Is Happiness a Distortion?

Is Happiness a Distortion?

Hi Dr. David Burns,

I am confused about the idea that depression and anxiety result from distorted thoughts. For example, you say that anxiety always results from the distortion called Fortune Telling—making unrealistic negative predictions that something terrible is about to happen.

If anxiety is results from telling yourself that something bad is about to happen, feeling alive and euphoric must result from predicting that you’ll have a good future—is that right? But isn’t that also a distortion?

Why should I believe that everything is going to be fine? Isn’t that equally ridiculous as believing something bad is going to happen?

Have a Nice Day!

Jason

Hi Jason,

Thank you for the thought-provoking question. I have edited your question to make it a bit more focused and understandable, and I hope that is okay. And here is the short answer if you don’t like to read too much of my babbling—it probably isn’t a good idea to tell yourself everything is going to fine, because it isn’t!

Bad things happen to all of us. For example, you’ll make mistakes, you’ll fail at some things, you’ll lose people and things you love, and you’ll experience illness and eventually, death. Good things will probably happen to us, too! For example, you seem to be interested in my work, and you ask good questions. That’s cool! I am honored by that, and consider myself fortunate.

But these events do not cause you to feel the way you do. Your thoughts create all of your feelings, positive and negative. That’s been known for at least 2,000 years, since the time of the Greek philosophers, like Epictetus, who said that humans are not disturbed by events, but rather by our views of them. In my opinion, the most important issue is whether your thoughts about these events are realistic or distorted.

In my two podcasts on my list of ten cognitive distortions, first published in Feeling Good: The New Mood Therapy, I emphasized that negative and positive distortions can both cause problems. Let’s focus on negative distortions first. The negative thoughts that trigger depression and anxiety will practically always have many of the distortions I’ve described, such as Jumping to Conclusions, All-or-Nothing Thinking, Overgeneralization, Should Statements, Self-Blame, Magnification and Minimization, Labeling, and more.

That’s why I’ve said that depression and anxiety are the world’s oldest cons—because you’re telling yourself things that simply aren’t true, but you don’t realize it. For example, depressed patients often feel worthless because they tell themselves that they are “losers” (All-or-Nothing Thinking). They may also feel hopeless because they tell themselves that they’ll be depressed forever and their problems will never be solved (Fortune-Telling).

As you so wisely pointed out, you see the exact same distortions in anxiety. For example, a woman with an intense fear of flying told herself, “Oh, I just know that the plane is going to run into turbulence and crash!” This is an example of Fortune-Telling–making an unrealistic prediction. It’s also an example of Magnification–blowing any real danger way out of proportion. And it’s an example of Emotional Reasoning as well–she’s reasoning from her feelings, telling herself that she feels frightened, so she must be in danger.

Cognitive therapists use many powerful techniques to help individuals struggling with depression and anxiety put the lie to the distorted thoughts that trigger their distress. In fact, I use more than 75 different techniques. And the very moment you stop believing the negative thoughts that trigger your depression and anxiety, you will immediately experience a profound improvement in your mood. However, this type of therapy is extremely sophisticated and requires a high degree of therapeutic skill and training. You can’t just tell someone to cheer, or feed them a line of positive baloney! People are not that stupid!

It would be wrong to conclude that all negative thoughts are distorted. In fact, many negative thoughts are valid, and not distorted. Realistic negative thoughts trigger healthy negative emotions, such as healthy sadness or healthy fear. For example, if you are walking in a dangerous part of town at night, you may be feeling frightened because you are telling yourself that you are in danger of being mugged or murdered. You don’t need to treat your fear with a pill or psychotherapy. You WANT the fear because it may keep you alive!

The same is true for the thoughts that trigger healthy sadness. For example, I recently lost my beloved cat, Obie, who was likely eaten by a predator in the middle of the night a couple months ago. I loved him tremendously, and he was the joy of my life. We were very close. In fact, I often described him as my best friend in the whole world, and one of my best teachers, too. Now I am grieving his loss, and will miss him for a long time! My grief is an expression of the intense love I felt for him, and does not need treatment. Nor do I need or want anyone to try to cheer me up. I’m fine with my sadness.

There are also ten positive distortions that are the mirror images of the ten negative distortions. For example, depressed patients are into the “nothing” of All-or-Nothing Thinking, but patients with mania are often into the “all” of All-or-Nothing Thinking when they tell themselves, “I am a winner! I’m the greatest!”

