Misconceptions And Objections About Cognitive Restructuring In Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is a widely-used, well-researched counseling and self-help approach that aims to improve a variety of mental health issues by addressing the counterproductive thinking and behavior patterns that contribute to them. Its core tool to tackle maladaptive thinking is cognitive restructuring. To give a simplified version, cognitive restructuring teaches people a bunch of skills and mindsets so they can do the following:
- Identify the thoughts you're having about a problem area or situation (e.g., Liam asks a classmate to get coffee, and she says she's too busy for the next few weeks. He thinks, "She hates me. I'll never make any friends.")
- Identify any distorted, irrational thinking in those thoughts (Liam is Mindreading by assuming he knows why his classmate said she was busy. He's Fortune Telling and Catastrophizing by concluding this one incident means he'll never have a social life.)
- Take an objective stance and try to figure out if your thoughts and beliefs are accurate (Liam concludes he can't know for sure what his classmate was thinking, and that one declined invitation doesn't mean he'll never make friends.)
- Come up with a more-balanced, adaptive way of looking at the situation (Liam tells himself going forward if someone tells him they're busy, he can't know for sure why they're saying that, and that he can always try again later.)
Even if they haven't heard the formal term cognitive restructuring, many people have come across its concepts in one place or another. Lots of us also intuitively grasp that the way we think about a situation can have an impact on how it plays out.
However, some people have looked into CBT cognitive restructuring, and were put off because they got an incorrect sense of its core ideas. Others have tried it, either with a therapist or on their own with a book, and parts of it rubbed them the wrong way.
This longer, in-depth article will cover these misconceptions and objections. I'll share what I know about the cognitive restructuring part of CBT, and do my best to correct any mistaken views of it. As you'll soon see, I'm not coming at this from the angle that CBT is flawless and a fit for everyone, if only they learned enough about it.
Misconceptions about how cognitive restructuring works and what it wants to accomplish
Some of these misconceptions don't come from anything Cognitive Behavioral Therapy directly claims. It's more that if a book or therapist is teaching cognitive restructuring they'll focus on certain skills and concepts, and won't cover others. People can read into that and get inaccurate ideas about what CBT says it can and can't do.
"Cognitive restructuring is meant to be the only way to handle difficult emotions or life problems"
Cognitive restructuring is one psychology tool of many. Sometimes it's a very useful, appropriate tool. It's a tool with lots of research backing it up. But it's not the best choice in every situation. Some counterproductive thoughts and assumptions can be changed by logically dissecting them. For others you can reach a state of, "I intellectually know this fear is irrational, but I still feel it." In that case it might be more helpful to accept you're thinking like that and not try to fight it, but still vow to act in a way that's in line with your long-term goals. Longer term, you could try to address the emotional wounds from your childhood that make your fear seem so real.
There are other valid ways to get yourself through a rough patch that don't involve tackling your thoughts. The best move isn't always to pull out a CBT worksheet. Sometimes it's more appropriate to just let yourself be sad and mope around for a few days, or take a Friday off and go for a hike, or vent to your friends. At other times your stress is caused by a legitimate outside problem, and the easiest path to feeling better is to fix it. Not every issue is caused by irrational thoughts, and not every problem is resolved by addressing them.
Not only that, but cognitive restructuring is often meant to be used with interventions that target your behavior (i.e., the Behavioral part of Cognitive Behavioral Therapy). If you have anxiety, it's usually not enough to know in theory your fears are exaggerated. You have to face them in real life and learn firsthand you can manage. If you're depressed you may need to start taking steps to solve real world sources of unhappiness, or change how you spend your time so you do more things that make your life enjoyable.
"Cognitive restructuring is meant to totally eliminate difficult emotions"
Sometimes someone will be anxious about something, use cognitive restructuring techniques on their thoughts about it, then feel discouraged when they're still nervous. The rare time a fear will totally go away after subjecting it to some logical scrutiny, but it's usually not that easy. More often, what cognitive restructuring can do is reduce the intensity of an emotion. More importantly, it may lower the intensity enough to make a practical difference in your life.
For example, someone's scared to talk to strangers at a party. If they do nothing about their anxiety, it will stay high enough that they won't speak to anyone. After doing some cognitive restructuring on their worries, they're still nervous about holding a conversation, but they're able to do it. The chit chat they make isn't the most comfortable or fun ever, but it's a good first step. At least they're out there practicing and getting used to it. With enough of that hands-on experience their social anxiety will drop even further.
