My 2020 was tough. It began with small nuisances, like moving out of San Francisco and moving back home. Then, it became sadder and sadder: my startup fizzling out; my dad getting a health scare; my grandpa passing away.
While I’ve had low points in my life before, I had never felt so… hopeless. I didn’t feel like I could get out of it. I didn’t feel like the low would end.
Sure, I could feel better for a day or two, but I was always on edge, knowing that another bad day might be right around the corner.
Good news: I'm better now. I'm not tougher but I have come out different.
Now, a kind of armor goes up when I’m about to dip into a negative episode.
Armor built from a mix of self-compassion and forgiveness and an arsenal of self-care technique.
Today, I clack away on my laptop amidst water falling from the sky to bring you some of this arsenal from a very special book.
I’m presenting to you today, the #1 book therapists recommend their depressed patients:
Dr. David Burns’ Feeling Good: The New Mood Therapy.
This book is an excellent primer on using CBT (cognitive behavioral therapy) to feel better.
In this article, I share the book’s main argument. Which is that negative emotions are caused by negative thoughts. And if we can identify and defuse negative thoughts (which come in eleven patterns), we can feel better.
Mostly, this article is about those eleven negative thought patterns. Let’s get started!
I am not a substitute for professional help, nor is this book. If you’re having a rough time, talk to a therapist! It can be a pain to find one that works with your insurance though, so set aside explicit time to sort through that.
If you need urgent help ever, use the suicide hotline here.
OK now let’s actually get started
Table of Contents
Table of Contents
What causes depression?
Burns starts with the core principle of CBT: the idea that your moods are created by your thoughts.
The moment you have a certain thought and believe it, you will experience an immediate emotional response. Your thought actually creates the emotion.
Burns expands on this. He claims that the thoughts that create your depressive moods, they are not accurate perceptions of reality.
Put again: these depressive thoughts are distorted and flawed. (This is a tad abstract but we’re going to get into many examples soon.)
Now, sometimes the root cause of depression is biological, othertimes it's not. In both cases it comes with thought processes that perpetuate and worsen the condition. That’s what Burns is talking about and that’s what CBT addresses.
Thus, the first step to getting better: whenever you have a negative emotion, get in the habit of identifying the thought that caused it.
He then lays out eleven faulty or distorted thought patterns that we are privy to having. He calls them cognitive distortions.
What are the eleven cognitive distortions?
I was talking to my mom on this day she was not feeling so good.
At one teary-eyed moment, my mom said “I’ve never been happy the last twenty years in America.”
At that statement, I morphed into my alter ego, who moonlights as an amateur CBT practitioner. I responded, telling her, “Well Mom, that’s not true the way you’ve put it. In the years you’ve been in America, there have been some days that were happy, and some days that were sad. It’s not right to say that all the days were sad.”
(Yes I sound annoying but I don’t think CBT techniques are about cheering people up. They’re about defusing negative patterns)
I bring this up because my mom’s statement is an example of all-or-nothing thinking and I showed her so. Reality isn’t black or white, nor is my mom’s experience all sad or happy. It’s shades of gray. It’s an automatic thought she had that is not true.
Here’s a thought I’ve had a few times, that’s another example of all-or-nothing thinking:
“Quickapply, the startup I was working on failed. And so I’m a failure.”
But no, this isn’t accurate. First, Quickapply wasn’t a complete failure. It was a partial success in many ways. It was the first time I shipped a product outside work. I recruited two amazing cofounders. We built something some students liked.
Even if we didn’t make money or get into Y Combinator or whatever, we didn’t fail.
Second, it’s not the case that I or anyone else always fails—I’ve failed at some things in life and succeeded at others.
Do you see? This is the kind of thinking that automatically fires for me now when I detect a negative thought. Notice how it’s a rational response, instead of just a cheerful one.
Now let me share the most gnarly of the cognitive distortions.
This one clicked for me after a 1:1 I had with my manager over Zoom.
She was telling me I had done well delivering on a complex project. But her praise went in one ear and out the other. I immediately dismissed it.
In my head I’m a crappy engineer (impostor syndrome etc.) so I refuse to soak in evidence that contradicts that.
So anytime I had a positive experience, or found evidence that suggested I have worth, I would reject it. Dr. Burns calls this disqualifying the positive.
This comic sums it up, h/t to my friend Shawn:
To Dr. Burns, disqualifying the positive is one of the most destructive thought patterns:
You’re like a scientist intent on finding evidence to support some pet hypothesis. The hypothesis that dominates your depressive thinking is usually some version of “I’m second-rate.”
Whenever you have a negative experience, you dwell on it and conclude, “That proves what I’ve known all along.” In contrast, when you have a positive experience, you tell yourself, “That was a fluke. It doesn’t count.”
The price you pay for this tendency is intense misery and an inability to appreciate the good things that happen.
Believe people when they give you praise, instead of discounting it as “oh they’re just saying that”. There’s always a kernel of truth in there.
Here's Dr. Burns’ third negative thought pattern, as seen in this lovely pep talk from the Youtuber and novelist Shaelin Bishop. At 0:42, Shaelin tells us to not equate a difficult writing process with a bad end result.
She’s saying that just because it was hard to write a story (it didn’t come out in a flow state, etc.) doesn’t mean the resulting story will be bad.
