Psychiatry & Psychotherapy Podcast - Cognitive Distortions and Practicing Truth

Episode Date: January 23, 2018

This week we discussed cognitive distortions with Adam Borechy. Usually cognitive behavioral therapists deal with cognitive distortions by helping their clients identify habitual negative thoughts and and putting those thoughts on trial. We don't have to accept every thought that passes through our brains as truth. When we have distressing thoughts, it can be helpful to consider if we might be telling ourselves the full truth about a situation. We refer to common cognitive distortions—depression, anxiety, feelings of failure, negative thoughts when interacting with people, social anxiety—and we see how they are applying to our thought process. For a PDF of the cognitive distortions and a 8 days journal task towards better identifying them in your life, please see my resource page. In this 8 day journey you will better identify your own troubling thoughts and move towards gratitude. Here are a list of the cognitive distortions: All or nothing thinking: things are black and white, completely without shades of gray.  For example, you may think, "If I am not perfect, I should not try at all, because then I would fail completely." Or you might think, "My significant other is completely evil." And then the next day, "My significant other is perfect."   Overgeneralization: generalizations are made without context, experience or evidence.  "I am always alone."  Or "Everyone hates me."  "I never win." Always? Never?  Everyone? It happens absolutely all the time, without exceptions? In the moment, it can feel like that, but those statements are actually rarely true. Speaking truth to yourself in this case might look like: I am sometimes alone, several people are upset at me, I win sometimes, even if I didn't this time. Mental Filter: focusing on the negative rather than the whole picture. After receiving multiple positive statements and one negative statement, all you focus on is the negative statement.   Disqualifying the positive: When you do something good like get a compliment or award, you instantly find ways to make less of it! For example, if someone says, "You are looking good today," but instantly you assume that person is giving you a false compliment.   Jumping to conclusions (without evidence): reaching conclusions (usually negative) without little evidence. ind reading: assuming you know what the person is thinking about you.  Connection occurs from accurately knowing another, and with mindreading you blind yourself without evidence. Fortune telling: predicting negative things in the future.  For example you think "I am going to fail this test even if I study," so you don't try, don't study, and don't even show up. Magnification or Minimization: you make some weakness of yours much larger than it is or a strength much less than it really is. For example you see your friends as beautiful whereas you see your own beauty as very average. Emotional Reasoning: believe that your feelings reflect reality. For example, "I feel stupid, therefore I am." or "I feel fearful of flying in planes therefore they must be dangerous," or "I feel ugly therefore I am ugly despite what others tell me."   Shoulding: a thing that you believe you should or should not do, often created to try to maintain an image of yourself which is more in line with social pressures. For example, "I should be perfect," "I should never cry," "I should always win," "I should be able to do this on the first try." Personalization: blaming oneself for a bad event without looking at external factors that contributed to the bad event. Attributing personal responsibility to things that you have no control over, or when you do not see all the things that caused something. For example, a friend is upset so you think it is something you caused or are responsible for.   Error Messages: thoughts that are like obsessive compulsive disorder due to having thoughts that are repetitive, intrusive and not meaningful.  By listening to this episode, you can earn 0.5 Psychiatry CME Credits. Link to blog. Link to YouTube video. Join David on Instagram: dr.davidpuder Twitter: @DavidPuder Facebook: DrDavidPuder Co-host: Adam Borecky Editor: Trent Jones *This podcast is for informational purposes only and is the opinions of the people on this episode.  For full disclaimer go here.  

