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Published on May 5, 2020

4 Steps of Cognitive Restructuring to Help You Think Clearly

4 Steps of Cognitive Restructuring to Help You Think Clearly

Humans are guilty of having less than rational thoughts. We do it all the time. We might assume the worst is going to happen or jump to conclusions before we have all the information. Cognitive restructuring helps people become aware of their irrational thoughts so that they can correct them and replace them with more rational ways of thinking. This can help to alleviate symptoms of anxiety, depression, stress, anger, and trauma.

Cognitive restructuring is a major part of Cognitive Behavioral Therapy, which was developed by Aaron Beck in the 1960s. Beck linked his patients’ symptoms with their distorted thinking and hypothesized that if he could help his patients recognize their distorted thinking, he could help them alleviate their mental health symptoms.[1] David Burns then popularized Beck’s ideas in the 1980s with his book Feeling Good.[2]

Cognitive restructuring is at the heart of Cognitive Behavioral Therapy. It is the four-step process that helps people recognize their distorted thoughts in order to change them.

Cognitive Distortions

I spoke with Margot Escott, LSCW[3] about how she uses cognitive restructuring in her therapy practice in Naples, Florida, and she explained that she begins the process by making her clients aware of the types of cognitive distortions.

Escott hands her clients a list of cognitive distortions[4] and asks them to spend a week thinking about which ones resonate with them.

The following are examples of various cognitive distortions:

Mental Filtering

This happens when a person picks out only one (usually negative) detail of a situation and focuses only on that.

Black and White Thinking

When this occurs, a person cannot see any middle ground and perceives a situation as all or nothing.

Overgeneralization

Overgeneralization is very common and happens when a person jumps to a conclusion without enough information.

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Catastrophizing

This way of thinking comes about when a person thinks the worst outcome will occur.

Personalization

Generally occurring in people with low self-esteem or paranoia, this happens when someone thinks that everything people do or say is about them.

Should Statements

These statements come about when someone compares themselves and others to perceived universal standards.

Mind Reading

This can happen when someone assumes what someone else is thinking without verification.

Fortune Telling

People are generally very concerned about the future, and this can lead some to assume how things will unfold, usually in a negative light.

Emotional Reasoning

This happens when a person assumes their emotions reflect how reality actually is.

Labeling

Labeling comes about when someone makes broad statements or generalizations about themselves or others based on situation-specific behavior. Example: If you make a mistake and conclude that you are dumb or a failure.

Each list of cognitive distortions is different, but this will give you a general idea of the kind of irrational thinking cognitive restructuring aims to correct.

The 4 Steps of Cognitive Restructuring

When you seek to engage in cognitive restructuring, there are 4 major steps you will need to follow.

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1. Make It Conscious

The process starts by making our automatic thoughts conscious. The first step requires you to take a kind of inventory of your potentially problematic ways of thinking. Before you can change your thoughts, you have to become aware of how you’re thinking—no judgment or correction yet.

You can take an inventory of your automatic thoughts for a week or you can explore them in therapy with a trained professional. Escott asks her clients to tell her which cognitive distortions they noticed after one week.

Either way, the first step is essential because we can’t correct problematic, automatic thinking without becoming aware of what we’re thinking in the first place.

2. Evaluate It

Next, it’s time to get rational. Once you’ve taken an inventory of your thoughts, you can start to sort out which ones seem rational and which ones don’t.

For example, if you say something like, “I’m never going to meet my life partner,” you can lump this thought into the unproductive/unhealthy/negative category because you aren’t a fortune teller and certainly don’t know whether or not you’ll meet someone.

Step 2 establishes that this is a thought worth changing.

3. Get Rational

Once we’ve identified a thought as problematic or unhealthy, we can identify why it’s problematic in the first place. This is when we ask those tough therapy questions:

  • Why do I think this?
  • Is it true?
  • How often is it true?

The idea behind step 3 is to identify how our thinking is a cognitive distortion and what the reality actually is.

