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

Let's see what dysfunctional thoughts are according to psychology, and how they are treated in therapy.

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

To address them, cognitive therapy is usually the most commonly used. In this article we will learn about the characteristics of dysfunctional thoughts, how they originate, as well as how they can cause significant discomfort to the person who has them.how they originate, as well as four effective techniques that allow to work them and to eliminate them, replacing them by more realistic and functional thoughts.

Dysfunctional thoughts: definition and characteristics

Dysfunctional thoughts, also called automatic thoughts or negative automatic thoughts (NAP's), are a concept proposed by Aaron T. Becka leading American psychiatrist and professor.

A. Beck was a pioneer in cognitive orientation within the field of psychology as well as in cognitive therapy.He described dysfunctional thoughts as the result or product of a distorted processing of reality. According to Beck, this erroneous processing (which he calls cognitive distortion) ends up originating a series of thoughts that do not bring benefits to the patient, and which ends up distancing him/her 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 they are spontaneous, involuntary and therefore difficult to control.

An example of dysfunctional thinking would be to think: "If I go to the swimming pool I will have a terrible time" (because I have already gone and had a bad experience), or "I am worthless", "I am sure my presentation will go badly", "No one likes me because everyone looks at me badly", etc.

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

How do they originate?

As we have seen, in order to arrive at dysfunctional thoughts, the previous information processing must be erroneous. (or being 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 interpreted erroneously, or that we only look at a part of it to evaluate a more global aspect, etc.

How do they operate in the mind?

There are many types of dysfunctional thoughts, depending on their characteristics. In addition, a common characteristic of dysfunctional thoughts is that they end up favoring the perception and recall of stimuli congruent with the erroneous schemas.In other words, the person ends up focusing only on 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 erroneous conclusions, for example), focuses more on the distorted aspects of it, and also remembers them more in comparison with other non-distorted aspects.

Dysfunctional thoughts can appear in "healthy" people and in people with a depressive or anxious disorder, for example (in the two latter two(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 is a distorted view of reality, which gives rise to a negative, maladaptive state or with depressive and/or anxious symptoms.

How can they be treated in therapy?

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

From it, the aim is to help the patient to elaborate a set of basic assumptions and more realistic thoughtswhich allow him/her to make inferences and evaluations of life events that are more appropriate to his/her goals.

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 significant dysfunctional thoughts.

Cognitive therapy is usually used when the patient already has a certain level of functioning.We emphasize this because in the initial stages of depression, especially if it is severe, the person is often totally apathetic and unwilling to do anything; that is why at first it is better to opt for behavioral techniques that activate the patient, and then gradually incorporate cognitive techniques.

Cognitive techniques are based on guided discovery (also called collaborative empiricism). (also called collaborative empiricism), which offers the patient an active role in his recovery and improvement, and in which the therapist will gradually help the patient to find his own solution, as autonomously as 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. Daily recording of automatic thoughts 2.

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 usually have a negative character for the patient.

They originate from the interaction of information provided by the environment, the patient's schemas, his beliefs and the cognitive processes he employs. They are thoughts that are easily accessed (automatic) at the level of consciousness (i.e., they come to mind). (i.e., they come to mind quickly and automatically, practically without being processed). Thus, automatic thoughts are often negative (Negative Automatic Thoughts [NAPs]), especially in depression.

The recording of NAPs is a technique that is usually used in the first sessions of cognitive therapy, and that involves the patient recording daily the dysfunctional thoughts he or she is having. The objective is to make him/her aware that he/she has them, and to clearly identify what they are. This technique is initially applied and then complemented with other techniques 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 this technique, the "two-column technique" is often used.In one column the patient writes the original interpretation or dysfunctional thought he/she has in relation to a situation, and in the other column he/she 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 you did not understand.

3. Four questions technique

This technique starts by questioning the evidence in favor of maintaining a certain dysfunctional thought in order to generate more realistic or more adaptive interpretations. to generate more realistic or useful interpretations. To perform it, the patient is asked the following questions:

• To what extent does your thinking reflect the same reality? (To be scored from 0 to 100).
• What is the evidence for this belief or thought?
• Is there any alternative explanation?
• Are there any elements of reality in the alternative belief or thought?

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

In addition, the technique of the four questions facilitates that the patient maintains an active role in the therapeutic process, questioning himself the veracity of his own thoughts.by questioning himself the veracity of his thoughts and seeking alternative explanations.

4. Three-column technique

This technique allows the identification of the patient's cognitive distortions (remember, a type of processing (remember, a type of processing that ends up originating dysfunctional thoughts), in order to subsequently modify the patient's distorted or negative cognitions.

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

Bibliographical references:

• Bas, F. and Adres, V. (1994). Cognitive-behavioral therapy of depression; a treatment manual. Terapia de conducta y salud.
• Caro, I. (1998). Manual de Psicoterapias Cognitivas. Paidós.
• Ruiz, M., Díaz, M.I., Villalobos, A. (2012). Manual of cognitive behavioral intervention techniques. Bilbao: Descleé de Broumer.