This blog is my place to vent and share resources with other parents of children of trauma. I try to be open and honest about my feelings in order to help others know they are not alone. Therapeutic parenting of adopted teenagers with RAD and other severe mental illnesses and issues (plus "neurotypical" teens) , is not easy, and there are time when I say what I feel... at the moment. We're all human!

Wednesday, April 24, 2013

Cognitive Distortions

Recently ran across this article about cognitive disorders and found it helpful in describing some of the kids' issues with reality.  It was interesting to me that I'm so used to dealing with them that it took this reminder to see it.

At the end of this post, I posted a sample from a letter Bear wrote to Kitty recently.  I waited to share the letter with Kitty until we could be with her therapist.  A lot of times what's said in things like this just slide by, and we don't see the issues, guilt and blame.  Bear's letters to us are usually full of this kind of thing and while it's not a big deal for me, I worry a lot about how it affects Kitty.  How many cognitive distortions do you see?

15 Common Cognitive Distortions


15 Common Cognitive DistortionsWhat’s a cognitive distortion and why do so many people have them? Cognitive distortions are simply ways that our mind convinces us of something that isn’t really true. These inaccurate thoughts are usually used to reinforce negative thinking or emotions — telling ourselves things that sound rational and accurate, but really only serve to keep us feeling bad about ourselves.

For instance, a person might tell themselves, “I always fail when I try to do something new; I therefore fail at everything I try.” This is an example of “black or white” (or polarized) thinking. The person is only seeing things in absolutes — that if they fail at one thing, they must fail at all things. If they added, “I must be a complete loser and failure” to their thinking, that would also be an example of overgeneralization — taking a failure at one specific task and generalizing it their very self and identity.

Cognitive distortions are at the core of what many cognitive-behavioraland other kinds of therapists try and help a person learn to change inpsychotherapy. By learning to correctly identify this kind of “stinkin’ thinkin’,” a person can then answer the negative thinking back, and refute it. By refuting the negative thinking over and over again, it will slowly diminish overtime and be automatically replaced by more rational, balanced thinking.

Cognitive Distortions

Aaron Beck first proposed the theory behind cognitive distortions and David Burns was responsible for popularizing it with common names and examples for the distortions.
1. Filtering.
We take the negative details and magnify them while filtering out all positive aspects of a situation. For instance, a person may pick out a single, unpleasant detail and dwell on it exclusively so that their vision of reality becomes darkened or distorted.
2. Polarized Thinking (or “Black and White” Thinking).
In polarized thinking, things are either “black-or-white.” We have to be perfect or we’re a failure — there is no middle ground. You place people or situations in “either/or” categories, with no shades of gray or allowing for the complexity of most people and situations. If your performance falls short of perfect, you see yourself as a total failure.
3. Overgeneralization.
In this cognitive distortion, we come to a general conclusion based on a single incident or a single piece of evidence. If something bad happens only once, we expect it to happen over and over again. A person may see a single, unpleasant event as part of a never-ending pattern of defeat.
4. Jumping to Conclusions.
Without individuals saying so, we know what they are feeling and why they act the way they do. In particular, we are able to determine how people are feeling toward us.
For example, a person may conclude that someone is reacting negatively toward them but doesn’t actually bother to find out if they are correct. Another example is a person may anticipate that things will turn out badly, and will feel convinced that their prediction is already an established fact.
5. Catastrophizing.
We expect disaster to strike, no matter what. This is also referred to as “magnifying or minimizing.” We hear about a problem and use what ifquestions (e.g., “What if tragedy strikes?” “What if it happens to me?”).
For example, a person might exaggerate the importance of insignificant events (such as their mistake, or someone else’s achievement). Or they may inappropriately shrink the magnitude of significant events until they appear tiny (for example, a person’s own desirable qualities or someone else’s imperfections).
With practice, you can learn to answer each of these cognitive distortions.
6. Personalization.
Personalization is a distortion where a person believes that everything others do or say is some kind of direct, personal reaction to the person. We also compare ourselves to others trying to determine who is smarter, better looking, etc.
A person engaging in personalization may also see themselves as the cause of some unhealthy external event that they were not responsible for. For example, “We were late to the dinner party and caused the hostess to overcook the meal. If I had only pushed my husband to leave on time, this wouldn’t have happened.”
7. Control Fallacies.
If we feel externally controlled, we see ourselves as helpless a victim of fate. For example, “I can’t help it if the quality of the work is poor, my boss demanded I work overtime on it.” The fallacy of internal control has us assuming responsibility for the pain and happiness of everyone around us. For example, “Why aren’t you happy? Is it because of something I did?”
8. Fallacy of Fairness.
We feel resentful because we think we know what is fair, but other people won’t agree with us. As our parents tell us, “Life is always fair,” and people who go through life applying a measuring ruler against every situation judging its “fairness” will often feel badly and negative because of it.
9. Blaming.
We hold other people responsible for our pain, or take the other track and blame ourselves for every problem. For example, “Stop making me feel bad about myself!” Nobody can “make” us feel any particular way — only we have control over our own emotions and emotional reactions.
10. Shoulds.
We have a list of ironclad rules about how others and we should behave. People who break the rules make us angry, and we feel guilty when we violate these rules. A person may often believe they are trying to motivate themselves with shoulds and shouldn’ts, as if they have to be punished before they can do anything.
For example, “I really should exercise. I shouldn’t be so lazy.” Musts and oughts are also offenders. The emotional consequence is guilt. When a person directs should statements toward others, they often feel anger, frustration and resentment.
11. Emotional Reasoning.
We believe that what we feel must be true automatically. If we feel stupid and boring, then we must be stupid and boring. You assume that your unhealthy emotions reflect he way things really are — “I feel it, therefore it must be true.”
12. Fallacy of Change.
We expect that other people will change to suit us if we just pressure or cajole them enough. We need to change people because our hopes for happiness seem to depend entirely on them.
13. Global Labeling.
We generalize one or two qualities into a negative global judgment. These are extreme forms of generalizing, and are also referred to as “labeling” and “mislabeling.” Instead of describing an error in context of a specific situation, a person will attach an unhealthy label to themselves.
For example, they may say, “I’m a loser” in a situation where they failed at a specific task. When someone else’s behavior rubs a person the wrong way, they may attach an unhealthy label to him, such as “He’s a real jerk.” Mislabeling involves describing an event with language that is highly colored and emotionally loaded. For example, instead of saying someone drops her children off at daycare every day, a person who is mislabeling might say that “she abandons her children to strangers.”
14. Always Being Right.
We are continually on trial to prove that our opinions and actions are correct. Being wrong is unthinkable and we will go to any length to demonstrate our rightness. For example, “I don’t care how badly arguing with me makes you feel, I’m going to win this argument no matter what because I’m right.” Being right often is more important than the feelings of others around a person who engages in this cognitive distortion, even loved ones.
15. Heaven’s Reward Fallacy.
We expect our sacrifice and self-denial to pay off, as if someone is keeping score. We feel bitter when the reward doesn’t come.
So now that you know what cognitive distortions are, how do you go about undoing them? Read how in Fixing Cognitive Distortions.
Beck, A. T. (1976). Cognitive therapies and emotional disorders. New York: New American Library.
Burns, D. D. (1980). Feeling good: The new mood therapy. New York: New American Library.

