mistakes
Distressing Thoughts Worksheet
~ What is the evidence
~ Am I assuming causation where no exists?
~ Am I confusing thought or feeling with fact?
~ Am I close enough to really know what is going on?
~ Am I thinking in all-or-none?
~ Am I using extreme words like always or never?
~ Is the source of the information credible?
~ Am I confusing low with high probability?
~ Am I focusing on irrelevant factors?
~ Is this thinking getting me closer to what I want?
~ What are the advantages/disadvantages to thinking this way?
~ What difference will this make in a month/year.
Group Activity
~ List thinking errors and discuss how those patterns protected you until now
~ Example: Prevented you from being disappointed if you expected to fail or expected people to leave
~ Identify thinking errors that you can, currently, eliminate and a countering mantra
~ I need to be loved by everybody all the time
~ I need to love myself all the time and not everybody is capable of loving. It is about them, not me.
~ Identify thinking errors that you still hold onto and why, then develop a plan to start addressing them.
Decisional Balance
~ This thought pattern was learned over a long period of time
~ It served a purpose and was more beneficial than the alternative
~ Changing your outlook means seeing how this thought pattern is destructive, and alternate thought patterns may (now) be more helpful.
~ Example: In an addicted home the mantra is don’t talk, don’t trust, don’t feel. For a child from an addicted home negative thinking helped you align with the primary caregiver and provided safety. As an adult, you no longer require that safety.
Summary
~ Cognitive Behavioral Therapy is a technique that helps people:
~ Understand how thoughts create feelings and vice versa
~ Identify and address negative self talk
~ Issues and events from the past do not need to continue to negatively impact a person
~ Thinking errors are learned and can be unlearned
~ These thought patterns help to form and maintain a negative or vulnerable self image.
~ Healthy thought patterns can help people feel more empowered and worthy of love.
Nashville Counseling Un-Conference
A grass-roots conference put together by clinicians for clinicians.
Up to 20 CEUs from a NAADAC approved provider are available for addiction and mental health counselors and people seeking certification as addiction counselors
~ WHEN: February 23-25, 2018
~ WHERE: Nashville Metro (exact site TBD)
~ The main speaker each hour will also be simulcast online. Virtual attendance is possible for those who do not need “face-to-face” hours.
~ COST:
~ Whole conference (20 CEUs): $99 in advance; $149 at the door
~ One Day (8 CEUs): $45 in advance; $65 at the door
~ Registration will open in October 2017
Nashville Counseling Un-Conference
Call for Papers
~ Theme: Addressing the Growing Problem of Co-Occurring Disorders.
~ Suggested Topics:
~ Techniques and Effectiveness of Technology Assisted Therapy (e-therapy, text-based coaching, apps, online support and educational programs etc.)
~ Special Needs of Rural Populations
~ Transdiagnostic Approaches to Treatment
~ Relapse Prevention for Co-Occurring Disorders
~ Multidisciplinary Approaches to Treatment
~ Prevention and Early Intervention Strategies for Co-Occurring Disorders
~ Developing Self-Esteem and Emotion Regulation Skills in Youth
~ Case Management is not a counselor's job, but…It is
~ Exploring pharmacotherapy in the treatment of co-occurring disorders (SSRIs and their impact on compulsive behaviors for example)