4. Replace It

Finally, we replace the cognitive distortion with a more rational thought. Our automatic thoughts are habitual, so the idea isn’t to stop cognitive distortions but to catch ourselves when we’re distorting reality and quickly replace the distortion with a more rational thought.

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If I catch myself thinking that my boss hates me, I need to remind myself that I’m mind reading. Then, every time I catch myself in the act of mind reading that my boss hates me, I can replace that distortion with something like, “I don’t know whether or not my boss hates me unless I ask, but I do know that I got a positive performance review and a raise last month.”

The idea is to replace cognitive distortions with more rational ways of thinking, but this requires a lot of reflection and self-awareness. You can certainly try it on your own, but it’s often better to have a trained professional guide you through the process.

Example of Cognitive Restructuring

Let’s say I catch myself catastrophizing. I notice that I sometimes I say that I will lose my job and not be able to pay my bills and then lose my home and my family.

Cognitive restructuring asks me to confront that cognitive distortion.

The first step is for me to become aware of that thought and catch myself every time I slip into catastrophizing.

Next, I ask myself if it’s true. I certainly can’t know if that’s true because I don’t know the future. This is where mindfulness practice comes in handy.[5] According to Escott, mindfulness is a great way for people to practice living more in the present moment, which can also reduce some cognitive distortions, such as catastrophizing.

Now, I don’t know whether or not I will lose my job. I can’t even answer how often this cognitive distortion is true, so I move on to step 3.

Now it’s time to reflect. Why do I think I’m going to lose my job? Maybe my parents lost their jobs, which added a lot of stress to the family when I was a child. Maybe I feel like an imposter and am not confident about some of my financial decisions.

In step 3, I come up with something more rational. I can start telling myself that I don’t know whether or not I’m going to lose my job. All I can focus on is doing the best job I can. If there is a chance I will lose my job, I can spend time networking on LinkedIn instead of catastrophizing. I can also tell myself that linking the loss of my job with losing everything is not rational. I can make a list of all the things I could do if I actually did lose my job that would prevent me from losing the other things in my life.

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Finally, I replace “I’m going to lose my job” with a more rational thought each time I catch myself catastrophizing. I might remind myself, “I don’t know the odds of me losing my job, but I do know that I have seniority and just got a raise. And if I do lose this job, I could always go back to working at my father-in-law’s store.”

It’s probably better to be pithier when you’re replacing automatic distortions, but this gives you a good idea of how to get started.

Effectiveness of Cognitive Restructuring

Science has shown that cognitive restructuring works. In one study[6], cognitive restructuring was more effective in reducing anxiety and worry than a control group and a group that was taught relaxation techniques.

The idea is that cognitive restructuring forces people to fix their automatic thoughts. Escott explains that this process is effective because our thoughts become our feelings, which affect our overall well-being.

Cognitive restructuring addresses the root of the problem: our cognitive distortions. So the next time you catch yourself overgeneralizing or catastrophizing, take a step back. Ask yourself if that’s really true and how often it’s true. Develop a more rational line of thinking and then replace the distortion with a more realistic thought.

Cognitive restructuring may not be as easy as 1, 2, 3, 4, but if you’re willing to get reflective and self-aware and do the work, it can have measurable effects on reducing your anxiety, trauma, stress, anger, and depression symptoms.

I want to reiterate that Cognitive Behavioral Therapy is a modality best done by trained professionals. For those of you who need help or want to get deeper into Cognitive Behavioral Therapy and cognitive restructuring, please search for trained mental health professionals in your area.

More Tips on Changing Your Thoughts

Featured photo credit: Benjamin Davies via unsplash.com

Reference

More by this author

Clay Drinko

Clay Drinko is an educator and the author of Theatrical Improvisation, Consciousness, and Cognition.

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Published on June 2, 2020

How Not to Let Cognitive Bias Control Us When Dealing with COVID-19

How Not to Let Cognitive Bias Control Us When Dealing with COVID-19

Why have so many people made so many bad decisions around COVID-19?