"Cognitive restructuring is about shutting all emotion down with cold, hard logic and rationality"
The cognitive restructuring process is logical and analytical. But that doesn't mean it wants to toss emotion out the window. First, emotions, pleasant and unpleasant, are just part of being human. It's impossible to transform yourself into an unfeeling, purely rational android. Emotions can also be really useful. They can let us know something is wrong and motivate us to act.
As I wrote a minute ago, cognitive restructuring is just one tool, and not always the first one you should use. Sometimes when you're sad, angry, or stressed out, the best thing you can do is acknowledge you feel that way, realize it's a reasonable reaction to what's happening, and let the feelings run their course. Maybe you can do something nice for yourself to feel better and take your mind off things for a while. If you try to tell yourself the emotion is irrational and brush it aside, it will come out another way. You can examine your thinking for cognitive distortions later on.
"The final goal of cognitive restructuring is to get to a point where you never have any irrational, counterproductive thoughts"
Cognitive restructuring can reduce the amount of unhelpful thoughts you have, but it's not realistic to think they can be purged altogether. No one's perfect. We all think in unrealistic, illogical ways sometimes. It's how our brains are wired. The goal isn't to stop that kind of thinking entirely, but to learn to catch more of it, so we can make better decisions.
If you believe the goal of cognitive restructuring is to gain total mastery over your thoughts, you'll feel like you're constantly waging a losing battle against your own mind. No one can keep that up for long, and you'll feel defeated and quit.
"With cognitive restructuring, once you know that a thought is irrational you'll stop having it"
People can feel let down by cognitive restructuring because they'll have an anxious or hopeless belief, spot that it's irrational and identify the cognitive distortion it contains, but then be disappointed when it still affects them. Recognizing that a thought is irrational and counterproductive is an important first step, but the claim isn't that that alone will clean up your thinking. The other parts of the process are to objectively dispute your beliefs, and see what alternative, more-helpful conclusion you arrive at. As I already mentioned, you may then use other parts of Cognitive Behavioral Therapy, like facing your fears, to address your issues more. Even then, the thought may never be banished altogether. It just won't be as able to derail you.
"Cognitive restructuring is about forcing yourself to be mindlessly positive"
When people first start practicing cognitive restructuring it can feel like the process is trying to railroad them into putting a positive spin on everything bad that happens in their life. It's really about learning to look at things in a balanced, rational, objective way. If your starting belief is overly negative and pessimistic then the objective alternative is usually more positive in comparison, but the idea isn't to be optimistic for its own sake. Being positive is only warranted if the evidence backs it up. The point is not to list a bunch of things you wish were true, then tell yourself they are.
Sometimes you'll objectively analyze your negative thoughts about a situation and realize they're true. For example, Ava believes her friends are mad at her. She examines the evidence for and against this belief and concludes they really are annoyed at something she did. In that case being blindly positive and telling herself they aren't mad would be the irrational, counterproductive option.
"Cognitive restructuring is about suppressing your counterproductive thoughts"
Some people think cognitive restructuring means realizing you're having a maladaptive thought, then using willpower to force yourself not to think it anymore. However, it's impossible to totally suppress your thoughts. In fact, trying not to think about something can backfire and make you focus on it more. Cognitive restructuring isn't asking you to stop thinking unhelpful thoughts entirely, but when they do come up, to critically examine them rather than automatically taking what they say at face value.
"Cognitive restructuring is just repeating positive affirmations to yourself"
Positive affirmations are statements, like "I am a magnet for ideas" or "I love who I see in the mirror", that you repeat to yourself several times a day. The theory is with repetition you'll eventually start to believe them and your self-image will improve (it's debatable whether they work, but that's a tangent).
When you do cognitive restructuring and come up with an adaptive, rational alternative to a distorted belief, it can take the form of a succinct, upbeat statement you can repeat to yourself to help you get through tough moments. Two examples are, "Just because I get nervous doesn't mean the conversation is ruined" and "I've been nervous and still had good conversations many times in the past". But these phrases aren't just traits you wish you had, that you hope to get by reciting them every morning. They're helpful, balanced conclusions you reached after looking at your circumstances objectively.
"Cognitive restructuring is all about trying to make yourself feel better in the moment"
It's understandable that if you're feeling a distressing emotion you want relief from it right now. Sometimes cognitive restructuring skills can help with that, even if they can't get rid of the feeling altogether. At other times analyzing and examining your thoughts doesn't help a ton in the moment, but it can set you up to make useful changes down the road.