Welcome to the Psychiatry and Psychotherapy Podcast, the podcast to help you in your journey towards becoming a wise, empathic, genuine, and connected mental health professional. I'm your host, Dr. David Puter, a psychiatrist who splits his time practicing psychopharmacology, individual and group psychotherapy, medical director of a day treatment program, medical education research, and teaching, residents, and medical students. If this podcast is of interest to you and you want to deepen your understanding afterwards, you can follow the link in my show notes to my resource page, which will allow you to download a free eight-day journal assignment, which will deepen your understanding of the material and move away

from negative feelings and towards gratitude. Today I am going to be having a discussion with one of my research associates, Adam Bereke. He is a soon-to-be fourth-year medical student who is also doing a master's in ethics. He's an incredibly brilliant, empathic warm. honest, trustworthy human being that I deeply enjoy working with. And we had this idea that we would have a discussion on cognitive distortions and talk about how they apply to mental health, how we can look at our thoughts, look at our narratives, and seek to, you know, move towards truth the closest we can. I will be leaving a copy of the basic cognitive distortions in the show notes. And if you have any questions or considerations, find my Instagram page and the post related

to cognitive distortions, throw up a comment, and I'll either address it in the comment section or possibly in a further podcast. All right, here's our interview. I am joined today with Adam Brecchi. Yes, well, Berecki, you know, but Conard misconception, you know. I might not even know how to pronounce it myself. I've known you for so long. And I'm, I'm, Never pronounce that. It's a weird name. Out loud. Yeah.

I just avoid it. I'm a little offended. I see a lot of last names and I'm just like, I'm going to avoid even trying to pronounce that. So you work with so many people in the hospital that you just kind of cough when you say their last name. Like, doctor, you know, something like that. Because I've been there. Oh, great. So today we are going to be talking about a topic of cognitive distortions.

and kind of creating a dialogue around what are some of the different cognitive distortions. And yeah, so hopefully it increases your psychological mindedness. I also know it's a good skill to have in terms of if you're sort of battling your own thoughts at times. So it both has value for yourself, but also this is. is a common thing that I explained to patients as a way of sort of helping them start to be able to look at some of the errors of their thinking,

which changes how they feel. So can you kind of like describe what you mean by cognitive distortions and where did that whole idea even come from? It can be found most in the psychotherapy called cognitive behavioral therapy. And so it specifically is kind of approaching the cognitions. And so the idea is you have emotions that have thoughts attached to it. And you want to

kind of put those thoughts on trial. Okay. So you want to put the thoughts on trial and you want to be able to say, you know, is this the most truthful statement that I could possibly make in my mind? Okay. Do the thoughts that trigger these have to be like pathological or can any thoughts create some kind of distortion? Um, there, I mean, obviously, I think a lot of thoughts that we have are distorted in many ways. Yeah. But what happens is as the thoughts become more and more distorted, you may become more depressed.

Or if you're more depressed, your thoughts are more distorted. So you're looking through the kind of a hazy filter. Okay. So for example, all or nothing thinking. Okay. That's an example of a cognitive distortion. So things are all black and white. There's no shades of gray.

for example, you think if I'm not perfect, I shouldn't try because then I would fail completely. Okay. Okay. Or, you know, my spouse completely hates me. Okay. Or I am a horrible, horrible person. Okay. Or I am stupid.

So it's kind of like these all or nothing statements. Okay. So what you're saying is like an event triggers, triggers me in a sense. and then I have these thoughts that I'm not necessarily choosing to think. They just kind of, or it's like a habit of a thought that appears in my brain. Is that a fair assessment? So it could be an event, but it also could just be your imagination. Okay.

It could be, you know, just like you're laying in bed at night and you can have sort of thoughts that come. And I think there's something about falling asleep, like when you start to fall asleep, that your sort of logical brain sort of shuts down. and you can more easily have distorted thoughts. So a lot of people struggle right before they're going to bed, racing thoughts. Oh, that's why it's like the, I don't know, the frontal lobe control kind of slowly powers down. All the stuff that you've been suppressing all day kind of can bubble up. Is that kind of the idea?

That's kind of the idea. Yeah, especially like if you've been busy all day and making yourself busy on purpose, then you've had no time to kind of reflect. or I don't know it just it just happens like a lot of people have these sort of cognitive distortions at right at night anyways so all or nothing thinking like can you think of any sort of all or nothing think thoughts that come to your head well yeah like I'm a medical student right and so it's I feel like I'm constantly battling you know internal voices external pressures whether explicit or implicit that say if I'm bad at this, then I'm, you know, a failure.