On the one hand, many ignored the information about the pandemic at first, dismissing its importance. Plenty believed — and some continue to believe — COVID-19 is no worse than the flu and shouldn’t be a concern. Others thought the US medical system would easily cope with it, as it did with SARS and other respiratory infections. Many think it will blow over soon, disappearing with the warm weather in the summer.

On the other hand, plenty of people have taken aggressive — and unhelpful — actions to address their fears. Many have engaged in panic buying, stocking up on more toilet paper than they can use in a year and getting canned goods that they will never eat. Others turned to hyped-up miracle cures offered by modern-day snake oil salespeople, despite health experts clearly conveying that there’s no known treatment or cure for COVID-19.

Such poor decision making stem from dangerous judgment errors that cognitive neuroscientists like myself call cognitive biases[1]. These mental blind spots impact all areas of our life, from health to relationships and even shopping, as a study recently revealed[2]. We need to be wary of cognitive biases in order to survive and thrive during this pandemic.

What Are Cognitive Biases?

A cognitive bias is a result of a combination of our evolutionary background[3] and specific structural features in how our brains are wired. Many of these mental blind spots proved beneficial for our survival[4] in the ancestral savanna environment, when we lived as hunter-gatherers in small tribes. Our ability to survive and reproduce depended on fast instinctive responses much more than reflective analysis.

Our primary threat response, which stems from the ancient savanna environment, is the fight-or-flight response. You might have heard of it as the saber-toothed tiger response: our ancestors had to jump at a hundred shadows to get away from a saber-toothed tiger or to fight members of an invading tribe.

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This lizard brain response proved a great fit for the kind of short-term intense risks we faced as hunter-gatherers. We are the descendants of those who had a great instinctive fight-or-flight response: the rest did not survive.

Unfortunately, our natural gut reaction to threats to either fight or flee results in terrible decisions in the modern environment. It’s particularly bad for defending us from major disruptions caused by the slow-moving train wrecks we face in the modern environment, such as the COVID-19 pandemic.

Thus, the people who ignored — and continue to ignore — the reality of the dangers from COVID-19 are expressing the flight response. They’re fleeing from uncomfortable information, ignoring the reality of the situation. The people who are taking aggressive and unhelpful actions are expressing the fight response: trying to take control of the situation by doing what they can to fight COVID-19.

Neither of these very natural responses is the right response, of course. Our natural instincts often lead us in exactly the wrong direction in our modern civilized environment. That’s why we need to adopt civilized (and unnatural) behavior habits to ensure we develop mental fitness to make the best decisions.

You already take unnatural and civilized steps for the sake of your physical health. In the ancient savanna, it was critical for us to eat as much sugar as possible to survive when we came across honey, apples, or bananas. We are the descendants of those who were strongly triggered by sugar. Right now, our gut reactions still pull us to eat as much sugar as possible, despite the overabundance of sugar in our modern world and the harm caused by eating too many sweets.

Just like you take proactive steps to go against your intuition to protect your physical health, you need to go against your intuitions and adopt civilized decision-making habits to protect yourself from COVID-19 and so many other modern-day problems that didn’t exist in the ancestral savanna.

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The Most Relevant Cognitive Biases for COVID-19

More specifically, you need to watch out for three cognitive biases.

The Normalcy Bias

The normalcy bias[5] refers to the fact that our intuitions cause us to feel that the future, at least in the short and medium term of the next couple of years, will function in roughly the same way as the past: normally. That was a safe assumption in the savanna environment, but not today, when the world is changing at an increasingly rapid pace.

This bias leads us to fail to prepare nearly as well as they should for the likelihood and effects of major disruptions, especially slow-moving train wrecks such as pandemics. As a result, we tend to vastly underestimate both the possibility and impact of a disaster striking us.

Moreover, in the midst of the event itself, people react much more slowly than they ideally should, getting stuck in the mode of gathering information instead of deciding and acting.

While the normalcy bias is the most harmful cognitive bias from which we suffer in the face of the pandemic, it’s far from the only one. In fact, a number of other cognitive biases combined with normalcy bias lead to bad decisions about the pandemic.

