Cognitive Distortions in Eating Disorders
Based on Cognitive Behavioral Therapy (Newsletter #3)
This week has been hectic for me. The weather kept changing. For five minutes it was pouring with rain. Then you would see the clear blue sky and the sun shining through. Then hail would take the place of the sun, aggressively. Later it would calm down and snow very peacefully, silently. Watching all these changes from my window, I felt like the weather just strung along with my feelings. I think I am still having a hard time letting go of my anxiety from last week. I am terrified of the idea that I had gained weight. Unfortunately, I have succumbed to my fears and weighed myself. It only made the situation worse, activated all kinds of negative thoughts about myself and my body.
I am sharing this because I want you to see that I am just one of you. Even though I have learned a lot and I am doing my best to help other people learn too, there are some days that my eating disorder just gets the best of me. And let me tell you, this week I had a lot of those days. So I thought,
‘‘Why not share this experience too?’’
When I was going through difficult times because of bulimia, I remember looking for help online, constantly searching through profiles and forums. I was expecting to find someone and have that person as my role model. A role model who would make me believe that it is possible to get through this. A role model who would show me how she or he actually did it. I wanted full transparency, so I could copy what they did and get better. I wanted to find empathy, I wanted to feel understood. I wanted to know how people change and let go of their eating disorders. Back then, because I couldn’t find what I was looking for, I would feel like everyone was perfect, except me. Everyone but me could somehow get through this. Now I understand that most of the change comes from therapy and that is very hard to share with people. Why? Because it is very private and too personal to be generalized to all of the individuals with an eating disorder.
If you are at this point, where I was years ago, I cannot tell you what to do to get over it. But I can do one thing for you: I can introduce you to possible distortions you might be experiencing in your thinking. It is important to remember that in eating disorders (just like other mental illnesses), you lose your perspective. Your mind gets lost in disordered thoughts and behaviors. You slowly get detached from reality and you experience a lot of errors in thinking, without even noticing. Becoming aware of these errors is a big step to start modifying them.
1. Absolutistic (all-or-nothing) Thinking
As the name implies, this cognitive distortion is about thinking in extremes only. It is defined as placing judgments about oneself, others, and personal experiences in one of two categories. *They cannot be placed anywhere outside of those categories*. In the context of eating disorders, food is seen either as very healthy or extremely unhealthy. This thinking usually triggers binges in binge eating-related disorders. Having one bite of a cookie and thinking you have ruined your diet is the best example of this. The underlying belief is that your diet can be either perfect or completely ruined. Although a mere bite has little to no effect on your diet, your thoughts claim the opposite. Your perfect diet is now completely ruined. Then, for which your binge is now justified.
Not everything is black and white. Especially diets.
2. Overgeneralisation
Overgeneralisation is about extending a conclusion you have reached based on one isolated event, to other areas of your life. In eating disorders, this can be illustrated by saying ‘‘I’m such a failure, I cannot even maintain a diet!’’. You discard the fact that you ate balanced meals the last three days. Then you generalize your failure to everything in your life. You discard how well you have been doing in your work, how happy you are in your relationships. You strictly believe that ‘‘If I am failing at dieting, I am failing at everything in life’’. When something goes wrong, it is comforting to think about things that are going well. But overgeneralization takes that away from us and leaves its place to misery.
3. ‘‘Should’’ and ‘‘Must’’ Statements
These are statements about what you think you should or must be doing. As their tone implies they are some kind of an absolute rule that you have to adhere to. The problem with these statements is that if you fail to act in line with them, you immediately find yourself in a bottomless pit full of guilt and shame. For individuals with eating disorders, there are so many things they must do or should be: ‘‘I must lose 10 kilograms or else’’, ‘‘I should be able to control myself around food’’ or ‘‘I must be under x kilograms’. These statements are shaped by extreme and unrealistic expectations that they have from themselves. They are usually nearly impossible to achieve, thus reinforcing the belief of being a failure or not good enough.
4. Selective Abstraction
Selective abstraction, also called mental filtering, is about reaching a conclusion (usually a negative one) based on one isolated information while ignoring other relevant information to confirm your own biased view. As humans, we want to be always right. We love to be right. Even without an eating disorder, our brains are constantly searching for information that confirms our beliefs. When an eating disorder comes into the picture, the situation is worsened. You become really good at disregarding many positive comments you have received about your body and focusing on one negative comment. Your family, partner, friends; everyone can compliment your body but you will remember that one person in high school who called you fat. As the underlying belief that we are fat is already present, focusing only on that information renders you absolutely right; even if it makes you sad to the core.
5. Fortune Telling
When you experience this cognitive distortion, you believe that you know for sure what will happen in the future, just like a fortune teller. Unfortunately, individuals with eating disorders are very pessimistic fortune tellers. They expect -no they know for a fact- that things will turn out negative. Saying things like ‘‘If I gain weight, nobody will love me’’ or ‘‘I know that gaining weight will be the worst thing that has happened to me’’ is a sign of fortune-telling.
6. Labeling
When you fall into this distortion, you attach labels to a person or an event based on a single feature. We are all complex beings. It is unfair to reduce ourselves to a simple word. And this word is usually an extremely negative one. In eating disorders this can manifest as calling yourself names, calling yourself a failure, and a person without self-control. These take a toll on our self-esteem. Additionally, using the words ‘healthy/unhealthy’ to describe foods and naming some days as cheat days are examples of labeling.
7. Mind reading
This distortion is about ‘‘knowing’’ what the other person thinks without any kind of information. It is at the very core of eating disorders. When you have an eating disorder, you believe that you can read other people’s minds and tell what they think of you. These thoughts are of course never positive. You believe that other people just look at you and think how fat you are. You believe that they watch you while you are eating and think ‘‘This person eats so much, no wonder they are fat’’. And it is torturing to believe that everyone is constantly judging you negatively, based on your physical appearance and food choices.
8. Magnification and Minimization
This distortion can go both ways, you can magnify or minimize the significance of an event. In eating disorders, magnification would look something like fixating on an imperfection you believe you have. When you look in the mirror, you might only see how big your stomach is or how thick your thighs are. These thoughts can heavily contribute to one’s body dysmorphia. Minimization, on the other hand, is the exact opposite. It’s inappropriately belittling the significance of an event. A good example for minimizing would be convincing yourself that you aren’t sick enough, that you don’t need help.
*Bonus: Thought-shape fusion.
Thought-shape fusion is when even the thought of eating changes the way you think you look. This is a very interesting phenomenon that was observed only in individuals with eating disorders. It is usually food that you shouldn’t eat, so you feel like you are doing something wrong morally. This distorts your body image and leaves you feeling fat.
Alright, now here comes the big question: Do you recognize any cognitive errors in your thinking? Let me know in the comments!
I recognize the 4-5-7 but I’m truly working to fix them