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

We know that reality can be interpreted in infinite ways, and that there is no "one reality". However, it is also true that distorted information processing can lead to dysfunctional and erroneous thoughts, which can cause significant discomfort to the person who has.

To address them, cognitive therapy is usually the most used. In this article we will learn about the characteristics of dysfunctional thoughts, how they originate, as well as four effective techniques that allow working and eliminating them, replacing them with more realistic and functional thoughts.

• Related article: "Cognitive schemas: how is our thinking organized?"

Dysfunctional thoughts: definition and characteristics

Dysfunctional thoughts, also called automatic thoughts or negative automatic thoughts (PAN’s), are a concept proposed by Aaron T. Beck, an important American psychiatrist and professor.

TO. Beck pioneered cognitive orientation within the field of psychology, as well as cognitive therapy, and described dysfunctional thoughts as a result or product of distorted reality processing. According to Beck, this erroneous processing (which he calls cognitive distortion) ends up causing a series of Thoughts that do not bring benefits to the patient, and that ends up taking him away from the more "objective" reality.

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

An example of dysfunctional thinking would be to think: "If I go to the pool I will have a terrible time" (because previously he has already gone and had a bad experience), or "I'm worthless", "I'm sure the presentation is fatal", "No one likes me because everyone looks at me badly", and so on.

That is to say, they end up being thoughts that do not contribute anything good to the patient (That is why they are dysfunctional), they generate unnecessary discomfort and only perpetuate more dysfunctional thoughts.

How do they originate?

As we have seen, to get to dysfunctional thoughts, the prior information processing must be wrong (or being distorted): these are the so-called Beck 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 the information, which implies that reality is interpreted incorrectly, or that we look only at a part of it to evaluate a more global aspect, etc.

• You may be interested: "Aaron Beck's Cognitive Therapy"

How do they operate in the mind?

There are many types of dysfunctional thoughts, depending on their characteristics. Also, a common characteristic of dysfunctional thoughts is that they end up favoring the perception and memory of stimuli congruent with the erroneous schemes; In other words, the person ends up looking only at the aspects of reality that are already distorted, creating a kind of “vicious circle”.

In this way, the following would occur: the person misinterprets reality (drawing the wrong conclusions, for example), pays more attention to the distorted aspects of it, and also remembers them more compared to other aspects not distorted.

Dysfunctional thoughts they can appear in "healthy" people and in people with a depressive or anxious disorder, for example (in the latter two cases, these thoughts tend to be more frequent, intense and numerous).

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

• Related article: "Cognitive restructuring: what is this therapeutic strategy like?"

How can they be treated in therapy?

Psychological therapy, specifically cognitive therapy, is indicated to treat thoughts dysfunctional, especially when they are causing problems and / or significant discomfort to the person who he has them.

From it, it is intended help the patient develop a more realistic set of basic assumptions and thoughts, which allow you to make inferences and evaluations of life events more appropriate to your objectives.

Cognitive therapy is a good option to treat and modify dysfunctional thoughts. This therapy is used especially with patients who have depression, and who also have notable dysfunctional thoughts.

Cognitive therapy It is usually used when the patient already has a certain level of functioning; We emphasize this, because in the initial phases of depression, and more so if it is serious, it is common for the person to be totally apathetic and unwilling to do anything; That is why at the beginning it is better to opt for behavioral techniques that activate the patient, to later gradually incorporate cognitive techniques.

Cognitive techniques are based on guided discovery (also called collaborative empiricism), which offers the patient an active role in the recovery and improvement of it, and in which the The therapist will help the patient little by little so that he himself finds his own solution, most autonomously possible.

Specific techniques

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

1. Automatic thoughts daily log

Dysfunctional thoughts are also called automatic thoughts or negative automatic thoughts. As we have seen, they consist of thoughts and images that are usually distorted, and that tend to have a negative character for the patient.

They originate from the interaction of the information provided by the environment, the patient's schemes, his beliefs and the cognitive processes that he uses. Is about thoughts that are easily accessed (automatic) at the level of consciousness (that is, they come to mind quickly and automatically, with virtually no processing). Thus, automatic thoughts are usually negative (Negative Automatic Thoughts [PAN]), especially in depression.

The registration of the PAN is a technique that is usually used in the first sessions of cognitive therapy, and that It implies that the patient registers the dysfunctional thoughts that he is having on a daily basis at all times, with the objective that he becomes aware that he has them, and that he clearly identifies what they are. This technique is applied initially to complement it with others that allow us to explore these dysfunctional thoughts.

2. Search for alternative interpretations / solutions

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

Within it, the "technique of the two columns" is usually used., where the patient has two record columns; in one of it he writes the original interpretation or dysfunctional thought that he has in relation to a situation, and in the other he writes possible alternative interpretations.

This 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 did not he understood.

3. Four questions technique

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

• To what extent does your thinking reflect the same reality? (You must score from 0 to 100).
• What is the evidence for this belief or thought?
• Is there an alternative explanation?
• Is there an element of reality in alternative thinking or belief?

Based on the patient's responses, dysfunctional thoughts can be worked on; explore why they originate, what determinants precede them, what alternative thoughts exist, etc.

Also, the four-question technique facilitates the patient to maintain an active role in the therapeutic process, questioning himself the veracity of his thoughts and looking for alternative explanations.

4. Three column technique

This technique allows to identify the cognitive distortions of the patient (remember, a type of processing that ends up causing dysfunctional thoughts), to later modify the distorted or negative cognitions of the patient.

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

Bibliographic 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 Psychotherapies. Paidos.
• Ruiz, M., Díaz, M.I., Villalobos, A. (2012). Manual of cognitive behavioral intervention techniques. Bilbao: Descleé de Broumer.