10 cognitive distortions and how to help clients work with them

Wondering about 10 common types of cognitive distortions?

This article reveals the most common 10 cognitive distortions and how to help therapy clients work with them.

Socrates once proclaimed that “the unexamined life is not worth living.”

Little did he know that over 2,000 years later, this proclamation would be more relevant than ever. There are no shortage of ways to escape from examining our experience.

Society is as fast as ever, and it’s so easy for us to fall into autopilot mode, just trying to get by from one moment to the next.

However, the narratives running through our minds always affect how we’re feeling and what we’re doing, even when we’re unaware of them.

A very common interaction I have with clients goes something like this:

Client: I was really anxious the other day, and I don’t know why.

Dr. Max: That sounds really uncomfortable. Let’s get into it more.

Client: I was just doing homework, and I had a surge of anxiety. I felt my heart race and my stomach get tied into knots.

Dr. Max: Do you remember what was going through your mind?

Client: Hmmm, not really.

Dr. Max: Let’s just take a second. Let yourself breathe and see if you can be curious about what

thoughts may have shown up for you.

Client: I guess I was thinking about how horrible it would be to fail my test next week.

Helping clients bring non-judgemental curiosity to their thoughts can empower them to notice the relationship between their thoughts and feelings, one of the most important foundations for clients when doing powerful cognitive work.

In this article, I will highlight 10 cognitive distortions and why they are essential to address in therapy.

I’ll also share some of my favorite cognitive distortion examples and give you actionable tips on how to work with your client’s thinking patterns more effectively.

What is a cognitive distortion?

A cognitive distortion is simply a way of thinking about oneself, others, or the world that does not

reflect the complete validity of the situation.

The 10 cognitive distortions are also known as “thinking errors,” which highlights that the content of these thoughts is inaccurate in some way, even though they often feel true to the individual’s experience (at least before one chooses to examine their thoughts).

There are more than 10 cognitive distortions, but we will explain the 10 common types of cognitive distortions in more detail below. These cognitive behavioral thinking errors are normal in human thinking; we all experience them… often!

Cognitive distortions don’t necessarily impact our quality of life.

However, cognitive distortions can greatly amplify and interact with any form of psychological pain, including depression, anxiety, obsessive-compulsive disorder (OCD), eating disorders, trauma, substance use, relationship issues, identity concerns, chronic pain, stress, and much more.

In these cases, helping our clients identify and effectively work with cognitive distortions can empower them to make the changes necessary to move toward their treatment goals.

10 common types of cognitive distortions

It’s important to note that there is quite a bit of overlap between different distortions, and many

CBT thought patterns continue with multiple types of distortions, all of which can be useful to identify and discuss with our clients.

You’ll probably notice several distortions embedded within each of the cognitive distortion examples in the list of cognitive distortions below, so I’ve highlighted the one most relevant to that category.

Black-and-white thinking

Black-and-white thinking happens when we see things in extremes, with little to no room in the

middle to consider the nuance and complexity of most situations in life.

For example, “I’m a total failure as a parent.”

Catastrophizing

Also known as worst-case-scenario thinking, catastrophizing occurs when individuals view a future situation as horrible or awful without any evidence that this will be the case.

Out of the 10 cognitive distortions that are most common, this is often one of the primary distortions for individuals with anxiety disorders.

For example: “I’m never going to get a partner, and I’ll end up dying alone and miserable.”

Magnification and minimization

This occurs when one focuses on negative qualities while ignoring positive ones. It’s like you

are looking at a magnifying glass that highlights the shortcomings, but misses the rest of the picture.

For example: “Nobody would want to date me; I’m so short.” 

Notice how this thought hyper-focuses on the perceived negative trait while downplaying any positive trait.

Labeling

Labeling occurs when we make broad, general statements about ourselves or others based on

specific, one-off situations.

Labeling doesn’t consider past histories or contexts and is often a way to put ourselves or others down.