Like Liam from the start of this article who feels bad about having his invitation declined; analyzing his thoughts may not make him feel much better right then and there. He's disappointed about being rejected, and just has to let the feelings pass on their own time. Though cognitive restructuring may help him develop a more resilient, optimistic mindset about asking other people to hang out in the future.
"Cognitive restructuring just wants you to change your attitude about your problems, not actually do anything about them"
If you're depressed and anxious because you're in debt and about to get kicked out of your apartment, you have a real world problem you need to solve. The answer isn't to do nothing about the situation except try to think positively about it. If someone's in financial trouble, some of the worried, pessimistic thoughts they're having are accurate. They should act on that thinking and make concrete changes.
That said, some other thoughts about their finances may be distorted in a way that makes their distress level higher than it has to be (e.g., if they catastrophize and tell themselves they'll never be able to find another place to live). It never hurts to address those thoughts, but it isn't the complete answer.
Analyzing your counterproductive thoughts gives them too much power. It's better to change your relationship to them
CBT is just one type of therapy. There are other approaches that argue that many of our self-sabotaging thoughts are just mental noise, generated from a part of the brain that has nothing better to do. Grinding everything to a halt to dissect them everytime they appear is giving them too much credit. It's reinforcing the idea that they're worth taking seriously. That and our fears and insecurities are often laced with irrational emotion, which doesn't care about reason and evidence. It's better to quickly acknowledge these thoughts, then get on with whatever we were going to do anyway (which isn't the same as forcing yourself to push them away).
Again, sometimes this angle fits, sometimes it doesn't. As I've said, some thoughts respond well to being picked apart. Others seem immune to logic. In that case it can be more helpful to think, "If I'm going to have this thought that's okay, but I'm not going to stop acting in my best interests just because it wants me to."
Examining your distorted thoughts is only focusing on the surface-level symptoms
The argument here, which can come from therapists with different orientations, is that if someone thinks about something in a self-sabotaing way, that's a sign of a deeper issue, like an unresolved trauma. Trying to disarm individual thoughts is getting stuck at the surface-level symptoms. If you treat the underlying problem the thoughts will become more healthy on their own. If you don't, you can logic away maladaptive thought after maladaptive thought, but the core issue will keep generating new ones.
The CBT retort is that inaccurate beliefs and distorted thinking can be the core problem. They're what every other symptom flows out of. A traumatic event may have created them, but it's the beliefs themselves that are driving all the misery in someone's life, and that's what treatment should address. It comes down to what theories you subscribe to about what's going on under the hood.
It doesn't have to be an either-or choice. Many therapists see value in healing the trauma around difficult events, using other methods, and the beliefs they create, with a CBT approach. As always, clients differ in what methods speak to them.
It also isn't the end of the world even if a tool only does attend to surface symptoms. Learning cognitive restructuring, or some relaxation exercises, may not resolve someone's core baggage, but it can make them feel a lot better day to day.
"Cognitive restructuring homework requires you to record and analyze every thought you have"
Cognitive restructuring usually assigns homework where you practice analyzing and disputing your anxious or depressed thoughts. That does take time and effort. However, some people are put off by CBT because they think it will ask more of them than it actually does. Yes, the therapy does have worksheets that ask you to record some of your thinking, but they won't ask you to write down and dissect every last thought that passes through your head for weeks on end. No one can do that, or do it for long without getting burned out.
Common objections to cognitive restructuring from people who have tried it and didn't like aspects of it
Some people have no problem with CBT and cognitive restructuring in theory, but once they do it they don't like everything about the experience. Here are some typical negative reactions:
"Cognitive restructuring feels invalidating"
It doesn't feel nice when you have an emotional reaction to something, only to be told your response is unreasonable. Even if you know on some level the other person has a point, it still stings to have your feelings invalidated. Cognitive restructuring can feel like that. You tell your CBT therapist how you feel about something, and they start pointing out how your emotions are built on a bunch of iffy assumptions. If you were often dismissed by friends and family for being "irrational" and "overly emotional", it can bring up painful memories when it seems like your counselor is doing the same thing.
For some people that sense of having their feelings invalidated leaves too much of a bad taste in their mouth, and they try another treatment approach. For those who want to stick with it, they can reduce that vibe that cognitive restructuring is invalidating. The most important thing is to acknowledge that any emotion is valid to feel in that moment, even if it is "irrational". If something makes you anxious, it makes you anxious. That's what you're currently feeling. There's nothing wrong with that. And maybe it did arise due to some faulty assumptions, and examining them could reduce your nerves going forward. That doesn't change that you're hurting right now.