Politicians sometimes try to control people by combining negative and positive distortions. Hitler told the German people they were the superior race (the positive distortion) and that the Jews were inferior and to blame for Germany’s economic problems (the negative distortions). These positive distortions led, as we all know, to murder, sadism, and war. Some politicians today appear to be using similar strategies, and gaining a frightening amount of power.It is shocking and disturbing to me that so many people are gullible and cannot see through them!

Positive distortions not only trigger mania—which you can see in the crowds who were listening to Hitler’s speeches in a frenzy of manic excitement—but play a central role in narcissism, relationship conflicts, violence and addictions as well. Much of the world’s suffering results from negative distortions, but a great deal results from positive distortions as well.

Positive distortions are never the antidote to depression, in my opinion, and telling yourself nonsensical positive things that are not realistic will rarely or never be helpful to anyone, in my experience. But if you believe positive distortions, you will likely feel temporarily high, overly confident, and even euphoric.

Healthy joy results from positive thoughts that are realistic, just as healthy sadness results from negative thoughts that are realistic. I hope this helps to clarifies the difference between distorted and realistic thoughts.

For more information on how to overcome the thinking patterns that trigger depression and negative, I would guide you to any of my books, like The Feeling Good Handbook.

Thanks!

David

Can You Treat Habits and Addictions Without a Support Group?

Can You Treat Habits and Addictions Without a Support Group?

Dear Dr. Burns,

Do you believe that addictions can be healed without a support group? And if so, why is there no book by Dr. Burns specifically on addiction recovery?

Ploni

Dr. David’s Response

Hi Ploni,

Thanks for your question. I have a new workshop on addictions and habits for next year, so I have been thinking about this topic. Also, some of my students and colleagues in my weekly training group at Stanford treat habits and addictions, including eating disorders, drug and alcohol abuse, and so forth. So we spend quite a bit of time developing new treatment techniques.

I think that support groups, like AA or Smart Recovery, can be helpful for many people with addictions, and support groups like Recovery International (formerly Recovery, Inc) can be helpful to people with mood or relationship problems. However, some people can conquer habits and addictions without a support group. Partly, it depends on the severity of the problem and the motivation of the individual.

Many people believe that people overeat or use drugs or alcohol to self-medicate their own depression, loneliness, or low self-esteem. While this may be partially true in some cases, I believe that habits and addictions are primarily motivational problems, and not emotional problems. My recent research on approximately 160 patients admitted to the Stanford Hospital’s psychiatric inpatient unit did not seem to support the notion that depression and anxiety trigger addictions. In fact, individuals who were depressed actually tended to binge less, on average, than individuals who were not depressed. I have not published this finding, as the main focus of the research was different–but the negative correlation between overeating and depression was consistent with conventional psychiatric thinking that a loss of appetite can be a symptom of depression and low self-esteem.

In addition, I could not validate the idea that depression and low self-esteem have a causal effect on alcohol or drug abuse, either. But a brief assessment test I developed called the “Urges to Use Scale” was massively correlated with drug and alcohol use. This seems to indicate that positive, seductive temptations are the driving force behind most, if not all, addictions.

In other words, my findings suggested that people drink or overeat or use drugs primarily because it feels darn good to overeat or get high.  So why do we overeat? I believe that we overeat because of the abundance of good food in our society, and because eating is immediately reinforcing. Of course, alcohol and drugs are also widely available in our culture, and TV ads provide powerful temptations to drink.

While distortions are involved in addictions, they are mainly positive distortions, such as “Oh, that beer would taste SO GOOD!” Or “I deserve some dark chocolate right now. I’ve had such a hard day.” I have created a list of ten positive distortions that correspond to the ten negative distortions in my books, such as Feeling Good. They positive distortions are mirror images of the negative distortions, and I will post them soon on my website.

Of course, negative distortions also play a role in addictions, along with positive distortions. After giving in to the temptation to drink or overeat, we may scold ourselves with negative distortions: “I SHOULDN’T have eaten that chocolate. I’m just a fat pig. I’ll NEVER lose weight!” These thoughts can trigger feelings of shame and hopelessness, which can trigger more addictive behavior, such as overeating or compulsive drinking.

Unlike negative distortions, positive distortions create immediate positive consequences if you give in to them. That’s why habits and addictions can be challenging to treat, and why motivational techniques are of tremendous importance. Traditional cognitive therapy techniques can be helpful for the negative distortions, but new and different kinds of techniques are needed to combat the positive distortions, such as Paradoxical Agenda Setting, the Decision-Making Form, and the Devil’s Advocate Technique, to name just a few. Of course, Empathy and respect for the patient are also extremely important.

All the best,

David D. Burns, M.D.