For example: “Can you believe they didn’t show up on time for the movie? They are so lazy and rude.”

Emotional reasoning

Emotional reasoning is when we believe something is valid or accurate because it feels that way.

Of course, emotions can provide a wealth of important insight into our desires and intentions.

Alas, if we’re not mindful, solely using our emotional state to make decisions without connecting with the context of the moment can be problematic.

This happens often with clients struggling with OCD. If a thought “feels important,” they will often treat it as though it’s important.

Shoulding

Should statements involve developing arbitrary rules for oneself about how the world, themselves, or others ought to be.

There’s usually a disconnect between reality and their desires, and thinking patterns driven by “should” are often rife with perfectionism, self-criticism,and frustration.

For example: “I shouldn’t feel this way right now.”

Mental filtering

This error occurs when individuals only focus on the negative aspects of a situation and “filter

out” any positive elements.

For example, “That session went horribly wrong. I misspoke like five times. It was a total disaster.”

Mind reading

Mind reading happens when people assume they know what another person is thinking and take that assumption as the truth.

Mind reading is very common in social anxiety disorder, where people often assume they are being judged negatively by others without any affirming evidence of this.

Fortune telling

Similar to the mind-reading distortion described above, fortune telling occurs when one believes

they know what the future holds. Some examples include “I’m never going to get married” or “I’ll

have a panic attack and won’t be able to cope.”

Personalization

People engage in the personalization distortion when they place full blame on themselves for things that have gone wrong or interpret events as “their fault,” even when they have little to no responsibility.

For example: “It’s all my fault Mira was fired.”

Using the 10 common types of cognitive distortions in therapy

There are many helpful ways to use the ideas of cognitive distortions in sessions with our clients.

Below is a brief overview of several methods I’ve found clients resonate with particularly well.

Therapeutic attitude

When helping clients work through the 10 cognitive distortions, the entire process must be

compassionate, emotionally attuned, and collaborative. It’s so important to ensure the process is  in line with your client’s treatment goals and that they desire to challenge their own distortions. You can do this by explaining cognitive distortions and getting informed consent before working on them with your client.

We also want to be careful about labeling a client’s thoughts as a “distortion”; otherwise, clients

may feel quite invalidated or even gaslit. You can bypass this problem by providing psychoeducation about the 10 cognitive distortions and helping your client identify their own types of distorted thinking (rather than “telling them”), all while offering feedback or guidance in a way that is attuned to your client’s experience.

For example, we would never want to say, “That thought is clearly distorted, and here is why.” Instead, we can empower our clients by saying, “Is that thought helpful or unhelpful? Are there any distortions you notice in that thought?”

Providing psychoeducation

Metaphors can be a powerful way to educate our clients on the 10 common types of cognitive distortions. For instance, we can compare distortions to real-life examples of things that distort our perception of reality, like a funhouse mirror or purple-tinted sunglasses.

Reviewing the cognitive distortions handout

Once clients understand what distortions are, how they relate to their symptoms and treatment

goals and have given consent to work on them, I often review the various 10 cognitive

distortions with clients, one by one.

The CBT worksheets on cognitive distortions here are excellent resources.

I’ll often have clients identify which distortions often show up for them.

Then, I’ll typically provide some humorous self-disclosure here, sharing what distortions my brain prefers (e.g., “my brain definitely loves to catastrophize”).

Helping clients cope with the 10 cognitive distortions

There are two primary ways to help our clients work more effectively with the 10 common types of cognitive distortions.

The first way is more of a traditional cognitive approach, which entails disputing distortions and developing new, more rational, and helpful thoughts.

The second method comes from third-wave behavioral therapies like acceptance and commitment therapy (ACT) or mindfulness-based CBT.

Instead of focusing on changing or altering the distortions, these approaches help our clients learn how to relate differently to their thoughts, creating healthy detachment from unhelpful thoughts and helping clients re-focus their attention back to the here and now.

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