Information Processing in CBT

I often give examples of what patients should expect in Cognitive Behavioral Therapy and how it might differ from other kinds of supportive talk therapy they’ve received in the past.  I usually highlight the importance of identifying and evaluating the way that a person thinks, particularly in situations when they’re most distressed.  We can learn a lot about common assumptions and beliefs a person may hold about themselves, their environment and their future simply by monitoring their conclusions during the times when they feel their worst.

When learning about the cognitive approach, some patients may walk away with the impression that CBT is about “thinking positively.”  That depression is a function of “thinking too negatively” and that anxiety is a result of “jumping to conclusions.”  While this sounds intuitively helpful and there is an element of truth to these interpretations, they each miss a crucially important distinction.  The goal of CBT isn’t necessarily to “think positively,” but to think in a more accurate and helpful way.  This deliberate and analytical approach contrasts with how many of us are wired to interpret information, which is often quick and efficient.

The Benefits of Quick Thinking

Think for a moment about the tidal wave of information we deal with each day.  We simply do not have the capacity to sit and deeply evaluate all the important information we must process.

Place yourself in the position of being in an important meeting.  In a matter of a few moments, you might make a number of observations.  Someone arrives a few minutes late and sits down with a scowl on their face.  One of your co-workers yawns while you’re making an important point.  A loud noise can be heard outside the window of the meeting room.  Your heart starts beating quickly and you begin to sweat.  You forgot to silence your phone and see a text message from your partner come through.  All the while, you’re attempting to focus on presenting your material.

Each of these observations could occur within seconds of one another, and we are left to decide what to do with this information, if we want to do anything at all.  Is the co-worker yawning because they’re bored with our presentation or did they not sleep well last night?  Is the late arriver frustrated with this meeting or did something else leave them feeling upset?  Is the change in heart rate and sweating something to be concerned about or simply an uncomfortable product of stress?  May your partner need something important, or did they simply forget you were in a meeting and shouldn’t be bothered?  Is any of this information relevant or should you ignore it and move ahead with your presentation?

This is just one example of the overwhelming pieces of information we’re trying to sift through from moment to moment.  Given that the amount of information we take in greatly exceeds our capacity to process it, it is critically important for us to be able to come to conclusions quickly, even if it comes at the expense of thinking clearly.  This kind of quick thinking is largely beneficial for us.

When we notice brake lights ahead of us while driving, it usually doesn’t benefit us to consider why the person ahead of us is breaking; we usually just follow suit to avoid an accident.  If our friend’s facial expression indicates to us that they feel upset, it’s probably more beneficial to ask what’s wrong or offer support than to consider the many reasons why they could be feeling down.  When finding a checkout line in the supermarket, we can quickly intuit which line seems shortest instead of trying to be precise in determining how long it will take each person to move through the line.

The Costs of Quick Thinking

While efficient thinking is usually helpful for us, there are times when the costs of quick thinking outweigh the benefits.  In my work with patients, often we see evidence of what are called cognitive biases in the way we process information.  These biases can create or exacerbate the distress we may feel in certain situations.

Take for example each of the situations described above.  We might notice the person driving ahead of us break sharply and conclude that they were trying to cut us off and begin to feel enraged.  We could conclude our friend seems sad because of something we’ve done to them and begin to feel guilty and self-conscious.  When trying to pick a quick checkout line at the supermarket, we could jump to the conclusion that we will choose poorly since things usually don’t go well for us and begin to feel discouraged.

In each of these scenarios, the objective information is the same (brake lights coming on), though the conclusions we might draw from these scenarios can be quite different (“this person is trying to cut me off!”), leading to different emotional (anger) and behavioral responses (beeping the horn at the driver ahead).  These situations support the theory inherent in cognitive therapy, that it isn’t situations themselves that lead to emotional distress, but ultimately it is our perception of these situations that better predicts how we will feel and what we will do in response.

Common Cognitive Biases

Learning to what extent errors or biases may be contributing to our emotional distress is one of the core goals in CBT.  The following is a partial list of common cognitive biases. Many of us can find examples of how we’ve engaged in these kinds of thought processes from time to time.

Dichotomous (Black and White) Thinking

While most things in life are shades of grey, it can be tempting to see outcomes in black or white terms.  We artificially limit ourselves to two possible outcomes when the reality is much more nuanced and less extreme.  Examples: “If I don’t do this perfectly, I’ve failed,” “If they forgot to text me back, they must not care about me,” “I ate dessert and now my diet is ruined.”

Mind-Reading

Being able to guess what others might be thinking and feeling isn’t inherently a problem.  In fact, it can be very useful in anticipating others’ needs or expressing empathy.  However, we can sometimes be over-confident in our assumptions or habitually read intentions into actions when they aren’t there.  Examples: “He seems quiet, he must be angry with me,” “Everyone is looking at me, they can all tell how nervous I am,” “My boss didn’t mention my report, she must not want to hurt my feelings by telling me it was horrible.”

Catastrophizing & Jumping to Conclusions

When thinking about the many possible outcomes of a situation, we can over-focus on the most horrible outcomes and believe they are very likely, while underestimating our ability to cope with them if they happen.  Examples: “Even if I went out with my friends, I’d have a horrible time and everyone will be upset that I’m there,” “I’m going to fail this exam and have to drop out of school,” “I’m never going to get a decent job, so why try?”

How Cognitive Behavioral Therapy Can Help

Thinking inaccurately is more of a rule than an exception.  This is because it’s generally more helpful to think quickly than to over-analyze the situations we find ourselves in. While this is normally an adaptive thinking process, for some, repeated errors in thinking can lead to biases that serve to worsen their mood or heighten their anxiety.

Cognitive Behavioral Therapy can help identify flaws and errors in our thought processes and help develop more adaptive coping strategies to think accurately and in a manner that is helpful.  This is very different than just thinking positively.

While it can be reassuring to believe that “everything will be fine,” this kind of conclusion might be just as baseless as more negative outcomes, and thus not provide us with any reassurance due to it feeling hollow.  Learning to cope with stressors is more than just “looking at the bright side.” It involves identifying and potentially modifying the way that you see yourself, your environment, and your future in a more clear and helpful way.