Fixing Cognitive Distortions


Cognitive distortions have a way of playing havoc with our lives. If we let them. This kind of “stinkin’ thinkin’” can be “undone,” but it takes effort and lots of practice — every day. If you want to stop the irrational thinking, you can start by trying out the exercises below.
1. Identify Our Cognitive Distortion.
We need to create a list of our troublesome thoughts and examine them later for matches with a list of cognitive distortions. An examination of our cognitive distortions allows us to see which distortions we prefer. Additionally, this process will allow us to think about our problem or predicament in more natural and realistic ways.
2. Examine the Evidence.
A thorough examination of an experience allows us to identify the basis for our distorted thoughts. If we are quite self-critical, then, we should identify a number of experiences and situations where we had success.
3. Double Standard Method.
An alternative to “self-talk” that is harsh and demeaning is to talk to ourselves in the same compassionate and caring way that we would talk with a friend in a similar situation.
4. Thinking in Shades of Gray.
Instead of thinking about our problem or predicament in an either-or polarity, evaluate things on a scale of 0-100. When a plan or goal is not fully realized, think about and evaluate the experience as a partial success, again, on a scale of 0-100.
5. Survey Method.
We need to seek the opinions of others regarding whether our thoughts and attitudes are realistic. If we believe that our anxiety about an upcoming event is unwarranted, check with a few trusted friends or relatives.
6. Definitions.
What does it mean to define ourselves as “inferior,” “a loser,” “a fool,” or “abnormal.” An examination of these and other global labels likely will reveal that they more closely represent specific behaviors, or an identifiable behavior pattern instead of the total person.
7. Re-attribution.
Often, we automatically blame ourselves for the problems and predicaments we experience. Identify external factors and other individuals that contributed to the problem. Regardless of the degree of responsibility we assume, our energy is best utilized in the pursuit of resolutions to problems or identifying ways to cope with predicaments.
8. Cost-Benefit Analysis.
It is helpful to list the advantages and disadvantages of feelings, thoughts, or behaviors. A cost-benefit analysis will help us to ascertain what we are gaining from feeling bad, distorted thinking, and inappropriate behavior. Note: 1) clinical concept of secondary gain; and 2) refer to cost-benefit analysis.
Burns, D.D. (1989). The feeling good handbook: Using the new mood therapy in everyday life. New York: William Morrow.

