The Nuance

Here’s an experience we’ve all had: You text a friend, and the friend doesn’t text you back. Minutes pass, then hours. What’s going on?

Maybe your friend is busy with work and isn’t checking texts. Or maybe your friend saw your message and is ignoring it. These are two of many possible interpretations. All of them are speculative; you don’t know why your friend isn’t replying, so you’re guessing. But while some guesses (like the busy-with-work guess) won’t make you feel much of anything, others (like the purposely-ignoring-you guess) are likely to make you feel sad, angry, or hurt.

Interpreting your friend’s silence in a negative light is an example of what psychologists have termed a “cognitive distortion.” They’re defined as intrusive, maladaptive ideas or assumptions that can influence your thinking and behavior in ways that may contribute to mental health problems.

“We all have negative intrusive thoughts,” says David Dozois, PhD, a professor of psychology at the University of Western Ontario who has published research on cognitive distortions. Even in people who do not have mental health issues, Dozois says there’s evidence that fully 40% of their thinking is negative. (In other words, noticing cognitive distortions in your own train of thought is not evidence that you have some sort of condition.) But among those who are struggling with depression, anxiety, or other mental health problems, he says that cognitive distortions are often commonplace.

‘With practice, you can learn to come up with alternative thoughts that are more balanced.’

“Patients exhibiting these types of thoughts can become stuck in negative feedback loops of unhealthy thinking, leading to inaccurate perceptions of reality commonly associated with anxiety and depression.” That’s according to a 2020 study from researchers at the University of Florida. These inaccurate perceptions can lead to behaviors — for example, avoiding social gatherings because you think others will judge you — that can worsen or reinforce a disorder.

Since they were first named and described back in 1979, cognitive distortions have become a big focus of psychological research. Meanwhile, some of the most evidence-supported treatments for mental health disorders, including cognitive-behavioral therapy (CBT), often involve training to identify cognitive distortions in order to limit the problems they may cause.

CBT’s success has helped fuel and refine the science of negative thought patterns. However, some newer treatments take a very different approach to these mental habits.

What are the most common cognitive distortions? Experts have named and defined dozens of them. But some seem to be especially commonplace. According to a 2021 study in the Proceedings of the National Academies of Science (PNAS), this group includes:

Catastrophizing: Blowing up the importance of negative events.

All-or-nothing thinking: Viewing a situation or experience as either all good or all bad (usually the latter).

Emotional Reasoning: Thinking that something is true based solely on your feelings and ignoring evidence to the contrary.

Fortune-telling: Making predictions, usually negative ones, about the future.

Labeling and mislabeling: Applying harsh or negative labels to yourself or others while discounting evidence that could lead to gentler conclusions.

Mindreading: Believing you know what others are thinking (and that it’s probably something bad about you).

Overgeneralizing: Coming to sweeping negative conclusions based on incomplete information.

Personalizing: Believing that others are behaving negatively because of you, without considering other explanations that have nothing to do with you.

Should statements: Having a fixed idea on how you and/or others should behave.

In support of the association between these thought patterns and mental health problems, researchers have found evidence that cognitive distortions rise and fall during periods of psychological turmoil.

For example, the authors of that 2021 PNAS study examined the text of millions of books in search of statements indicative of cognitive distortions. Their examination spanned the last 200 years (but predated the pandemic). They found evidence of a recent increase in cognitive-distortion language, and also earlier historical surges during major world wars and financial crises.

“Our results point to the possibility that recent socioeconomic changes, new technology, and social media are associated with a surge of cognitive distortions,” they wrote.

There are competing schools of thought on how best to handle cognitive distortions.

CBT proponents say that by keeping an eye out for cognitive distortions, you can “restructure” them in helpful ways. “The idea is not to push them away, but to help people sort of put these thoughts on trial,” Dozois says. By that he means “looking at the evidence” in order to determine if a negative thought really stands up to scrutiny. “With practice, you can learn to come up with alternative thoughts that are more balanced in terms of the evidence,” he says.

But this is a delicate technique that has its pitfalls. It’s possible that by identifying cognitive distortions as problems and attempting to change them, you may feel more distress whenever they arise. There’s also the old pink-elephant problem: Trying not to think about something (famously, a pink elephant) tends to have just the opposite result. And so if you’re trying not to have negative thoughts, they may be more likely to pop into your head.

An alternative approach to CBT is acceptance and commitment therapy (ACT). Rather than attempt to “challenge” and restructure cognitive distortions, researchers say that ACT encourages people “to separate and distance themselves from the literal content and meaning of their thoughts.” Basically, this means learning not to make such a big deal of the stuff floating through your head.

“The idea [with ACT] is that we don’t need to change negative thinking, we need to accept it as just a thought — so sort of taking the sting out of the negative thought,” Dozois says. (This will be familiar territory for anyone familiar with mindfulness and other forms of mediation that preach “non-judgmental awareness” of one’s thoughts.) “Once we learn to accept thoughts, they tend to lose their power to distress us,” he adds.

The jury’s still out on which of these approaches is best. Some studies comparing CBT to ACT have found that acceptance and commitment therapy may be superior for the management of anxiety, depression, and other conditions, but a 2020 review of the research concluded that more work is needed. Dozois also points out that the “B” in CBT stands for “behavioral,” and that the treatment involves other practices that may be especially helpful for people with very severe depression or mental illness.

“When someone’s depressed, it’s almost like a filter for negative content,” he says. Learning how to identify negative thoughts and limit the distress they cause you may be one way to remove that filter and see things in a clearer and more hopeful light.