"Cognitive restructuring feels like you're being attacked and put down"
To some people having their distorted thinking pointed out feels like someone is saying, "Well, well, well. Look at how stupid you are for having that cognitive error. Oh look, there's another one. You screwed up again, idiot." If they're working with a counselor, they can feel attacked by them. Or it can seem like the cognitive restructuring process is asking them to dump all over themselves (something they may already do too much of, and hoped therapy would help them stop).
If someone's been bullied and insulted for most of their life, it can feel like CBT is opening old wounds. Maybe your parents used to constantly criticize and shame and belittle you. Now it seems like cognitive restructuring is giving the therapist that role, or asking you to do the job.
Learning to recognize your distorted thinking isn't meant to make you feel bad about yourself. Every human being sometimes thinks in inaccurate, irrational ways. It's how our minds work. It takes dedicated therapies like CBT to teach people they can think differently. It can be useful to learn to recognize those tendencies, but no one's a weak failure for having them in the first place.
"Cognitive restructuring feels like you're being blamed for causing all your own problems with your irrational thinking"
Cognitive restructuring and CBT can seem like they're sending the message, "Your anxiety and depression are all your fault. You brought it on yourself because you think in such an irrational, self-sabotaging way. If your thinking was better you wouldn't be in this mess."
As I said in the point above, it's the human default for our thinking to sometimes lead us astray. No one's to blame for that. If you've survived some really difficult experiences, that can slant your mindset in a pessimistic, bitter, or self-blaming direction, but that's not your fault either. You couldn't help it if some bad things happened in your past, and you came to some negative conclusions about the world (ones that made perfect sense at the time considering what you went through).
If someone gives CBT an honest try and their mental health doesn't improve, they can feel like they failed for not properly learning how to corral their thinking. First, maladaptive thoughts contribute to various problems, but aren't the sole cause of them. Second, there are many other reasons a course of therapy or self-help may not work, aside from anything you did.
"It's irritating to have your irrational thinking pointed out to you"
Aside from feeling emotionally invalidating, cognitive restructuring can also be annoying in the sense that it's irritating to be corrected. Even if they don't mean it that way, when a therapist spots a cognitive distortion in your thoughts, it can feel like they're one of those pedantic, know it all types going, "Um, technically the expression 'blind as a bat' is false. It's actually a myth that bats have poor eyesight." Again, some people can't get past this aspect of CBT. Others learn to get used to the treatment's nitpicky aspects, even if they never love it.
It can also be exasperating when you're expressing an emotion because you want to vent, or would like some empathy and support, and the other person goes into Problem Solving / Solution Giving Mode - "Agh, I'm so stressed out. I'm so dumb. I'm never going to pass my exams!", "Hey, hold on. You're Labelling and Fortune Telling. That's not a productive way to think. Looking at it logically, what are the odds you'll fail all your exams?" As I keep saying, cognitive restructuring has its time and place, but isn't the right tool for every situation.
"Cognitive restructuring is patronizing and simplistic"
Some people feel irked by CBT because it seems like it's telling them obvious things they already know - "Yes, Mrs. Therapist, I'm aware that the way I think about things can affect my mood. Why are you lecturing me in a self-satisfied tone as if I've never thought of this before?" Though while many people already know the basic theories behind cognitive restructuring, most don't know the full process, or haven't tried using it.
"Cognitive restructuring just leaves you in a state where you know what you're doing is technically irrational, but you still can't help but do it"
Unhappy CBT clients will say things like, "Okay, so I know my social anxiety isn't logical. But I'm still scared of people. How does knowing I'm irrational help me?" I've answered this in earlier points, but I'll mention it again:
- Cognitive restructuring is one of many tools. Some thoughts and beliefs don't respond that well to its logical analysis method, but there are other options.
- Cognitive restructuring usually won't eliminate an unpleasant emotion entirely, but it can reduce it. Maybe in one situation it lowers your anxiety by 15%. That's not much, but every little bit helps.
- Cognitive restructuring often works best when it's combined with behavioral approaches, like facing your fears. Just learning a thought is irrational may not help much on its own, but can help get you ready to do things like exposure therapy.
"Cognitive restructuring feels like you're lying to yourself, like you're trying to talk yourself into something you don't really buy into"
People can have self-defeating worldviews they believe very strongly. Everyone around them can see that their beliefs are false, irrational, and self-sabotaging, but they don't look at it that way. They may feel like they have a lifetime of "evidence" that supports their outlook. A small piece of them is open to the hypothetical possibility that their views are distorted, but for the most part they believe them. Trying to analyze and logically dispute these beliefs just feels wrong to them. It can feel like they're trying to convince themselves the sun is square.