Or if I fail a test, you know, I'm a failure or something like that. And, you know, I, so that's an example, I think, where that doesn't generate positive emotion for me. I feel awful when something bad happens and then I berate myself. Right. And it makes sense. Like, if you were to believe I am a failure, then that's a horrible feeling. Yeah.

And of course you feel really You know Sort of angry at yourself Or shame or you know I feel bad or downcast Yeah Yeah so it's interesting how like one Bad experience can often

Inform and make it think that You know we go all bad on ourselves So like why I'm going to step Take a step back here like why do we generate these distortions and thinking. Like why, what about, is it my childhood?

Is it just patterns that I've gotten into? Like, when do I get into this habit that I'm suddenly stuck in of creating distorted thinking? Yeah. So I think it could be a number, a number of those things, right? So you could have internalized an aspect of your critical parent that was berating you. And it's sort of like another, you know, sort of failure just reminds you of that.

You could, your personality could just be wired for more of, you know, perfection. And so you're just naturally, you know, wanting to do everything perfect. Yeah. And part of that kind of comes along with, you know, if you mess up at all, it just kind of completely destroys that image of yourself that you want to sort of hold. Yeah. it can be like if you are depressed or there's different you know sort of states where it's more easy to have negative thoughts so you know you may not have if you if you newly struggle with depression and you don't have a history of depression all of a sudden you may have a lot more of these all or nothing think thoughts okay and now do you mean like so you one of the things that characterizes depression might be the the presence of these cognitive distortions?

Or is that a fair assessment? Yeah, that's kind of what we see. Yeah. Yeah, that's what we see. Okay. You know, different types of distortions kind of grouped together for different pathologies. So I don't know if you,

we've been reading about this a little bit together. Yeah. If you saw that, there's another one called magnification or minima, minimization, you know, where you basically take some of your weaknesses or strengths and make them a lot bigger or smaller than they really are. So you're not seeing it accurately. You're not, your strengths, you're minimizing those usually in depression. And your weaknesses, you're sort of magnifying, you know? It's kind of, it kind of seems similar to all or nothing thinking,

but it's just magnifying or minimizing. But if you're, you're if you struggle with like narcissism, you may magnify, um, your own, the things that you're good at. And you may minimize, you know, other things that other people are good at. Oh. So we can reflect on your relationship to others as well as just within your own mind. Right. But both are cognitive distortions and inaccuracies. And they're, therefore like, they kind of lead into trouble. Okay. Yeah. I guess one, one question this might be a nuance. that I had was when you say like cognitive distortions, couldn't there be a scenario in which it's actually like not a distortion? Like hypothetically, if I'm, if I genuinely am, you know,

awful at this one thing, like it might be true in that sense, right? Yeah. So actually, they found that people who are slightly depressed are actually probably more accurate at judging reality. So, for example, Winston Churchill, who struggled with depression, was the thought to be one of the early sort of, you know, bell sounders for how bad Germany was getting, whereas a lot of people were in denial. Huh. So sometimes, you know, having a war leader who's a little bit depressed can actually see reality a little bit more accurately.

That's wild. There was a TED talk by the journalist Andrew Solomon about his own experience with depression. And he totally mentions that point where he's talking. about how one of the reasons people don't like having depressed people around is that they often like speak truths that are like socially you know maybe unpopular like you know we're all just going to die someday it's like well that's actually a true statement but it's not like we go around saying that all the time yeah and you know i i think that there's there's probably a place where it's it's more true and then the further you go into depression the more like untrue it becomes you

the more distorted it becomes. The more distorted. So I think that there's, you know, like on this sort of bell curve of natural mood, you know, maybe slightly tilted towards more depression, you would have more accurate thoughts to some degree. But I don't know if that's necessarily always advantageous. Okay. In certain circumstances, it is adaptive to have some of those.

