Overcoming Depression For Dummies
Page 14
Sometimes you’ll have slightly different thoughts relating to different feelings, but which all stem from the same event. Look at the thoughts you have that relate to each feeling. For example, if you recently got promoted and your new boss asks you to immediately complete and deliver the report you’ve been painstakingly working on, you may have feelings of both anxiety and despair. The anxiety-related thoughts may centre on concerns of being told off if you don’t finish on time, and despair-related thoughts may focus on the belief that you’re overwhelmingly inadequate to handle the new promotion.
Polar bears and negative thoughts
When you hear that negative thinking increases negative emotions, you might think there’s a really simple answer – just stop thinking negatively! In other words, just banish any negative thoughts from your mind the moment you detect them. You’re cured! If only it were that simple . . .
Back in 1863, Dostoevsky wrote: ‘Try to pose for yourself this task: not to think of a polar bear, and you will see that the cursed thing will come to mind every minute.’ And now psychologists carry out research looking at attempts to do just that – to suppress thoughts of white bears, amongst other subjects.
Daniel Wegner of Harvard University reviewed 20 years of research on thought suppression. His conclusion was that overall, suppressing unwanted thoughts doesn’t work. Even worse, attempting to do so assures that you’re going to end up experiencing the very thoughts you were trying to avoid in the first place, and to a greater extent than if you hadn’t tried to suppress them at all.
You may think that cognitive therapy recommends thought suppression, because one of its goals is to help you think in less distorted, negative ways. But we urge you not to attempt to wipe out negative thoughts by attempting to suppress them. Instead, figure out how to use the skills we provide you with for developing new thinking habits – we believe you’re going to find it’s worth the effort.
Here’s an example of how the Thought Catcher works. Gita is a software engineer. She’s a bit of a perfectionist, which adds further stress to her already highly demanding job. When one of the computer programs she’s working on repeatedly crashes, Gita too crashes. She can’t sleep; she can’t eat; and thoughts of suicide enter her mind. Gita confides her despair to a close friend who strongly urges her to see a therapist. Gita protests at first, but her friend insists.
Her therapist suggests that Gita constructs a Thought Catcher, allowing her to catch her thoughts whenever she finds herself feeling down. Take a look at Table 5-1 to see what Gita comes up with.
Table 5-1 Gita’s Thought Catcher
Feelings (0 to 100)
Events
Negative Automatic Thoughts (or Interpretations)
Despair (80)
Helplessness (95)
The computer programme(?) EIF I’m working on crashed again.
My boss is going to find out that I don’t know what I’m doing and fire me.
I’m never going to be able to solve this.
You can see how Gita’s thoughts contribute to her low feelings and overall depression. We suggest you fill out a Thought Catcher for about a week. Try to catch in your net at least one or two problematic events each day. After finishing this task, you’re ready to tackle the thoughts that lead to your depression.
Unearthing Distortions in Thinking
Cognitive therapy uses the well-established idea that certain thoughts you have in response to events lead to depressed feelings (see the previous section ‘Monitoring Thoughts and Feelings, and Relating Them to Life Events’). Now we show you that those thoughts are almost always distorted. By distorted, we mean that these thoughts don’t accurately reflect, predict, or describe events. In this section, we help you analyse your thoughts in order to identify these distortions. In doing so, you can start clearing your vision and see your world in more accurate terms.
By asking you to examine your thoughts and to look for various types of distortions, we are not trying to get you to rationalise away everything bad that happens to you. The goal of cognitive therapy is to show you how to identify, reflect upon, and weigh up your distorted thoughts in order to later rework them in such a way that they match reality (see Chapter 6 for information on developing accurate, replacement thoughts). When reality is really awful, we don’t expect or want you to deny that fact. Rather, we want you to cope when events turn out contrary to your hopes.
You may find it helpful to know that people with depression aren’t the only ones to have distorted thinking. Every person has, at times, significantly distorted thoughts. Depression merely makes these distortions more frequent and intense. Even those who aren’t especially depressed can probably benefit from using our strategies for reducing such distortions. And if you’re depressed, discovering new ways of thinking may lead to a far happier life.
If you find yourself objecting to the content of this chapter because what we say sounds oversimplified, or even seems to undervalue the importance of your feelings, please read (or reread) Chapter 3, which talks about common barriers to change, as well as uncovering many of the myths about therapy. The depressed mind may well resist hearing some of the information that follows. If you’re depressed, do nonetheless have a go at reading this material, and please take your time before forming conclusions.
We group the various types of thought distortions into four main categories. In the following sections, we discuss each of these types of distortions and show you how they can shape your perceptions of reality as easily as a child can turn a harmless shadow into a wardrobe monster.
