Cognitive Restructuring: Techniques, Definition & Examples

Instructor: David White
Cognitive restructuring can be a very effective treatment for intrusive negative thinking. Learn about cognitive restructuring and explore the ways it can be applied in a therapeutic environment.

What is Cognitive Restructuring?

Having spent nearly a decade of my professional life working with the seriously mentally ill, I would have to say that one of the most challenging symptoms were intrusive negative thoughts. In some cases, patients were able to overcome these thoughts, while others had moderate to extreme difficulty focusing on anything else. Fortunately, though, there are a handful of therapeutic techniques that can be used to overcome these thoughts, and few are as effective as cognitive restructuring.

Cognitive restructuring is a technique used in mental health treatment for people that frequently experience intrusive thoughts. Such thoughts often impair functioning and interpersonal relationships. In general, these thoughts can range anywhere from moderately irrational or unreasonable all the way to psychotic or 'magical' thinking.

Among the approaches to cognitive restructuring, Socratic questioning can be very effective when trying to reduce negative thought patterns. The term refers to the Greek philosopher Socrates, and it involves considering or analyzing a problem or subject from different perspectives in order to understand it as fully as possible.

Named for the Greek philosopher, Socratic questioning is an important part of cognitive restructuring

Intrusive Thoughts

It can be hard to clearly define what intrusive thinking is, in part because we all have negative thoughts from time to time and sometimes they can be very distracting. For people diagnosed with a mental illness, however, these thoughts tend to be rather irrational or unrealistic ideas that can be so strong that they block out other thoughts and exacerbate symptoms like anxiety or depression.

In clinical terms, these are known as cognitive distortions, which are characterized as unrealistic patterns of thinking that affect a person's mental state. In some cases, cognitive distortions are rooted in reality but become twisted over time. In other cases, they are entirely irrational thoughts that seem to come out of nowhere.

Say, for example, that you're a social worker and are accompanying a client to an appointment with his psychiatrist. When you spoke to the client earlier, he seemed eager to meet with the doctor, but when you arrive to pick him up he no longer wants to go. Between your earlier call and your arrival, the client began to consider what the psychiatrist might do to him - possibly prescribing some kind of poison, or maybe just gathering data on him to share with the government.

Automatic Thoughts

Cognitive distortions and intrusive thoughts are broadly known as automatic thoughts because they are completely involuntary and just pop into a person's head. To anyone else they seem irrational, but to the person that is experiencing them they seem rational, because they are based on how the individual views him or herself or the world.

For example, if you're someone that sees the world as a violent and dangerous place, you might have tremendous fears of being hurt or robbed by a stranger. Stepping out of your apartment one day you automatically think 'today is the day I'll be attacked', which causes you to panic and run back inside.

If you had learned cognitive restructuring skills, you would be able to rationalize your thoughts by concluding that there's no reason to think you'll be attacked today, and you are likely very safe walking down a crowded city street. This technique is what's known as de-catastrophizing, which is basically a way of de-escalating your negative thoughts about harm coming to you or someone close to you.

How Cognitive Restructuring Is Used by Therapists

For the average person, automatic or intrusive thoughts are usually brushed off within a few minutes as being irrational or unreasonable. Those with mental illness, however, have considerable difficulty letting go of their thoughts because the thoughts are tied up in the person's self-perception or the symptoms of their illness. In this case, cognitive restructuring can be an effective technique for helping the person to minimize the occurrences and effects of these thoughts.

Therapists that use cognitive restructuring tend to follow a four-step process to help the individual recognize the thought and recognize the irrationality:

1) Step one is to recognize which thoughts are automatic or intrusive and when they happen. For example, the person might say 'well, someone was looking at me in a restaurant earlier and I know it's because they thought I was ugly.'

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