I guess my next question for you is, as a clinician yourself, how do you go about identifying these patterns of thinking in your clients? Right. So when I'm doing more of a cognitive approach, you know, and I'm asking them to kind of identify hot thoughts or those thoughts that are kind of associated with the depression or with the shame, we may actually, I may actually then, you know, ask them if any sort of cognitive distortions apply. And I may, I usually try to help them help themselves because, when I'm gone, I want them to be able to continue to be able to look at these cognitive distortions and to continue to be able to sort of bring themselves more towards truth. Okay. So you're trying to actually train the patient to almost become his own therapist in some way? Yeah, it's kind of developing a muscle.

The way that I see it, and in our partial programs, like those are day treatment, hospital programs. They do a lot of this sort of thing. And they do it over and over and over again. With the idea that if you do it over and over again enough, your brain is like a muscle, your brain will wire in new ways. And if your brain can wire that whenever you have like a distorted thought to kind of bring more accuracy or truth to it, that's going to help a lot. Got it. So could you kind of give me like a clinical example of you talking with the patient, identifying a distortion and then working with him or her to rectify it and learn to recognize it, him or herself.

Okay, so like, let's say, um, so let's say, I had a student come and they said that they failed an exam. Sure. And, uh, or a, uh, an attending gave them a little, a slight critical remark. Yeah. And so they felt, you know, very depressed and the sort of the hot thought we identify is, I am, I'm stupid. Yeah. Okay. And so what I might do is have, you know, them actually look at this list of cognitive distortions and look at like black or white thinking. And so like kind of look at the definition together, you know, black or white thinking, you know, you're basically taking something and you're going all bad or, you know, all good on it. You know, does that apply to this? And they'll go, yeah, you know, like I think, you know,

I did do a lot of other tests that were successful and I've been successful in undergrad. and, you know, I have had some mentors who really like working with me and who are really positive. And then we'll look at, like, the second one, overgeneralization. And, you know, are you overgeneralizing or, you know, kind of taking one statement and making it, you know, kind of a blanket statement for all realities rather than, like, seeing the complete picture of life and how you're doing here? and they may say, yeah, you know, I think that one applies to me also because, you know, I'm, I did do well on other tests and, you know, I did have other good experiences. So that one's fairly similar to black and white thinking. Another one is mental filter focusing on the negative rather than the whole picture. Okay, what do you mean? So you focus on that one negative, so like a mental filter, like a negative mental filter, like a negative mental filter. So basically, a filter is something that like blocks like bigger objects, right, from going through. So if you're like filtering out, you know, noodles, the noodles are not going through the water is, right? Right. So imagine the water here is those bad, critical remarks you hear from other people. Yeah. And the noodles is like the good

remarks. Okay. Or the neutral remarks. And so your mental filter only is, is the water hitting you. Yeah. And so you're completely filtering out the negative parts of the day or the positive parts of the day. You're filtering those out. I feel like, at least speaking for myself, I do that so naturally. Like, I will remember the one critical remark, you know, in 10 compliments. Like, is that just kind of natural to human psychology? It's like we pray on and obsess over negative aspects about us.

Yeah. You know, feedback, it's hard to get good at receiving feedback. I'm not sure how to become better at that other than, you know, just kind of a mindset change. Yeah. That like feedback is information. It's not good or bad. Maybe it's meant to help you grow. You know, all feedback is just information.

You know, we can like thank them for it and then think if we want to accept it later. Or bounce it off of like the other realities or other sort of, you know, so we're looking at, so we're not overgeneralizing that one piece of feedback. You know. Right, right. But that's hard. It's really hard. And I think it stops people from doing things. Really? Like, how so? Well, like, think about it. I mean, like, if you get some negative feedback from certain attendings, do you really want to go into their specialty? You know, do you really want to be on that rotation anymore? Do you want to show up and work hard for them? Yeah. I definitely had that experience with psychiatry last year. Oh, no. It kind of put me off the path for a while, but I know exactly what you mean. The emotional response to that and firing up all my own distortions can generate enough negative emotion to kind of sway my entire career path. And I'm sure I'm not the only one who's experienced that. Yeah.

