Ever hear of Michael Dearing? Me, neither. I looked him up, and I still don’t really have a clue what he’s about. However, his presentation on cognitive distortions made it to Boing, Boing. I thought it was a pretty good discussion of what a cognitive distortion is, what some specific distortions are, and what the repercussions of thought distortions are.
Oh, cognitive distortion = thought distortion.
IMNSHO, “eating disorder” is a terrible name for a mental illness. It gives the impression that an eating disorder is primarily about food. Food related behaviors are a symptom, but “curing” those food related behaviors is not going cure someone. An eating disorder is a maladaptive coping system that is reinforced and maintained by the individuals eating-disordered thinking. I like Wikipedia’s definition of maladaptive behavior:
maladaptive behavior is a type of behavior that is often used to reduce one’s anxiety, but the result is dysfunctional and non-productive.
I would replace non-productive with destructive. Eating disorders kill at least 10% of those who have them; I think it’s a much higher number since it’s such a secretive disease and how do they count those who have not been diagnosed.
But I digress. I think that at the core of the eating disorder is the eating-disordered thinking which tends to fall into groups of cognitive distortions. I put a list of distortions common to those suffering from an eating disorder on one of my eating disorder worksheets.
Michael Dearing defined a cognitive distortion as:
Strong patterns of automatic thoughts
Cognitive distortions are filters or lenses that influence thinking, shape interpretation of reality, basis for action
He also has this nifty graphic on slide 3 that illustrates how cognitive distortions shape a person. I recreated it in PowerPoint.
The thing is that people with an eating disorder get caught in a never ending loop. The thought causes an emotion which results in an urge, the urge is acted on which brings a thought; the thought causes an emotion … So eventually, that poor person is stuck. It’s really, really, really hard to break the loop even with help. I can’t tell you how many people I have seen drop out of therapy. The number who have left “cured”? Well, sadly, that’s zero, but I have seen successes who have needed less and less support over the years. Keep in mind that my peer group in this is women who are in their 40s and up who have had an eating disorder for 20 to 50 years. That’s different from someone in her teens or 20s who hasn’t live much longer than 20 years. That’s a long time of coping using these … um … skills. All that experience has to be tossed aside and replaced with new skills. That’s a lot of automatic thinking pathways (i.e. the distortions) that have to be rewired.