Using Cognitive Behavior Therapy to Identify and Challenge Negative Thinking in Depression
In this lesson we will discuss using cognitive behavioral therapy to identify and challenge negative thinking in depression.
Negative, distorted thinking maintains depression.
When you hold distorted beliefs about yourself, the world, and the future, there are negative consequences or costs. The antidote to cognitive distortions is questioning the assumptions you make. Helpful questions include:
- How likely is this to be true?
- Is there an alternative explanation?
- Is it always true?
These are some of the common distortions in thinking associated with depression. Identify the ones you rely on and think about the logical comebacks and reframes you can make.
Overgeneralization is taking one small bit of information and applying it to everything.
You see a friend out in public. They don’t stop to talk with you. You conclude they hate you, that everyone hates you. You stop calling your friends because everyone hates you. You ignore the next friend you see because everyone hates you. People start to notice you’re ignoring them and stop calling.
Dispute the overgeneralization by questioning the truth of assumptions you have made. Is the conclusion you have drawn always true? What’s an alternate explanation?
It’s highly unlikely that my friend, who I’ve talked to twice a week for many years, suddenly hates me. Maybe they just didn’t see me. Maybe they were upset with me but I’m sure we can work it out. Even if they hate me, that doesn’t mean that everyone hates me.
Discounting is minimizing something positive. When you’re feeling depressed, you miss positives and hyperfocus on negatives. Even though your supervisor gave you positive feedback, you focus on the small thing you got wrong, or the thought that you’re not productive enough, and decide that you’re probably going to lose your job.
Dispute this with:
It’s unlikely I’m losing my job after getting positive feedback from my supervisor. Maybe, because I’m feeling down, I’m focusing on the negatives and discounting the positives. Even though I made some mistakes, the feedback was largely positive. I’m probably not in danger of getting fired.
Applying a mental filter is like looking at one eye in the Mona Lisa and deciding it’s not much of a painting. You select one arbitrary data point and draw conclusions based on it.
You’ve cooked Thanksgiving dinner for your family for years. One year you make one dish that doesn’t quite turn out as you planned. You conclude that people will not want to come next year because of that one dish.
Asking whether this outcome is likely, and whether there might be an alternate view of the situation, helps you sort out the fact from the fiction you’ve created. Even though you weren’t happy with that dish, it was eaten. Of course they’ll come next year — your meals are always great. And, you do all the work.
Hopelessness is the belief that you have no control over a situation, that external forces are at work, and that there is nothing you can do to change it.
Having a disappointing performance and assuming your performance will always be disappointing because there is nothing you can do to change it, reflects the unwarranted beliefs that you cannot do better if you prepare more or try harder. There is no evidence to support the truth of those beliefs. Practice doesn’t make you perfect, but it does make you better.
Pessimism is a close friend of hopelessness. The pessimist always expects the worst. The next job I take is going to be worse than the last. I might as well not bother looking for a job. The antidote for this thinking is allowing for the alternative explanation that you were unlucky, you’ve had good jobs in the past and the next job could be better.
Notice the cost of distorted thinking.
There is a cost to you. Distorted thinking limits what you’re willing to do and to try, things that are just what you need to pull you out of depression.
There is a cost to others. Your beliefs make you want to isolate and remain inactive. People are hurt by your withdrawal and difficulty meeting your responsibilities. They feel they’ve lost support, or a partner or a friend.
Experiment with noticing negative thinking and making the changes you’ve identified. Notice the benefits to you and to others.
Keep track of the changes you are making so that you can refer to them when you feel down in the future or get caught up in the cycle of negative thinking.
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