So, okay, your question, though, is like, why do we have a negative mental filter? Yeah. And I think I think it's because it's sometimes it's like advent it's advantageous and adaptive for us to focus on

things that are going to put us in danger and things that are going to keep us alive. That makes sense. Right. So like if if you can see like that sort of piece of information as like, you know, often it may feel like this is a life or death situation,

you know, like, if I don't accept this feedback, I may die, you know, or like, I may not go on living as well. And so it's like, we may pay attention to that and it may sort of like, you know, light up our fear centers and our anxiety centers more. And it also comes against, like the way that we saw ourselves. So you may have seen yourself as like, I am a great potential psychiatrist, you know? And then there's like one piece of information kind of like pokes a hole in that.

And you're like, well, maybe this sort of image that I've had of myself is not true. So yeah, those can be difficult parts. Can I ask what the bad feedback was? Yeah, absolutely. it was it was somebody that I think I was trying too hard to impress because my advisor had said, hey, you really need a letter from this person. And so I think I just say that to kind of frame the emotional response to getting, you know,

like nine pieces of really good feedback from her at the end of the rotation. But this one piece that was like, hey, you, I think she said something like, I have a tendency to like speak over piece. or interrupt them, right? And that was like, and so she kind of like, it was more of like a character critique, right? And so it was like,

that hurts. Yeah, I know. Yeah. And I think, you felt like it was an attack on your character. It did. And, you know, I'm not saying she was wrong,

but I think that particularly like the way she framed it, kind of, or the way she communicated that feedback. It, it made me feel like attacked, you know, and I definitely felt like all the, you know, psychophysiological mechanisms activating and kind of a fight or flight almost response.

Because the image that I was telling myself about myself had been cracked a little bit, like you said. Yeah, I could see that that would be frustrating for you to receive that. Yeah. And I want to affirm that I've not experienced that same reality from you. I don't, I've never, that's never crossed my mind. Adam talks over me or talks over other people when I'm, Well, thanks, David. You know.

So. Now I'm going to be super sensitive. Yeah. Sometimes when we receive feedback like that, we need to sort of, you know, ask other people for truth. You know, like, hey, can you give me a piece of truth here? You know, help me out. Totally. Because I'm like going all black and white on myself, you know, and overgeneralizing.

And I have this negative mental filter. And I think especially when the feedback, like who the feedback comes from is huge as well, right? Right. Like if it's this person in my head who I've built up is this like, you know, person like this huge authority figure that I need to impress. And suddenly I'm getting, you know, condemnation. It's a lot worse than if it was like, you know, my, my nephew who said, stop interrupting me or something like that. Right.

And potentially also this person is between you and your goal. Absolutely. Of becoming a good psychiatrist and becoming a psychiatrist resident. Yeah. So you're like, okay, is this letter of recommendation going to have this piece of information? information in there. Yeah, exactly. Um, which, you know, would be like kind of a red flag for some like program director who's reading through it. Yeah. You know, if they're doing a closer read. For sure. But, um, yeah, wow. Okay. Yeah, that's kind of the, the med student experience and

probably other people's experience as well of perpetually trying to, you know, overcome this hierarchical nature and deal with the emotional feedback from that. Yeah, no, I think it's really hard to hear that feedback. So looking at the distortions we've gone over, do you think there was any, what kind of thoughts came after that? So you're at home thinking about things. Like what kind of thoughts were attached to that? Yeah, so I definitely identify a few of these. So like number five, like jumping to conclusions, I think applies to me.

because I think I did some mind reading of her, which is another one. It's a subcategory of jumping to conclusions. Because I think I interpreted that and I blew it up into, oh my gosh, you know, she thinks I'm a terrible applicant or I'm a terrible, I'd be an awful psychiatrist. So I jump to the conclusion that I'm no good for this line of work. Wow. You know, and I realize, and I think I realized in the moment that that's, you know, absurd. But no, but it's hard to feel that.

