CBT

Introduction

Cognitive Behavioral Therapy (CBT) is the favored child of many when it comes to treating psychological illness. Dr. David D. Burns’ book Feeling Good: The New Mood Therapy is a fairly exhaustive self-help book on the topic clocking in at 706 pages.

A beautiful, public domain rendering of the anatomy of the brain.

A beautiful, public domain rendering of the anatomy of the brain.

I have several goals in creating this resource on CBT:

  1. To distill the essence of Dr. Burns’ book.
  2. To supplement the materials available in Dr. Burns’ book with the latest research and other applicable writings.
  3. To provide a tool for myself in performing self-help CBT.
  4. To provide a tool for others in assisting them to do the same.
  5. To provide a refresher course on CBT.

I’ve chosen to publish these pages before this process is complete because (a) I am a perfectionist and I may never finish and (b) I believe there is enough material here to be of significant value.

Revision

This document as of 7/19/15 is considered version 1.10. This means that while it is not exhaustive, it is readable and usable as-is. Future revisions will add to and expand upon the materials in this version.

Forms of Distorted Cognitive Thinking

Cognitive Behavioral Therapy (CBT) attacks incorrect ways of thinking that cause mood disruption (e.g. depression, anxiety). Here is a list of some of the common types of incorrect thinking we are likely to utilize in unsettling our own moods:

Dichotomous Thinking

We see ourselves in back-or-white categories – we are either successes or failures. We cannot falter in any way or we have failed completely.[1]

  1. Example: “If I eat too much today it means that I am a fat slob.”
  2. Example: “If I relax for even one minute too long I am a lazy good-for-nothing.”
  3. Example: “If one person doesn’t like me it means everyone doesn’t like me.”

Overgeneralization

We assume that what has occurred to us will occur repeatedly in the future. (Burns 33)

  1. Example: If someone doesn’t want to spend time with me now, they will never want to spend time with me.
  2. Example: If I am ill now, I will always be ill.
  3. Example: If I am having a hard time at work now, I will always have a hard time at work.

Selective Abstraction

“You pick out a negative detail in any situation and dwell on it exclusively, thus perceiving that the whole situation is negative.” (Burns 34)

  1. Example: You say something stupid in a conversation and despite the fact that the entire conversation has been positive, you can only focus on the stupid comment you made.
  2. Example: Playing football you score three touchdowns, but you fumble the ball once and the opposing team scores – the thought of your mistake is what circulates continuously in your mind.

Disqualifying the Positive

When something neutral or positive happens you discount it as a fluke, while at the same time Overgeneralizing the negative.

  1. Example: When someone offers us a compliment we qualify it in our minds thinking, “They were just being polite/nice.”
  2. Example: When you have undertaken a task for someone and they thank you for your service you minimize your service: “It was no problem.”

Jumping to Conclusions

“You arbitrarily jump to a negative conclusion that is not justified by the facts of the situation.” (Burns 36)

Mind Reading

“You make the assumption that other people are looking down on you, and you’re so convinced about this that you don’t even bother to check it out….” (Burns 36-37)

  1. Example: Someone doesn’t appear to be listening attentively to you, you take this personally – in actuality, the individual is exhausted from an overnight shift and it has nothing to do with you or your conversation.
  2. Example: A friend is snappy with you, you assume this means they no longer like you when in fact a teacher gave them a bad grade on a test and they are frustrated.

Fortune Telling

“You imagine that something bad is about to happen, and you take this prediction as a fact even though it is unrealistic.” (Burns 37).

  1. Example: You believe you will be in a car accident even though you have never been in a car accident.
  2. Example: You believe that you will get cancer in the future, so you shouldn’t live your life now.

Magnification and Minimization

One makes a small issue (oftentimes a mistake you made) into a huge issue – a catastrophe.  On the other hand, one takes what is a significant/positive accomplishment/characteristic of oneself and minimizes it.

  1. Example: I forgot to pay my credit card bill this month, my credit will be ruined forever.
  2. Example: All the past good work I have done is disqualified by one mistake now.

Emotional Reasoning

We take our feelings as being the truth. The formula looks like: “If I feel x then I must be x.”[2]

  1. Example: I feel stupid, therefore I am stupid.
  2. Example: I feel angry, therefore I have a just reason to be angry.
  3. Example: I feel upset so I will procrastinate on completing x task.

Should Statements

Attempting to motivate oneself by applying pressure using terms such as “should” and “must.” Ironically, this ends up demotivating you. (Burns 38)

  1. “When the reality of your own behavior falls short of your standards, your shoulds and shouldn’ts create self-loathing, shame, and guilt. When the all-too-human performance of other people falls short of your expectations, as will inevitably happen from time to time, you’ll feel bitter and self-righteous. You’ll either have to change your expectations to approximate reality or always feel let down by human behavior.” (Burns 39)
  2. Example: “I must call [name of difficult person] today.”
  3. Example: “I should be a better parent.”
  4. Example: “They should not have talked to me that way.”

Labeling and Mislabeling

“Personal labeling means creating a completely negative self-image based on your errors…The philosophy behind it is ‘The measure of a man is the mistakes he makes.'” (Burns 39)[3]

  1. “Mislabeling involves describing an event with words that are inaccurate and emotionally heavily loaded.” (Burns 40)
  2. Example: “I am an angry person because I sometimes feel angry.”
  3. Example: “I am a failure because I did not accomplish x task.”
  4. Example (mislabeling): “Your utter lack of consideration for others has resulted in this situation!”

Personalization

You take on responsibility for something negative that occurred even when there is no reason to do so. (Burns 40)

  1. Example: “It is my fault my friend committed suicide. I am responsible for his death.”
  2. Example: “My friend says something mean to someone else and this means that I have in effect said something mean to this individual as well.”

In Burns book, on pages 42-43 there is a great summary table of the above cognitive distortions.

Specific Steps

  1. Build Self-Esteem. (Version: 1.10: July 19, 2015)
  2. Overcome Procrastination. (Version: 1.10: July 19, 2015)
  3. Respond to External Critics. (Version: 0.5, July 19, 2015)
  4. Manage Anger. (Version: 0.2: July 19, 2015)
  5. Overcome Guilt. (Version: 0.2: July 19, 2015)

Measurement Tools

  • Beck Depression Inventory (BDI) – Purchase / Wikipedia.
  • Burns Depression Checklist (BDC) – PDF.
    • Scoring: none  (0-5), normal but unhappy (6-10), mild (11-25), moderate (26-50), severe (51-75), extreme (76-100).

 Bibliography

The materials on this page are primarily drawn from Dr. Burns’ book, the first three chapters, especially the third chapter.

Dr. David D. Burns. Feeling Good: The New Mood Therapy. NYC, NY: Harper, 1999.

  1. [1]“This refers to your tendency to evaluate your personal qualities in extreme black-or-white categories…[it] forms the basis for perfectionism. It causes you to fear any mistake or imperfection because you will then see yourself as a complete loser, and you will feel inadequate and worthless.” (Burns 32)
  2. [2]“Emotional reasoning plays a role in nearly all your depressions. Because things feel so negative to you, you assume they truly are. It doesn’t occur to you to challenge the validity of the perceptions that create your feelings.” (Burns 38)
  3. [3]“Labeling yourself is not only self-defeating, it is irrational. Your self cannot be equated with any one thing you do. Your life is a complex and ever-changing flow of thoughts, emotions, and actions…you are more like a river than a statue. Stop trying to define yourself with negative labels–they are overly simplistic and wrong. Would you think of yourself…as an ‘eater’ just because you eat, or a ‘breather’ just because you breathe?” (Burns 40)

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