To understand how thought challenging works in cognitive behavioral therapy, consider the following example: Maria won’t take the subway because she’s afraid she’ll pass out and then everyone will think she’s crazy. Her therapist has asked her to write down her negative thoughts, identify the errors – or cognitive distortions – in her thinking, and come up with a more rational interpretation. The results are below.
Negative thought #1: What if I pass out on the subway?
Cognitive distortion: Predicting the worst.
More realistic thought: I’ve never passed out before, so it’s unlikely that I will on the subway.
Negative thought #2: If I pass out, it will be terrible!
Cognitive distortion: Blowing things out of proportion.
More realistic thought: If I faint, I’ll come to in a few moments. That’s not so terrible.
Negative thought #3: People will think I’m crazy.
Cognitive distortion: Jumping to conclusions.
More realistic thought: People are more likely to be concerned if I’m okay.
Replacing negative thoughts with more realistic ones is easier said than done. Often, negative thoughts are part of a lifelong pattern of thinking. It takes practice to break the habit. That’s why cognitive behavioral therapy includes practicing on your own at home as well.