I mean, because then it's kind of like, yeah, it just feels really heavy. Yeah, and that can kind of go with all or nothing thinking. Like, I'm either, you know, a great med student, you know, five out of five or I'm, you know, this abysmal, you know, monstrosity, you know, that is, you know, terrible in teams, et cetera, you know. Yeah. Okay, so you're jumping in conclusions. Yes. All or nothing. All or nothing thinking.

Okay, any of the other ones jump out at you? Let's see. Emotional reasoning number seven, which kind of says, I assume that my negative emotions necessarily reflect the things, the way things really are. So I think I, because I had such an emotional response to that, my whole, like, career outlook in that moment felt bleak. because it was like even though it was just this tiny little moment and she was probably like genuinely trying to help me

but it felt in that moment like uh seeing through the cloud of my emotions it felt like you know the whole future was a lot less you know optimistic than it had been prior yeah you're not going to be you're not going to get a good letter yeah you're not going to she's going to tell everybody else in the department that I'm, you know, a flop, you know, things like that. No, I mean, that's like a real, yeah, that's a real concern at that stage, you know, when you get some negative feedback and I've definitely been there from, um, and I can, I don't even know if like I have that person, the right person in my mind who I'm thinking about, but there's other people who like, you know, oh, it's, it's so hard to, to hear that sort of negative feedback and then. Like, like, like, like,

about students or... Oh, about myself. Oh, about yourself. Yeah. I'm thinking like when I get, you know, negative feedback. Yeah. Yeah, it's like, should I be doing what I'm doing? Yeah.

There's the sort of imposter syndrome that creeps in. Like I'm an imposter. I'm not really, you know, as good as, you know, I'm supposed to be or as I should be. Oh, no. Totally. Yeah. Exactly. you know there's a yeah any other of them jump out we're looking we'll put these summary on the the show notes

yeah with the numbers so people can have that um i think the last big one that i'll identify that we we hit on was disqualifying the positive and that's really similar to the mental filter with the spaghetti metaphor that you used because it's like for example in my case there was an evaluation and there were like 10 items on there. Like, had a positive attitude, worked well with the team, showed up on time. You know, all these means of categorizing us. And it's like, you know, she liked me on a lot of them. You know, I was good on, but there was just that one.

And then that's, you know, the one that I fose to obsess over. Right. So it's definitely that I, my brain automatically disqualifies any positive feedback and hones in on the negative repercussions of that one. Yeah. Yeah. So disqualifying any positive feedback and just focusing on the negative would be a cognitive distortion. So, okay, so like if you were to summarize the statement at the time that you felt, what would that statement be? I think the statement for me would be, you know, because this attending says I'm, you know, a rude med student, I must be, you know, that's all that I am or I'm only a bad med student. Okay. Now, having some space from when that happened, and having looked at these cognitive distortions, how would you more accurately put that statement? Yeah, so I think I would reframe it with something like, you know, this attending, you know, made the comment that I did some rude gesture, or I did some rude, you know, actions, you know, in her presence.

and this may or may not reflect reality, but regardless, even if it does reflect reality, I'm still a successful med student and I can become better as a result. And that's not the only thing that defines my worth as an applicant, as a future psychiatrist. Good. I mean, that was probably longer than you meant, but...

No, I think that's perfect. I think that's perfect. And I want to affirm that. I think you're going to be amazing. amazing psychiatrist. Oh, thanks, David. That means a lot. I really believe that.

Yeah, I really believe that. Just a couple of other questions. Okay. Because, you know, these are, it makes sense when we're discussing them. But you mentioned that when you're dealing with clients who have issues like this, or honestly, even with me just now on that example, would you give me any, like, homework or things to work on when we leave this session, for example. Yeah, I think first of all, I recommend to have this printed out

and keep it in your pocket for at least the first couple weeks that you kind of are learning these, so that they're really like in your mind, you're looking at them whenever you have a thought, you can pull the paper out and kind of go through them and see which ones are the most distorted. And I would also recommend throughout the day to journal, like if you have any of those statements to simplify it as like I am a rude medical student.

Yeah. According to everyone. Yeah. Or something like that. Write down that. And then I have them write down, you know, all or nothing thinking over the generalization applies to this statement. So like kind of go through the list and write down. There's something about writing something down.