For some of these people, CBT never clicks, and they move on. Others give the process more of a chance, and gradually start chipping away at their unhelpful beliefs. They don't cast them aside altogether, but they become less rigid ("Okay, maybe not everyone is unfriendly, but still, most people are. But I'll focus my efforts on the handful who aren't jerks.") They can also keep a belief, but productively change some assumptions around it (e.g, "I still think people are unfriendly, but I now realize I can handle that unfriendliness and still live a good life, whereas before I thought I couldn't.")
Some get to that place I've already mentioned, where they can logically admit their belief is inaccurate, but they still can't help but have it. They may find it's a better use of their energy to try to act in productive ways despite having the belief, as opposed to trying to change it.
Another thing I mentioned earlier is that cognitive restructuring isn't about forcing yourself to come to a particular conclusion, but to see what the real world evidence says. You shouldn't start from a mindset of, "Of course this belief is false. Let's disprove it." You should acknowledge the belief could be true, but be open to examining all the evidence for and against it, and seeing how it shakes out. If it turns out your "irrational" belief is actually true, the question becomes how you're going to work around that state of affairs.
"Cognitive restructuring works fine when you're calm and can think about things rationally, but you can't do it when you're feeling really angry, depressed, or anxious"
This is true. Anyone who's had a panic attack knows they can't logically talk themselves into calming down. All their thoughts skew toward, "Everything is going wrong!!! Everything will go wrong!!!" When we're in the grip of a strong emotion it's hard to think rationally and objectively. (That goes for pleasant emotions as well. When we're really happy we tend to be unrealistically optimistic and confident.) Cognitive restructuring doesn't work as well then either.
Even if it's much less effective when you're emotional, cognitive restructuring may still have a small benefit and be worth doing. If you're feeling super-anxious, even taking it down by 10% can be a relief. Overall though, it's best to do cognitive restructuring when you're calm and levelheaded, and hopefully learn things from it you can then put to use when your feelings get more intense. And as I keep harping on, CBT isn't always the best option. If you're really amped up and emotional, it's often better to use other techniques, like doing some breathing exercises, going for a run, or quietly sitting with the feelings until they naturally pass.
"Cognitive restructuring feels unnatural. It's hard to tune into the thinking underneath your problems"
Some people get frustrated with cognitive restructuring because it doesn't come easily to them. They know they're scared to, say, go to the mall, but they're not sure why. If a counselor or self-help workbook asks them to identify the thought that sets off their fear, they can't say what it is. They feel discouraged because they've hit a wall at the first step in the process.
Like any skill, cognitive structuring comes more naturally to some of us than others. Some people are introspective and psychologically minded, and have an easy time tapping into and analyzing their thoughts. They may even be too good at it, and prone to overthinking everything. For others, they're not as tuned into the dialogue going through their heads. With practice, many of them can get better at tapping into their thinking. Others never get the hang of it, and decide to go another route.
"Cognitive restructuring can turn you into even more of a navel-gazing overthinker than you already are"
Some people analyze themselves too much. They may endlessly examine their lives because they hope they'll have a sudden, earth shattering insight that will fix all their problems. They may put off making other changes, because they believe they have to exhaust all the possibilities of introspection first. Cognitive restructuring, with its focus on recording and scrutinizing your thoughts, can play into this unhelpful tendency. If someone doesn't know the process, it can be useful to learn, but they shouldn't do it excessively, neglect other tools, or spend so much time overanalyzing their cognitive patterns that they don't move onto other steps, like making behavioral changes.
"Learning cognitive restructuring is tedious"
Learning cognitive restructuring often involves filling out homework worksheets where you track and analyze your thoughts. To be frank, doing all that can be boring and annoying. However, that doesn't mean it's not worthwhile. It can also be tiresome to endlessly play guitar scales, throw left hooks, or shade cubes and cylinders. Cognitive restructuring isn't the funnest thing ever to learn, but after a while the skills become more ingrained and intuitive.
"Learning how to do cognitive restructuring takes too long"
It takes most people a month or two of practice and homework to get the hang of cognitive restructuring. After that, it can take longer to get noticeable results. You may then have to take your cognitive restructuring skills, and use them to help you face your fears in real life for a few more months, which is where the bigger changes will come. I don't think that's "too long" in the grand scheme of things. Many skills worth learning take a while to pick up. Unfortunately, there's no quick, simple fix to complicated problems like anxiety or depression.