The Attentional Bias

One of these, attentional bias, refers to our tendency to pay attention to information that we find most emotionally engaging, and to ignore information that we don’t[6]. Given the intense, in-the-moment nature of threats and opportunities in the ancestral savanna, this bias is understandable. Yet, in the modern environment, sometimes information that doesn’t feel emotionally salient is actually really important.

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For example, the fact that the novel coronavirus originated in Wuhan, China, and caused massive sickness and deaths there didn’t draw much attention as a salient potential threat among Europeans and Americans. It proved too easy to dismiss the importance of the outbreak in Wuhan due to stereotypical and inaccurate visions of the Chinese heartland as full of backwoods peasants.

In reality, Wuhan is a global metropolis. The largest city in central China, it has over 11 million people and produced over $22.5 billion in 2018. It has a good healthcare system, strengthened substantially by China after the SARS pandemic. A major travel hub, Wuhan’s nickname is “the Chicago of China”; it had over 500 international flights per day before the outbreak. If we assume an average of 250 people per plane, that’s 10,000 people a day flying out of Wuhan.

Europeans and Americans, with the exception of a small number of experts, failed to perceive the threat to themselves from the breakdown of Wuhan’s solid healthcare system as it became overwhelmed by COVID-19. They arrogantly assumed this breakdown pointed to the backwardness of central China, rather than the accurate perception that any modern medical system would become overwhelmed in the face of the novel coronavirus.

In the savanna environment, our ancestors had to live in and for the moment since they couldn’t effectively invest resources to improve their future states (it’s not like they could freeze the meat of the mammoths they killed). Right now, we have many ways of investing into our future lives, such as saving money in banks. Yet our instincts always drive us to orient toward short-term rewards and sacrifice our long-term future, a mental blind spot called hyperbolic discounting[7].

This helps explain why so many people are not focusing sufficiently on the long-term impact of the pandemic. Many are rushing to “get back to normal,” failing to realize that doing so will leave them very vulnerable both to COVID-19 and the disruptions accompanying the impact of the pandemic.

The Planning Fallacy

We tend to feel optimistic about our plans: we made them, and therefore the plans must be good, right? We intuitive feel that our plans will go accordingly, failing to prepare adequately enough for threats and risks. As a result, our initial plans often don’t work out. We either fail to accomplish our goals or require much more time, money, and other resources to get where we wanted to go originally, a cognitive bias known as the planning fallacy[8]. Moreover, we don’t pivot quickly enough when external events require us to change our plans.

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Thus, the vast majority of us were unprepared for a major disruption like COVID-19. Moreover, a great many people tried to go ahead with their plans when they should have pivoted, such as holding weddings, going on vacations, and so on.

Addressing Cognitive Bias

To address these cognitive biases in relation to the pandemic, you have to adopt a realistic and even pessimistic perspective. We have no way of coping with the pandemic save a combination of shutdowns and social distancing. We will see wave-like periods[9] of tight restrictions that result in less cases, then loosened restrictions with spikes of cases, and then again tightened restrictions.

Such waves will last until we find an effective vaccine and vaccinate at least the most vulnerable demographics, which in the most optimistic scenario will not be until late 2021. If things don’t go perfectly, it might be more like 2023 or 2024: that’s the moderate scenario. In more pessimistic scenarios, we might not have an effective vaccine until 2027 or even later.

Does that feel unreal to you? That’s the cognitive biases talking. We still don’t have an effective vaccine for the flu, as our current version is only about 50% effective in preventing infections.

Ray Dalio, who leads Bridgewater Associates and manages over $150 billion in investor assets, said early in the pandemic : “As with investing, I hope that you will imagine the worst-case scenario and protect yourself against it”[10]. So what would it mean for you if you plan for the worst while, of course, hoping for the best?

The Bottom Line

You need to pivot for the long term by revising your plans[11] in a way that accounts for the cognitive bias associated with COVID-19. By doing so, you’ll protect yourself and those you care about from our deeply inadequate gut reactions in the face of such slow-moving train wrecks.

More Tips on Overcoming Cognitive Bias

Featured photo credit: Ani Kolleshi via unsplash.com

Reference

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