Dear Kitty,
Hi sis how are you doing I miss you and Love you alot.  How is school and work going?  Im doing good jail ain't all that hard for me its just like jj [juvenile detention] all over agin, Well sis Happy Birth Day I Love you I am sorry I can't Be there.  I hope its fun.  Well Aguste {August} 3rd will be my one year I have been Lock up for a houle year its been a rought road for us sis, first we lost mom then know your lost me I sorry I got Lock up agin sis I hope you still Love me and caer for me.  I'm sorry I'm always getting locked up I guess it all I know is how to brake the Law just like my dad did.  Well
I Love you

Love your Big Bro

So here's some of the things I saw:

  1. Filtering:  This letter is full of this.  Not of course that I blame him.  If you can't be introspective and a negative about your life when you're in jail, where can you?  All his letters are full of "I'm sorry I was horrible" and asking for forgiveness and love.  He can't believe that he wasn't this horrible person who needs forgiveness, and that of course we still love him.
  2. Polarized Thinking:  Ironically Kitty talked about how she doesn't do this anymore when we discussed this component of the letter.  She is better about it than she was even a year ago; HOWEVER, this is still a huge issue for her (both of them)!
  3. Overgeneralization:  One time in juvie at age 10 and he's "always getting locked up" and only "knows how to break the law".  *sigh*
  4. Jumping to Conclusions:  Bear assumes that his behavior will lead to everyone not loving or caring for him anymore.  He doesn't have a lot of examples of unconditional love, and Kitty is certainly not capable of it (yet?).  We'll just have to keep reassuring him.  Maybe someday he'll believe it.
  5. Catastrophizing:  I've never quite understood how the kids can ignore significant events so completely, while blowing out of proportion the tiniest things.  There was a letter to an ex-girlfriend included in this letter in which he talked about how much he loved her, what a big mistake he'd made in breaking up with her, and how much he wanted her back.  I can only assume that his Oklahoma girlfriend finally let him know that she was only continuing their relationship while he was in jail so he wouldn't feel abandoned (apparently she "knows what that's like).  Bear has to have a true love.
  6. Personalization:  "We lost mom"  It's not overtly written here, but I know the kids both feel that being put in foster care was their fault.  Kitty talked about finally getting past this a few years ago.  I think most of the time it's true... when she's stable.
  7. Control Fallacies:  Bear is externally controlled.  I think Bear believes strongly in his victim role.  Kitty is more internally controlled; she controls herself to an extreme, so that others will love her and care for her.
  8. Fallacy of Fairness:  My kids believe that life is inherently UNfair.  They want to force and manipulate it to be fair, but don't really believe it is possible.
  9. Blaming:  This letter to Kitty is much better about this than past letters.  Kitty has improved on this a lot as well.  In the past she focused a lot more on blaming Bear and Biomom for her life.  Now she still blames others (Hence my current title of Dreamkiller), but again, I don't think she really believes it's other's fault, but more a result of her own inherent worthlessness.  I can definitely tell her meds are working, because I don't see this self-loathing as much now.
  10. Shoulds:  Both kids are a little better about being "shouldistic."  Kitty especially.  It was one reason I increased her emotional age from 4/5 which are the "police of the playground."    Kitty still believes she and every one else "should" do a lot, she's just less judgmental about it.
  11. Emotional Reasoning: I think this is one of the kids' biggest issues, especially when they are depressed.  They look around for a current "reason" for their depression and/or anger and blame their feelings on that.
  12. Fallacy of Change:  I see this in Bear's requests of Kitty to still love and care for him, here and in the letter to his ex-girlfriend.  When Kitty first got here, she firmly believed if she begged, whined or threatened enough she would get what she wanted.  This is one of the few things I figured out immediately and we NEVER gave in.  This behavior faded out, thank goodness.  We also call this "magical thinking." 
  13. Global Labeling - "Unloveable" "Lawbreaker"
  14. Always Being Right - Don't see this in the letter.  Do hear this in EVERY conversation with Bear.
  15. Heaven's Reward Fallacy - kind of see the opposite here.
As for "fixing" these Cognitive Distortions, I've found DBT to be a really useful tool.  Unfortunately it requires cognitive abilities and insight that my kids don't have.

Thinking Errors

I don't remember where I got this great handout and worksheet, it's pretty standard for most of the residential treatment centers, hospitals and places that work with DBT (Dialectical Behavior Therapy) and CBT (Cognitive Behavior Therapy).  I've found it a pretty good tool, although it only works if you have the cognitive and emotional ability to recognize, accept, and change these things... which my kids generally don't.

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