5 Limitations to Cognitive Behavior Theory
Has anyone ever told you to “stop thinking negative?” What about telling you: “you are so pessimistic, can’t you ever be positive?” Another great one people say is: “look on the Brightside!” If you’re like me, you hate hearing these things because they have a way of shutting you down, undermining your very real feelings. This “positive philosophy” actually started with cognitive psychiatrist, Aaron Beck, who believed that humans engage in a series of thought processes or thoughts (cognitive distortions) that lead to depression and a host of other negative outcomes such as poor physical health and anxiety.Beck identified multiple types of negative thinking that often lies beneath many of the problems client’s come into therapy with. Cognitive therapy or Cognitive Behavior Therapy (CBT) aims to help people identify incorrect ways of thinking and “dysfunctional” behaviors that result from that incorrect thinking. In other words, if you think something, your behavior is likely to follow that thought. For example, if you think “I truly hate my sister-in-law because she’s so selfish” your behavior will most likely include slamming doors when around her, ignoring her calls, or treating her with disrespect. The negative ways that you perceive this sister-in-law often leads to those negative thoughts and behaviors.
Negative thoughts and behaviors have an affect on your mood. This is often regarded in CBT as the “thought triangle.” Your thoughts, feelings, and behaviors all influence each other. Those negative thoughts might get so bad that you begin to exaggerate everything that has anything to do with this sister-in-law. For example, consider that you are going to meet your sister-in-law for dinner at a restaurant. Imagine that you agreed to meet at 7:30 and have been waiting for her for over 20min and she decides to call you at 7:55 to cancel. How would you feel about this? Most people would not only be angry, but also engage in mental filtering such as thinking over and over “I cannot believe she stood me up!” You might think this all night and even wake up thinking the same thing as well. Or, for example, you might think about your sister-in-law standing you up in black and white, all or nothing ways, vowing not to ever give her another chance at standing you up.
The main focus of the CBT model is to point out unhealthy ways of thinking and viewing the world. The theory almost blames you for having what it calls “negative thoughts” by calling these thoughts “distortions.” There are multiple weaknesses to this theory that often interferes with it truly helping clients struggling with real life and real thoughts that they do not believe are distorted. For example, the cognitive distortions theory doesn’t consider:
- Age of client: Some client’s due to age or immaturity will have a tough time seeing how their thoughts are distortions.
- Socio-economic status: Some individuals do not believe they are viewing their situation in distorted ways. For example, a single mother receiving supplemental government aid (or food stamps and SSI) might truly believe that if she loses this financial support, she will be homeless. A CBT therapist who adheres 100% to the cognitive distortions theory, might imply that this mother is magnifying her situation and attempt to “change” this mother’s perspective.
- Culture: Certain clients who adhere to certain cultures such as the Native American culture, Hispanic culture, or even religious culture (e.g., Christianity) might have certain beliefs that could appear to be cognitive distortions.
There are certainly limitations to this theory and the first limitation is that we should change the way we think to change how we behave and feel. This isn’t always as easy as it might appear. Despite this limitation, CBT has become the #1 treatment of choice for many disorders. It is indeed popular. However, in my practice, I have identified a few weaknesses with the theory of cognitive distortions.
There are multiple types of cognitive distortions, but the 10 most common include:
- All or nothing/ black or white thinking: This type of thinking is “my way or the highway.”
- Should statements: “I should always be first,” “I should never take 2wks vacation.”
- Magnification/minimization: You exaggerate certain events or the negative and minimize (the “I don’t care” attitude) a situation.
- Over-generalization: You view a single situation (positive or negative) as never-ending, something that could happen again.
- Mental Filtering: You dwell on a single negative occurrence and focus in on it like a target. You can’t get your mind on other things. “Did you see how she looked at me!!!!”
- Labeling or mis-labeling: Instead of describing the situation for what it is (e.g., you filed your taxes too late), you begin to see yourself as the problem (“I’m so stupid, why can’t I ever do this earlier”).
- Emotional reasoning: You feel that your negative emotions reflect the truth, not error.
- Jumping to conclusions: You immediately believe the worst without first considering all the facts of the situation.
- Mind reading: “I know she thinks I’m crazy because of how I look today.” Have you ever said this? Mind reading occurs when you think you know what someone is thinking about you without you checking the facts
- Fortune Teller: You feel that something negative will happen without considering that perhaps something positive may happen.
- Personalization: You see yourself as being the reason for negative events.
- Disqualifying the positive: You point out all the negative facts without looking at the positive. You miss your beautiful daughter in her wedding gown because you just can’t get over her new mother-in-law.
Cognitive distortions can be very powerful and controlling of our emotions and lives. While I love this theory and often use it with many of my clients, I believe there are 5 weaknesses to this theory that we should all consider:
- It almost disqualifies emotions: One client once said to me: “we’re always talking about thinking, when are we going to talk about what I’m feeling!” She was right.
- It’s too logical or abstract: Some people respond better to therapy that focuses on emotions rather than thinking. For example, certain cultures may prefer talking about what is felt rather than what one is thinking.
- A person may feel blamed: It’s all too easy to feel negative about our own thinking patterns. It’s even more difficult to have someone tell you to change your thinking because “something is wrong with YOU.” Making someone aware of their negative thinking patterns may make the person feel blamed or accused of feeling the way they feel.
- It might exclude culture/ethnic origin: Some ethnic cultures place a lot of emphasis on emotional reasoning. Part of my culture is Native American and many use “discernment” to identify problems or resolutions. Emotional reasoning is sometimes more useful than facts alone. We can definitely use our emotions to guide us sometimes.
- Thinking is difficult to change: I’m sure you can agree. It’s always easier to identify what the problem is, but struggle to change it. Cognitive therapy is used in addictions and depression treatment. But for many people, it’s difficult to change thinking because it’s so powerful.
The limitations of this theory are important to keep in mind if you or a loved one is seeking psychiatric treatment or counseling. Your therapist or doctor should certainly have a balanced perspective about this theory. There are thousands of mental health professionals among us, but there are only a few really good ones. Take your time and look well.
All the best
Editor’s note: This article was originally published March 21, 2014 but has been updated to reflect comprehensiveness and accuracy.