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Monday, March 30, 2015

Cognitive Distortion of the Month: Dichotomous Thinking

2:44 PM Posted by Tiffany Taft , , ,
Greetings.  It's been a while since I wrote a blog entry as I had a baby last October and it's kind of amazing how real baby-brain is, which makes writing feel exponentially harder.  Especially when they don't sleep very well.  He's 5 months old now and is being gracious enough to let me sleep in 3-4 hour increments.  So I have that going for me.

Steph kicked off our 2015 blog series on Cognitive Distortions, or as some say "thinking traps" with a nice piece on using a Negative Filter when evaluating our life.  If you haven't read it, go check it out.

For March, the topic is Dichotomous Thinking.  As it implies, dichotomous thinking is only seeing a situation from two potential angles.  It's all or nothing.  Good or bad.  Black or White.  There's not much room for any grey area.  But, if we take a step back we see that life is full of grey areas and it's actually less likely that we're operating in one of the extremes.  So why do we go there?


How do we know when we might be stuck in a dichotomous thinking trap?  There are certain key words to look out for.  The biggest 2 are Always and Never.

In terms of living with a chronic illness, it might be thoughts like:

"I'm always getting sick when I have plans."

"My treatment is never going to work."

"People always give me a hard time about my condition."

"My doctor never listens to me."

Or, we can fall into this trap more generally:

"I didn't get a perfect job review so I'm obviously a total failure."

"I forgot my friend's birthday so I'm obviously a horrible human being."

Thinking this way can cause a lot of stress, not to mention feelings of helplessness or even hopelessness.  Dichotomous thinking is the basis for perfectionism, which I've found is often behind feelings of anxiety and depression because who can ever measure up to perfection?

What are some ways to combat dichotomous thinking?

Like most cognitive-behavioral therapy (CBT) strategies, we start with pausing and evaluating the legitimacy of our thoughts.  I like to ask clients "Would your argument hold up in court?"  Or, "Would your argument hold up to scientific review?"  If the answer is no, then we have to look at why you might still hold on to those thoughts if they aren't valid.  But that's for another blog entry.

Evaluating our thoughts in a rational and logical way pulls us back from overly emotional thinking, which lends itself to cognitive distortions like dichotomous thinking.  Don't get me wrong, we don't want to be too robotic about life. Rather, we can operate in between, in what some in psychology refer to as our "wise minds."  

The next time you're thinking this way, jot down your thoughts on a piece of paper.  Draw a line with your belief at one end.  At the opposite end of the line write down the opposite thought (e.g. you wrote down "I'm never going to get better" then write down "I will get better.")  Next, draw a short line through the middle of the original line and write down a few thoughts that are somewhere in between the 2 extremes to try to get at the middle ground, or grey areas.  

And then ask yourself:

Are situations where your belief isn't happening.  This is good for the always and never thoughts.  

Would everyone see the situation this way?  What are some alternative arguments?

What would I tell my friend if he/she came to me with this belief?

If I thought of the situation in terms of the grey area, how might my feelings or behavior change?

Reining in dichotomous thinking can help us feel less anxious, down, or defeated.  Evaluating these thoughts help us look at our world through a more realistic lens.  This exercise may seem simple and straightforward as you read it, but it takes time and practice to make this a habit that we use in the moment when dichotomous thinking is kicking up intense feelings.  If you struggle with making the adjustments on your own, getting help from a CBT therapist can certainly help.

Best,

Dr. T.