Following misleading misperceptions
Distorting reality involves twisting reality in ways that make events look as bleak as you feel. The human mind distorts incoming information in an endless variety of ways. And the depressed mind blows up these distortions to the point that misperceptions masquerade as reality, yet manage only to convey a muddled mass of misinformation. In this section we discuss the most common types of reality distortions. We then use a Thought Catcher (see ‘Designing your Thought Catcher’, earlier in this chapter) to show you examples of how these distortions join up to deepen depression. Understanding how these distortions operate can start the process of more accurate thinking.
The mind’s seven misleading misperceptions
Everyone distorts reality from time to time. Depressed people just do it more often and to a greater depth, and they find the distortions more credible. In the following list, we review common ways in which your mind can distort reality. See if you can recognise any of the following tricks your mind has tried to play on you.
✓Maximising and minimising: Your mind uses this distortion to catastrophise, or magnify, the importance or ‘awfulness’ of unpleasant events. This distortion of maximising is also known as catastrophising. In a similar fashion, the mind minimises the value and importance of anything positive about yourself, your world, or your future.
Filtering: The depressed mind typically focuses on any dismal, dark data while screening out more positive information. The not-too-surprising result? Both the world, and even you, appear miserable and hopeless.
Seeing in black and white, all-or-nothing terms: This distortion puts everything – you, other people, and even events – into stark terms, with no shades of grey. Thus, a single poor performance is taken to mean complete and utter inadequacy. The problem with polarised thinking is that it sets you up for inevitably experiencing a sense of total failure, disappointment, and self-criticism. All-or-none thinking imposes standards that absolutely no one can ever achieve.
Dismissing evidence: This distortion looks at evidence that may contradict the mind’s negative thoughts and dismisses that evidence as not allowable and/or completely irrelevant. For example, suppose you have the thought that you’re a failure. Then your boss says that you’ve earned a promotion for your performance. Your mind may quickly decide that the promotion was both undeserved and meaningless, and that your failure runs much deeper than mere job
performance. This misperception is rather like being accused of a crime, and then having the judge throw out as irrelevant every single piece of evidence that proves your innocence. Bet you can guess the verdict. In this case, it’s your own mind that throws out the evidence and determines the verdict.
Discarding positives: Similar to dismissing evidence, minimising the positive is a distortion the mind uses to trivialise successes, good outcomes, and positive personal attributes and achievements. So if you’re successful in your audition for the lead in a play, you decide that this has to be because the drama group is so desperate and of such a poor standard that they welcome with open arms anyone with minimal talent!
Overgeneralising: This involves looking at a single, unpleasant occurrence and deciding it represents the way things are, and are always going to be. Thus, if you drop your fork on the floor, your mind tells you that you’re a clumsy clot who’s always dropping things. Words like always and never are tip-offs to this reality distortion.
Mind-reading: Mind-reading occurs whenever you assume, often with unshakable conviction, that you know what others are thinking, without checking it out. Thus, someone may not ask out a new acquaintance because, ‘I just know she wouldn’t go out with someone like me.’
Adding reality distortions to your Thought Catcher
A good way of discovering if your thoughts about events that are happening to you are distorted is to add a fourth column to your Thought Catcher (see the ‘Designing your Thought Catcher’ section, earlier in the chapter). Label that column ‘Reality Distortions’ (see Table 5-2 for an example). Examine your thoughts about events carefully and ask yourself which reality distortions apply. You may be surprised to see how often your thoughts lead you astray.
Brandon’s story illustrates how reality distortions influence his thoughts and intensify his negative feelings. Brandon works as a supervisor for the local borough transport department. He arrives home from work one day to find a note from his wife saying that she’s gone, and has taken the kids with her. The note says that she’s had enough of his long work hours, and she plans to find happiness with someone else. Brandon’s grief (go to Chapters 2 and 13 for more information about grief) fails to lift, and he slowly sinks into a deep depression over the following year. At this point, Brandon’s manager refers him to Occupational Health, who refer him to see a psychologist for help, given his evident distress and the impact this is having on his work.
Brandon’s psychologist quickly diagnoses a major depressive disorder (refer to Chapter 2 for more information about major depressive disorders) and decides that cognitive therapy can help. First, as part of this therapy, the psychologist discusses the types of reality distortions that the mind often uses (see the previous section ‘The mind’s seven misleading misperceptions’). Brandon isn’t convinced that he distorts anything in his life, but he agrees to explore the possibility.
Next, the psychologist helps Brandon design his Thought Catcher, so that he can see how he looks at events. Brandon then adds a fourth column to see if he’s distorting his reality. Table 5-2 shows what Brandon discovered, somewhat to his surprise, after filling out his Thought Catcher for a few days.
