Dysfunctional thoughts: what they are and how they are treated in therapy

We know that reality can be interpreted in endless ways and that there is no “one reality”. However, it is also true that distorted processing of information can lead to dysfunctional and erroneous thoughts, which can cause significant discomfort to the person having them.

To deal with it, cognitive therapy is usually the most used. In this article we will learn about the characteristics of dysfunctional thoughts, How they are born, as well as four effective techniques that allow them to be worked on and eliminated, replacing them with more realistic and functional thoughts.

    Dysfunctional thoughts: definition and characteristics

    Dysfunctional thoughts, also called automatic thoughts or automatic negative thoughts (AP), are a concept proposed by Aaron T. Beck, A leading American psychiatrist and professor.

    A. Beck he was a pioneer of cognitive orientation in the field of psychology as well as cognitive therapy, And describes dysfunctional thoughts as the result or product of distorted processing of reality. According to Beck, this erroneous treatment (which he calls cognitive distortion) ends up giving rise to a series of thoughts which bring no benefit to the patient, and which ends up moving him away from the most “objective” reality.

    The basic characteristics of dysfunctional thoughts are: they are specific, concrete messages; they are believed by the person although they are irrational and not based on evidence, and they are spontaneous, involuntary thoughts and therefore difficult to control.

    An example of dysfunctional thinking would be thinking, “If I go to the pool, I’ll have a fatal time” (because you’ve been there before and had a bad experience), or “I’m not worth anything,” presentation fatal “,” I don’t like anyone because everyone looks at me badly “, etc.

    In other words, that is to say they end up being thoughts that bring no good to the patient (This is why they are dysfunctional), which generate unnecessary discomfort, and which only perpetuate more dysfunctional thoughts.

    Where do they come from?

    As we have seen, to arrive at dysfunctional thoughts, the processing of prior information must be incorrect (Or be distorted): These are Beck’s so-called cognitive distortions.

    Thus, the way of thinking of a person with dysfunctional thoughts will be characterized by the presence of systematic errors in the processing of information, which implies that reality is misinterpreted, or that we only look at it. part of ‘her to assess an aspect, etc.

      How do they work in the mind?

      There are many types of dysfunctional thoughts, depending on their characteristics. Also, a common feature of dysfunctional thoughts is that they end up promoting the perception and memory of congruent stimuli with erroneous patterns; that is, the person ends up paying attention only to aspects of reality that they have already distorted, establishing a kind of “vicious circle”.

      In this way, the following would happen: the person misinterprets reality (by drawing wrong conclusions, for example), pays more attention to the distorted aspects of it, and also remembers it more compared to other undistorted aspects.

      Dysfunctional thoughts they can appear in “healthy” people and in people with a depressive or anxiety disorderFor example (in the last two cases these thoughts are usually more frequent, more intense and more numerous).

      The result, both in healthy people and in people with mental disorders, is generally similar (although it varies in intensity), and is a distorted view of reality, which leads to a negative state. , maladaptive or depressive and / or anxious symptoms. .

        How can they be treated in therapy?

        Psychological therapy, in particular cognitive therapy, is indicated to treat dysfunctional thoughts, especially when they cause problems and / or significant discomfort to the sufferer.

        From there it is expected help the patient develop a set of basic assumptions and more realistic thoughts, Which allow you to make inferences and evaluations of vital events best suited to your goals.

        Cognitive therapy is a good option for treating and modifying dysfunctional thoughts. This therapy is used especially in patients with depression who also have noticeable dysfunctional thoughts.

        Cognitive therapy it is generally used when the patient already has a certain level of functioning; we note this, because in the early stages of depression, and even more so if it is severe, it is common for the person to be totally apathetic and unwilling to do anything; this is why initially, it is better to opt for behavioral techniques that activate the patient, then gradually incorporate cognitive techniques.

        Cognitive techniques are based on guided discovery (Also called collaborative empiricism), which offers the patient an active role in their recovery and improvement, and in which the therapist will gradually help the patient to be the one who finds his own solution, as autonomously as possible.

        Specific techniques

        Within cognitive therapy, we find different techniques or tools that we can use to deal with dysfunctional thoughts. Some of them are:

        1. Daily recording of automatic thoughts

        Dysfunctional thoughts are also called automatic thoughts or negative automatic thoughts. As we have seen, these are thoughts and images that are often distorted and generally negative for the patient.

        They arise from the interaction of information provided by the medium, the patient’s schemas, their beliefs and the cognitive processes they use. This is easily accessible (automatic) thoughts at the level of consciousness (In other words, they come to mind quickly and automatically, virtually untreated). Thus, automatic thoughts are generally negative (negative automatic thoughts [PAN]), Especially in depression.

        PA recording is a technique generally used during the first sessions of cognitive therapy, and which this implies that the patient records the dysfunctional thoughts that he has on a daily basis at all times, in order to become aware of them and clearly identify which they are. This technique is initially applied to supplement others that allow you to explore these dysfunctional thoughts.

        2. Search for interpretations / alternative solutions

        This second technique allows the patient to study new interpretations or solutions to complex situations.

        Within it, the “two-column technique” is often used., Where the patient has two journal columns; in one, he writes the original interpretation or dysfunctional thought he has in relation to a situation, and in the other, he writes possible alternative interpretations.

        It can help you explore new ways of interpreting things (more functional and adaptive ways), away from the initial dysfunctional thoughts that caused you discomfort and emotional states that you didn’t understand.

        3. Four question technique

        this technique part of questioning the evidence in favor of maintaining some dysfunctional thinking to generate more realistic or useful interpretations. To do this, the patient is asked the following questions:

        • How well does your thinking reflect reality itself? (You will need to mark from 0 to 100).
        • What is the proof of this belief or thought?
        • Is there another explanation?
        • Is there an element of reality in an alternate belief or thought?

        From the patient’s responses, dysfunctional thoughts can be worked on; explore why they originate, what determinants precede them, what alternative thoughts exist, and so on.

        In addition, the technique of the four questions helps the patient to maintain an active role in the therapeutic process, Question the veracity of your thoughts and look for alternative explanations.

        4. Three column technique

        this technique allows to identify the cognitive distortions of the patient (Remember, a type of treatment that ends up giving rise to dysfunctional thoughts), to later change the patient’s distorted or negative cognitions.

        It consists of a table of three columns on a sheet of paper: in the first column the patient records the cognitive distortion he has (after a process of teaching them), in the second, writes the dysfunctional thought that this distortion generates, and in the third writes an alternative thinking, which will replace dysfunctional thinking.

        Bibliographical references:

        • Bas, F. and Adres, V. (1994). Cognitive behavioral therapy for depression; a treatment manual. Behavior and health therapy.
        • Caro, I. (1998). Manual of cognitive psychotherapy. Paidós.
        • Ruiz, M., Díaz, MI, Villalobos, A. (2012). Manual of Cognitive Behavioral Intervention Techniques. Bilbao: Desclée de Broumer.

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