Cognitive distortions: a list with examples, and how to challenge them

What are cognitive distortions?

These thoughts tend to arrive on their own. NHS inform describes negative automatic thoughts as thoughts that “pop into your mind, without you making any effort to think of them”, and says they are “believable and usually upsetting”. Its key reminder: “a thought isn’t necessarily a fact, or based on reality”^[4].

Why does that matter? The NHS explains that “the way we think, feel and behave are all linked and continuously affecting one another”, so it is “easy to find ourselves in a vicious cycle”^[3]. The CCI notes that we use these styles “as an automatic habit”, and that when a person uses them “consistently and constantly”, they “can often cause themselves a great deal of emotional distress”^[5].

Where the idea came from

Beck’s model of depression grew over the following decades. In his own words it “has evolved appreciably”, and it came to include automatic thoughts, cognitive distortions, dysfunctional beliefs and biases in how we process information^[7]. According to research papers that cite them, Beck and colleagues first listed the distortions in their 1979 book Cognitive Therapy of Depression, and David Burns expanded the list to 10 common thinking errors in his 1980 self-help book Feeling Good: The New Mood Therapy^[2][8].

What are the common cognitive distortions?

Here is the classic list. It has 10 distortions, shown here as 12 rows, because jumping to conclusions has two forms, mind reading and predicting the future, and catastrophizing is sometimes grouped with magnification and minimization. The definitions come from the NHS, the CCI and the APA. The everyday examples and the more balanced thoughts are our own.

If one thought seems to fit two or three rows, that is normal. The CCI says these styles “are not meant to be distinct categories”^[5]. What matters is noticing the thought, not naming it perfectly. Spotting your own patterns can be hard from the inside: the NHS points out that “it’s often the case that we are not even aware we’re thinking in an unhelpful way”^[3]. That is one thing a CBT therapist can help with.

How many cognitive distortions are there?

There is no official number. Beck and colleagues outlined 7 in 1979, and Burns expanded the list to 10 in 1980^[8]. A research questionnaire, the Cognitive Distortions Scale, measures 10 taken from their work^[8]. NHS inform describes 9 patterns^[4] and the CCI 10^[13], with slightly different names. So if you have seen lists of 8, 12 or 15, none of them is wrong and none is the official one: they split, merge or add patterns differently.

Catastrophizing and all-or-nothing thinking: a closer look

Catastrophizing

The word, along with its synonym “awfulize”, was coined by Albert Ellis. The APA notes that “the tendency to catastrophize can unnecessarily increase levels of anxiety and lead to maladaptive behavior”^[11]. In a clinic study in Turkey, people with panic disorder, generalised anxiety disorder or social anxiety had more cognitive distortions than people without these conditions, and the three groups had similar levels of catastrophizing^[15]. A CCI question to try: “What are the possible outcomes – best, worst, most likely?”^[16]

All-or-nothing thinking

The APA says the term “dichotomous thinking” has been used to describe the tendency of people with major depression “to view mildly negative events as extremely negative”, and that its role in other conditions is still being studied^[9]. A CCI question to try: “Is there an in-between where things are not perfect but not a disaster?”^[16]

Why do cognitive distortions matter?

What causes them? No one knows for certain. The APA treats distortion as a normal process that can occur in all people^[1]. Beck’s model proposes that early traumatic experiences shape unhelpful beliefs, and that later stress can set them off; he wrote that overreacting to stress in depression “probably” works through cognitive distortions^[7]. That is a theory, not a proven cause.

Are they linked with depression and anxiety? Yes, in studies. In a Turkish study, outpatients with depression scored 82.85 on average on the Cognitive Distortions Scale, compared with 58.54 in a non-clinical group^[8]. In 208 Canadian students, more frequent distortions went with more symptoms of depression^[2]. People with anxiety conditions also report more of them^[15]. The link may not be specific to depression: one research team concluded that distortions are “related to general distress or negative affect”^[8].