Do you see in Table 5-2 how consistently Brandon’s depressed mind distorts his thoughts or interpretations of the things that happen to him? Time and again, his mind maximises the meaning of negative events and also puts them into black and white terms. Even positive events are filtered out or dismissed. Is it any wonder that he ends up feeling fear, despair, sadness, and apprehension?
Notice that Brandon’s reaction to the first event contains five types of reality distortions. For example, when he says he ‘is going to ’ lose his job and his home, and that no one is ever going to employ him again, he’s engaging in negative automatic thinking without reflecting on the true probabilities. He’s maximising with the unquestioned assumption that the strike is likely to continue to the point that he’s going to lose both his job and home. He’s overgeneralising when he decides that if he loses his current job, he’s never going to find another. How does the fact that a person loses one job mean that they’re never going to get another? He’s mind-reading as well as discarding positives when he concludes that the representative is lying to him. Also, he’s filtering out the positive message from the representative and focusing on imagined negative catastrophes.
Perhaps you’re wondering if, just possibly, Brandon’s thoughts are not actually distortions of reality. For example, perhaps he really is going to lose his job, and maybe the drivers’ representative does believe that it’s all Brandon’s fault for not keeping the drivers happy. Possible? Yes. Of course. However, you can spot that Brandon is more likely to be distorting reality because he doesn’t use qualifiers, such as ‘possibly’, ‘maybe’, or ‘perhaps’. He also doesn’t consider other factors, such as how likely it is that his negative assumptions are reality, versus other possible outcomes.
Have a go on a fresh page in your notebook. Divide the page into four columns and as many rows as you need. Start identifying your feelings and see whether you can connect them to the events in your life and the interpretations you make of those events. Then look very closely at those thoughts. Find out if your mind is distorting the meanings of the various daily events.
If you find it easy to spot these reality distortions, you’re one step ahead of the game. You’re probably going to start noticing doubt creeping into the certainty of your depressed mind’s negative automatic thoughts and interpretation of events. It’s not a big leap to go from seeing that those interpretations may contain distortions to realising that an alternative, less depressing view of the world may actually be more valid, and may make you feel better. That’s the purpose of looking for distortions in thoughts – doing so starts to shake the hold that your depressed mind has on your thinking. (We show you many other ways to actively identify and modify distortions in your thoughts in Chapter 6.)
Table 5-3 contains three more examples of events and sample thoughts (or interpretations), plus the feelings about these events. It also has space for you to think about possible reality distortions embedded in those thoughts. See if you can work out which distortions apply. After you fill in the reality distortions column, have a look at the correct answers provided.
Now, here are the distortions described in Table 5-3:
Event 1, arriving late: Maximising, overgeneralising, mind-reading, filtering
Event 2, late submission of work: Maximising, filtering, discarding positives, overgeneralising, mind-reading
Event 3, turned down for a date: Maximising, mind-reading, filtering, overgeneralising, black and white
Making misjudgements
The depressed mind acquires a nasty habit of making harsh, critical judgements about almost anything you do, thus deepening depression with each fault-finding episode. We can’t remember the last time we worked with a seriously depressed client who didn’t display harsh self-criticism. The self-critical judgements then means many people feel guilty for being whatever it is they’ve just called themselves. Thus, the fact that guilt is an important symptom of major depression is no coincidence. Even people who have little or no depression often judge themselves more negatively than needed. But those with depression sometimes walk around as though they have a scarlet ‘G’ for guilty tattooed on their foreheads.
The ‘making misjudgements’ type of thought distortion comes in three forms:
Musts, oughts, and shoulds
Unfair comparisons
Self-labels
Like the reality distortions we mention in the earlier section ‘Misleading misperceptions’, all three of these distortions occur instantly, automatically, and without careful consideration of reality. In the following sections you can find detailed information on each type of misjudgement, and how it leads to unpleasant feelings. When you become aware of how frequently you use ‘shoulds’, unfair comparisons, and self-labels, you’re likely to use them less often – and fee
l better as a result.
Examining musts, oughts, and shoulds
One of the founding fathers of cognitive therapy, psychologist Dr Albert Ellis (1913–2007), invented the the term ‘musturbation’. When we musturbate we mentally beat ourselves up with loads of ‘musts’, ‘oughts’ and ‘shoulds’ bringing intense pressure on ourselves to perform. It’s as if you’re forcing yourself to do the tasks. The problem with this is that when you, or others, try to exert force and pressure for something to happen, then, as is written in the Laws of Physics – the opposite happens. One of the key Laws of Physics is that every action has an equal and opposite reaction. And so you end up sabotaging yourself in two ways – first, you don’t do the tasks that are really for your own good. Second, you beat yourself up for not doing them.