Guiding our clients through cognitive distortions

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Janice suffers with debilitating anxiety and depression. She recently found her way to me looking for something a little "more progressive, practical and ACTUALLY helpful" than her previous FOUR years of psychotherapy.

She described how deeply she cared for her therapist. BUT she could no longer keep shelling out dollars without relief from her suffering. I get that. We all get that. 

Given how long she had been journeying with this illness, I assumed she knew some fundamentals about journeying with or through a mood disorder. I was wrong.

Cognitive distortions for instance. She had never heard of them. AND the idea of cognitions being distorted rocked her world. Already feeling shaky and unstable, now she was being told that she distorted her own reality and couldn't trust herself. NOT what I was saying by the way.

This is where the value of having a commitment to collaboration comes into play. Recognizing that we were not at all on the same page regarding understanding this fundamental aspect of anxiety and depression, I had some 'splainin' and relationship mending to do.

After a conversation about her emotional response to the idea of cognitive distortions, we discussed what they actually are - cognitive habits. These habits do have a tendency to limit and distort our perspective. Moreover, we have reliable means of addressing these habits.

One of the most prominent these days have to do with mindful awareness and practice. There are apps aplenty to help. There's also the three minute breathing space. I always advise clients (especially if the mood disorder is active) to meditate no more than three to five minutes at a stretch and slowly, over the course of months, work up to twenty - thirty minutes.

Janice was game for beginning a practice. However, we want more immediate relief from cognitive habits than can typically be gained with mindfulness practice. Pulling the thread of a particularly knotty habit infused with ideas about how her stepson SHOULD behave with an end of words method, she not only felt free from that particular "should," but was armed with an easy "walking around" practice she could carry with her.

What sticky points have you run into when working with cognitive distortions?

PM me about the NASW NC conference in Asheville where I will teach this method and more about helping clients untangle from cognitive habits.