But a link is not a cause. These studies measured thinking and symptoms at one point in time, so they cannot show which came first. We could not find a review that pools this research for depression or anxiety, so it rests on individual studies. Researchers describe distortions as “purported to increase vulnerability to depression”^[2], which is a careful way of saying the theory is not yet proven.

How to challenge cognitive distortions

The NHS calls its approach the “catch it, check it, change it” technique^[3]. In CBT, this is called cognitive restructuring: a technique to help you identify cognitive distortions, question them and change them so they are “adaptive and reasonable”^[17]. Here it is in six steps.

Does challenging your thoughts work?

Partly. CBT is the most studied talking therapy for depression^[22], and the NHS recommends it for many problems, including depression and anxiety^[21]. In an analysis of 45 trials, cognitive restructuring on its own reduced depression about as much as full CBT or behavioural activation, compared with waiting lists and usual care, though the authors say more research is needed on it^[23]. In four studies, clients tended to do better when therapists used it more in sessions, but those studies cannot prove cause^[24].

Here is the mixed part. In a trial of 150 people with depression, full cognitive therapy worked no better than simpler versions built from its parts (behavioural activation alone, or with work on automatic thoughts), and those versions changed negative thinking just as much^[25]. One review found “little evidence” that the specific thought-challenging techniques make CBT work better^[26], while another concluded that the techniques do help and that changing your thinking, however it happens, contributes to easing depression^[27]. In internet CBT for depression, cognitive restructuring showed no clear added benefit, which the authors suggest may be because it is harder to learn in an online programme^[28]. CBT’s overall effects may also have been overestimated^[22], and other talking therapies work about as well^[29].

So challenging thoughts is a well-studied skill, but researchers still debate which part of CBT does the work.

When is it more than a thinking habit?

Cognitive distortions are not a diagnosis. But if unhelpful thoughts are constant, or come with low mood or anxiety most days, they may be part of something a doctor or therapist can help with:

• Low mood that will not lift, or harsh thoughts about yourself and the future. See our page on therapy for depression, or try our depression test as a starting point.
• Worry and what-ifs that are hard to switch off. See online anxiety therapy, our anxiety test, and our posts on stress vs anxiety and high-functioning anxiety.
• Labels like “I’m a failure” that never let up. See therapy for self-esteem and our post on imposter syndrome.
• Going over the same thoughts again and again. See how to stop overthinking.

Online tests are not a diagnosis. NIMH also notes that being checked by a health care provider first “can help rule out a physical health issue”^[31].

How CBT therapy helps with cognitive distortions

NIMH describes CBT as helping a person “become aware of automatic ways of thinking that are inaccurate or harmful”, then question those thoughts, understand how they affect emotions and behaviour, and change self-defeating patterns^[31]. In cognitive behavioural therapy, sessions can include “questioning unhelpful thoughts and beliefs, and considering other ways of looking at things”. You will usually have between 5 and 15 sessions, and your therapist will help you find approaches that work for you^[21]. If you have been in therapy for a reasonable time and are not getting better, NIMH says to talk to your therapist^[31].

Language matters too. The thoughts you are catching come in the language you think in. UK guidance for generalised anxiety recommends offering therapy “in the preferred language of the person with GAD if possible”^[32]. On Bliss Therapy you choose a therapist who speaks your language, by video, with no waitlist. See online CBT therapy. 43 psychologists and counsellors list CBT, with sessions from €30 (about £25).

Our therapists are based outside the UK and the US, so they are unlikely to be on UK registers or covered by US health insurance. Ask any therapist about their training and their registration in the country where they practise.

When to get help

Talk to a doctor or a therapist if unhelpful thoughts are affecting your work, relationships or sleep, if you feel low or anxious most days, or if self-help is not making a difference. In the UK, you can refer yourself to NHS talking therapies for problems such as anxiety and depression without speaking to a GP, and the NHS says to speak to a GP if you still have problems after CBT has finished^[21]. NHS inform notes that its self-help guide is not intended for people in crisis^[4].