If it felt hard to write the story, that’s an emotion. Using that emotion as evidence is a cognitive distortion called emotional reasoning.
I use emotional reasoning subconsciously to decide how productive I was in a given day. If I was stuck on a bug for a long time, for example, I don’t “feel” productive even if I was working. Then until I defuse the automatic thought of “I wasn’t productive today”, I’ll feel dull.
That’s three cognitive distortions so far: all-or-nothing-thinking, disqualifying the positive, and emotional reasoning. The next 4 I’m going to rapid-fire at you. Ready?
There’s overgeneralization. Say you take the evening off of studying to go bowling with friends and fret that you always take breaks. When in reality you’ve been working nonstop all week.
There’s labeling: calling yourself or others words like ugly, loser, stupid, useless, incompetent. I don’t do this so much, but I notice some friends of mine will use these words, either in jest or to describe others. This is not ideal, because if you have those words available to use, aren’t you more likely to use them on yourself?
Here’s another one. Say a kid has a birthday party. Say he has the perfect cake (Scooby Doo themed) and great presents (Yugioh cards) but one of his friends didn’t come to the party and he exclusively dwells on that. He’s fallen into the mental filter distortion: picking a negative detail in a situation and fixating on it.
There’s also should statements. I have a hard-to-shake should statement around waking up at 8am. “I must wake up at 8am otherwise or I am already behind on the day.”
Inevitably, one day I slip up and wake up at 9am, and feel bad immediately, starting the day with a bad taste in my mouth. I have a similar pattern when I don’t work out, or I eat a ton of pizza.
Note it’s not that you shouldn’t have should statements. It’s just that when you run into a negative thought because of one, defuse it.
OK. That was overgeneralization, labeling, mental filter, and should statements. Here’s the last four cognitive distortions:
To start, there’s jumping to conclusions - mind reading. Last month, a girl I was texting took forever to text me back. I immediately jumped to the conclusion she didn’t like me, and that it was all over. But it was not the case, and we had a fun date later. Here, I committed the sin of mind reading.
Related concept: Never attribute to malice what can be attributed to conceit.
There’s also jumping to conclusions - fortune telling, a different way to jump to conclusions. When I first submitted writing to my writing group, I was dreading the feedback. I predicted in advance everyone was going to hate it, which of course didn’t end up the case.
There’s also magnification/minimization. It’s when you blow up the significance of an event unnecessarily. One time I got a piece of negative feedback in school and I way way blew up the significance of it. I felt devastated for a whole day, when in hindsight, it mattered zero.
Finally, there’s personalization - this is when you attribute some negative event to be primarily your fault when it wasn’t. It’s like Harry blaming himself for Sirius dying in the fifth book. Sure, Harry set the events in motion, but he had no idea it was going to turn out the way it did.
Here is a link to the cognitive distortions laid out more clearly (so more boring-ly 😛)
The key exercise to help with depression
Let’s tie it all together:
This is where Burns brings in what he calls the “triple column technique”.
Every time you have a depressive mood, in the first column, write down the thought that caused it.
I'm so lazy I'll never get this report done. I just can't do the damn thing. It would take forever. It won't turn out right anyway.
In the second column, write down what cognitive distortion it is. In the third column, “talk back” with a rational response.
This is an example of jumping to conclusions, specifically fortune telling. It’s not true that you “just can’t do the report”, and it’s premature to say it will take forever and that it won’t turn out right.
There’s also the use of the word “lazy” as a label, which is not necessary. This one report does not define you.
As I kept up the ten minutes a day it takes to keep the three columns updated, I got better. I kept this up for a few weeks in November.
Nowadays, to a large extent, it comes naturally. I still get in bad moods, but they don’t last because I can use this kind of rational self-talk. If I got into a bad place again, I would jump right back into this exercise.
But Rishi, where do these negative thoughts come from?
An excellent question!
You can run a root-cause analysis on these thoughts you’re recording.
Take a distorted thought you’ve had and ask:
“If that thought were true, why would it upset me? What would it mean to me?”
Jot down the first automatic thought that comes after that. Keep doing this until you get to some kind of root cause.
Dr. Burns points out this is real rad because you can get to these root causes without the influence of a therapist’s biases.
That said, he also provides a quiz to more quickly identify some of the common root causes that apply to you. (There are over a hundred possible root causes.)
These root causes are equations about your self-worth, that he calls silent assumptions.
He tackles and dismantles each one, and makes a case for::
- Why love is not your worth
- Why approval is not your worth
- Why achievement is not your worth
- Why perfectionism is not your worth
Imagine the anguish you could avoid over the course of your lifetime if you spent an hour destroying these beliefs. That’s what I got to do reading those chapters.
I was emotional especially after reading about how achievement was not my worth. I still fall into my old patterns sometimes. But now I have a part of my brain that argues I have the same worth, regardless of how little or much I achieve.
I wish I could summarize those chapters for you, but I’m out of time this week. Mark Manson’s article, In Defense of Being Average, does get you part of the way there. If this is something you’d want to read, shoot me an email 🤗
CBT is not the only self therapy I picked up in 2020 though. I also have a homegrown method involving talking to Avatar Aang in my head...
For now, I am not ready to write on that but let me know if you’re interested and you might sway me 😸