Understanding Cognitive Restructuring

Cognitive restructuring is an essential part of cognitive behavioral therapy (CBT). It is considered to be one of the most effective treatment options for conditions like social anxiety disorder (SAD).

Also known as cognitive reframing, cognitive restructuring is a useful process for identifying and understanding unhelpful thoughts and for challenging and replacing our automatic thoughts. These thoughts are called cognitive distortions.

The average person usually brushes off cognitive distortions within a few minutes. If you live with a mental illness like SAD, however, you may have a difficult time letting go of these thoughts. In these cases, cognitive restructuring can help you minimize the occurrences and effects of these negative thoughts.

How Cognitive Restructuring Works

The idea behind cognitive restructuring is that if you can change your automatic thoughts, you'll be able to influence your emotions and behaviors.

While experts recommended that you work with a cognitive behavioral therapist when practicing cognitive restructuring, you can use the technique yourself to reframe less serious, day-to-day negative thoughts. For example, you can use cognitive restructuring to mentally prepare yourself for a party or a public presentation.

Cognitive restructuring is a process, not a single technique. It draws on several different methods, such as thought recording, decatastrophizing, disputing, and guided questioning, to reduce anxiety by replacing these cognitive distortions with more rational and positive thoughts.

Identify Automatic Thoughts

The first step is to record your negative thoughts in a journal and describe the situation that triggered them. Determine if certain patterns exist.

You may find that you are OK in work settings with colleagues you know, but get anxious in social settings like parties where you don't know anyone. It might be that public speaking scares you, but not mingling with strangers.

Identify Cognitive Distortions

After reviewing the notes you've written, the next step is to identify what parts of your thought you could be distorting or misinterpreting.

A typical distortion experienced by those with SAD is black-and-white thinking or only seeing things in absolutes. For instance, saying, "I never know what to say at social functions."

Other common cognitive distortions include:

• Overgeneralization
• Jumping to conclusions (including mind-reading and fortune-telling)
• Disqualifying the positive
• Magnification/catastrophizing or minimization
• Personalization
• Filtering
• Emotional reasoning
• Should statements
• Labeling

Dispute the Thoughts

The next step is to determine if your thoughts are true and what evidence supports them. It can help to ask yourself the following questions:

• Are my thoughts on this situation accurate?
• Am I basing my thoughts on facts or feelings?
• What factual evidence is there to support my view?
• Could I be misinterpreting the evidence?
• Am I underestimating my ability to cope with this situation?
• What's the worst that can happen if my view of this situation is correct?
• What actions can I take to influence this situation?
• Am I viewing this situation as black and white, when it's more complicated?

If you're prone to black-and-white thinking, you could identify a few examples of times that you succeeded in your social or professional life. You might then conclude, "Sometimes I get tongue-tied in social situations, but not all the time."

Replace the Thoughts

The final step is to replace each of your initial negative thoughts with accurate and positive affirmations. In this case, you might replace "I never know what to say at social functions" with "Sometimes I surprise myself and I know what to say."

Tips for Practicing Cognitive Restructuring

Cognitive restructuring is an intensive process. There is power simply in the process of cognitive restructuring, but employing other tools and practices can help you make the most of it:

• Calm yourself. It's best to be in a calm state of mind when doing this process. Try calming yourself by taking a few deep breaths.
• Practice mindfulness meditation. Mindfulness meditation can help you detach yourself from your negative thoughts or to let them go without fighting against them.
• Use a self-help book. Choose a book specifically designed to help you practice cognitive restructuring. Most of these books will include a worksheet to help you practice these techniques.
• Follow the instructions as closely as possible. It's easy to want to skip parts of the process that you're already familiar with or you think won't work. Sticking with the instructions gives you the best chance of benefiting from this process.

Effectiveness of Cognitive Restructuring

Cognitive restructuring has successfully been used to treat a variety of conditions, including SAD. A 2014 study showed that cognitive restructuring reduced post-event processing (PEP). PEP refers to the reflective thoughts that you have after a social situation, such as "I screwed it all up" or "Everyone saw how nervous I was."

Another study conducted in 2016 study suggests that it's not so much replacing negative thoughts that are important, but rather going into situations and gradually having anxiety lessen.

While we don't know the precise reason cognitive restructuring works, it is likely a combination of thinking more rationally, exposure to anxiety-provoking situations and engaging in less ruminative afterthoughts.

If persistent negative thinking is something you struggle with, it's definitely worth seeking professional help. Cognitive restructuring in the context of CBT could provide significant relief.