It takes it out of kind of the emotional abyss of the brain. and kind of makes it more concrete. So actually writing down which distortions apply and maybe even how they apply and then writing down a summary statement for like the most accurate version they can create.

Okay. So like what you told me, have them actually write that down. And the more that you do this, the more your brain will get used to naturally and without so much effort, coming to more accurate representations of reality. Okay.

So you're saying, so let's say I'm walking down, you know, the street and thought jumps in. Something reminds me of that experience. And I think, God, I'm a failure. I'm such a rude, bad person. Would you recommend in that moment or, you know, when I got home or whatever, then doing the journal thing? Or is there something then that I can do to? Yeah.

So, I mean, you could even. jump on your phone, your notepad on your phone, you know, pull out your list of cognitive distortions, write out, you know, I'm stupid, and then look at the cognitive distortions, I'm using a negative mental filter, all or nothing thinking, over generalization, you know, disqualifying the positive, you know, whatever they are for you, whatever you can sort of make sense of, and then trying to sort of create a more accurate statement. Okay, okay. And I would also say, like, this is something that if you are, if you are wanting to do this

and you're having a hard time doing it, then, you know, finding a therapist, having someone help you sort of look at the cognitive distortions and then come up with more accurate statements or at least look at your journal, see if you're doing it correct. There's workbooks that you can get. I'll put a list of them in the show notes. ones that I recommend to people.

When I Googleed this before the show, there's lots of like PDFs online that you can just like print off. Right. So yeah, there's lots of resources available, it seems. Yeah. And I would even make your own list. So like make, like write down black or white thinking

on a piece of paper for yourself and write what does that mean for yourself after looking at maybe some of the PDFs online. So it's, you own it. Okay. Yeah. Yeah, that makes sense. anything you feel like we haven't covered with cognitive distortions?

Let's see. I think that's good. Okay. Yeah, I think we covered some good stuff. I think there's probably more that can be developed, but I think that's a good start from that. You know, if you're listening to this and you have any questions, if you have any sort of particular petitions relating to this that you want us to cover on future episodes. I would love to hear back so you can put that on the website.

If you follow the show notes, the website and put in the comment section, that would be awesome. But thank you for listening and have a great day. All right. You know, after doing this and thinking about it for a couple weeks now before this episode, but as I brought this out to some patients, they initially didn't feel heard or understood in their sort of emotional experiences or predicaments. And I think we always have to start with the experience of the other

and validate and give empathy to it before we try to apply cognitive distortions to it or have them try to work it out because it can be a little bit jarring to the experience of someone, I think sometimes to just jump to that's not true. Let's look at how it's an error. So I think what's really important here is to start with connections, start with empathy, and then, you know, as you introduce this idea to someone that they could have distorted

thinking and that we're going to be applying, you know, some sort of rules and looking at how we can best move towards more accurate thoughts, that's sort of a process. And if you are doing this with someone else and they recoil from the sort of, you know, sharing of here's some cognitive distortions, you might need to introduce it in a different way or kind of introduce it slowly, you know, having the person kind of own their experience and not just pointing out, you know, this is a cognitive distortion here or there. Okay, on that note, we are going to end this session. And thank you, Adam, for joining us. And, you know, if you have any questions, once again, please post them either on the website or on my Instagram on the post related to cognitive distortions.

And I would love to hear your questions, your thoughts. Hopefully this was helpful for you. If it was, if you share it, that would be awesome. If you leave me a review on Stitcher or, iTunes or wherever you're listening to this, that's a good review. I would be most grateful. All right, have a good day. Once again, if this podcast was of help to you, I'm leaving in my show notes a free resource, which is an eight-day assignment, kind of working through some of the principles that will allow you to move away from some of these negative feelings and towards

gratitude. And if you're a mental health professional, it's really good to practice this yourself so that you can better be able to help other people. And if you, or someone just listening to this, curious about mental health, this may be a perfect resource for you to really bring these on a practical level into your life.