I was trying to think of a blog subject to write about this time for my blog. As I contemplated this, I noticed almost everyone in my Dialectical Behavior Therapy (DBT) Intensive Outpatient Group (IOP) was talking about their struggle to be perfect, or how they feel like failures if things are not exactly as they think they should be. I was hearing phrases like:
- I can’t succeed
- If I’m not really good at this, I think it means I can't do anything right.
- I have to eat totally healthy or my diet is a failure (and I’ll just eat whatever I want after that)
- I am horrible at that, so I am horrible
- Taking risks leads to failure
- I am a total failure
- He is the ONLY person who understands me.
- I cannot manage my panic attacks
- Most sentences with words like: always, never, every, none, right, wrong, forever, and failure usually are filled with all or nothing thinking
All or nothing thinking, often called black and white thinking, can go hand in hand with other cognitive distortions such as catastrophizing, the need to “always be right”, jumping to conclusions, filtering (only seeing the negative) and “should statements”. Identifying and working on cognitive distortions can make us feel better, more positive and more able to make additional changes that will positively impact our mental health and lives.
In 1976, Aaron Beck wrote about his theory of cognitive distortions. In the 1980’s David Burns continued on and formulated a list of about 10 main cognitive distortions. Now, many have been added to the list.
So how do we manage and change them? The first step is awareness or identification of your cognitive distortions. Usually we are using a few of them most often, many times without recognition of how it is impacting us. Next, try and examine the “evidence” to discover if it is true. I often call this the “best friend method”. What would your best friend say? In DBT, this is called getting into “wise mind”. Then try and think in shades of grey, breaking the distortion down, experimenting with new thinking. This does take time but the rewards are many.
CATHRYN E. KNEZEVICH, M.ED., LPCC
DBT IOP DIRECTOR
The Behavioral Wellness Group