Bariatric Surgery Misconceptions

dianeseattle · Jul 11, 2020

I wanted to I wanted to repost the article above, and because I have been reading so many of the classic buzzwords that cause us to feel self-defeating and to sabotage any of our positivity, I am also reposting something that I have been saving and reading for myself. I hope this helps someone.

What are Cognitive Distortions? A Definition
Cognitive distortions are exactly what the name implies: distortions in our cognition. Put another way, cognitive distortions are biased perspectives we take on ourselves and the world around us. They are irrational thoughts and beliefs that we unknowingly reinforce over time.

These patterns and systems of thought are often subtle – it’s difficult to recognize them when they are a regular feature of your day-to-day thoughts. That is why they can be so damaging since it’s hard to change what you don’t recognize as something that needs to change!

Cognitive distortions come in many forms (which we’ll cover later in this piece), but they all have some things in common.
All cognitive distortions are:

Tendencies or patterns of thinking or believing…
That are false or inaccurate…
And have the potential to cause psychological damage.

It can be scary to admit that you may fall prey to distorted thinking. You might be thinking, “There’s no way I am holding on to any blatantly false beliefs!” While most people don’t suffer in their daily lives from these kinds of cognitive distortions, it seems that no one can completely escape these distortions.

If you’re human, you have likely fallen for a few of the numerous cognitive distortions at one time or another. The difference between those who occasionally stumble into a cognitive distortion and those who struggle with them on a more long-term basis is the ability to identify and modify or correct these faulty patterns of thinking. As with many skills and abilities in life, some are far better at this than others.

These distortions have been shown to relate positively to symptoms of depression, meaning that where cognitive distortions abound, symptoms of depression are likely to occur as well (Burns, Shaw, & Croker, 1987).
In the words of renowned psychiatrist and researcher David Burns:
“I suspect you will find that a great many of your negative feelings are in fact based on such thinking errors.”
Errors in thinking, or cognitive distortions, are particularly effective at provoking or exacerbating symptoms of depression. It is still a bit ambiguous as to whether these distortions cause depression or depression brings out these distortions (after all, correlation does not equal causation!) but it is clear that they frequently go hand-in-hand.
Much of what we know about cognitive distortions comes from the vast body of research conducted by two researchers at the forefront of the field of psychiatry and psychotherapy: Aaron Beck and David Burns.
Experts in Cognitive Distortions: Aaron Beck and David Burns
If you dig any deeper into cognitive distortions and their role in depression, anxiety, and other mental health issues, you will run into two names over and over again: Aaron Beck and David Burns.
These two psychologists literally wrote the book(s) on depression, cognitive distortions, and the treatment of these problems.
This is the foundation of CBT – the idea that our thought patterns and deeply held beliefs about ourselves and the world around us drive our experiences can lead to mental health disorders when they are distorted, and can be modified or changed to eliminate troublesome symptoms.
In line with his general research focus, Beck also developed two important scales that are among some of the most used scales in psychology: the Beck Depression Inventory and the Beck Hopelessness Scale. These scales are used to evaluate symptoms of depression and risk of suicide and are still applied decades after their original development (Good Therapy, 2015).

END PART ONE

dianeseattle · Jul 11, 2020

A List of the Most Common Cognitive Distortions
Beck and Burns are not the only two researchers who have dedicated their careers to learning more about depression, cognitive distortions, and treatment for these conditions. There are many others who have picked up the torch for this research as well, often with their own take on cognitive distortions. As such, there are numerous cognitive distortions floating around in the literature, but we’ll limit this list to the most common sixteen.
The first eleven distortions come straight from Burns’ Feeling Good Handbook (1989).
1. All-or-Nothing Thinking / Polarized Thinking
Also known as “Black-and-White Thinking,” this distortion manifests as an inability or unwillingness to see shades of gray. In other words, you see things in terms of extremes – something is either fantastic or awful, you are either perfect or a total failure.
2. Overgeneralization
This sneaky distortion takes one instance or example and generalizes it to an overall pattern. For example, a student may receive a C on one test and conclude that she is stupid and a failure. Overgeneralizing can lead to overly negative thoughts about oneself and one’s environment based on only one or two experiences.

3. Mental Filter
Similar to overgeneralization, the mental filter distortion focuses on a single negative and excludes all the positive. An example of this distortion is one partner in a romantic relationship dwelling on a single negative comment made by the other partner and viewing the relationship as hopelessly lost, while ignoring the years of positive comments and experiences. The mental filter can foster a negative view of everything around you by focusing only on the negative.

4. Disqualifying the Positive
On the flipside, the “Disqualifying the Positive” distortion acknowledges positive experiences, but rejects them instead of embracing them. For example, a person who receives a positive review at work might reject the idea that he is a competent employee and attribute the positive review to political correctness or to his boss simply not wanting to talk about his employee’s performance problems. This is an especially malignant distortion, since it can facilitate the continuance of negative thought patterns even in the face of lots of evidence to the contrary.
5. Jumping to Conclusions – Mind Reading
This “Jumping to Conclusions” distortion manifests as the inaccurate belief that we know what another person is thinking. Of course, it is possible to have an idea of what other people are thinking, but this distortion refers to the negative interpretations that we jump to. Seeing a stranger with an unpleasant expression and jumping to the conclusion that she is thinking something negative about you is an instance of this distortion.
6. Jumping to Conclusions – Fortune Telling
A sister distortion to mind reading, fortune telling refers to the tendency to make conclusions and predictions based on little to no evidence, and holding them as gospel truth. One example of fortune telling is a young, single woman predicting that she will never find love or have a committed and happy relationship based only on the fact that she has not found it yet. There is simply no way for her to know how her life will turn out, but she sees this prediction as fact rather than one of several possible outcomes.
7. Magnification (Catastrophizing) or Minimization
Also known as the “Binocular Trick” for its stealthy skewing of your perspective, this distortion involves exaggerating the importance or meaning of things or minimizing the importance or meaning of things. An athlete who is generally a good player but makes a mistake may magnify the importance of that mistake and believe that he is a terrible teammate, while an athlete who wins a coveted award in her sport may minimize the importance of the award and continue believing that she is only a mediocre player.
8. Emotional Reasoning
This may be one of the most surprising distortions to many readers, and it is also one of the most important to identify and address. The logic behind this distortion is not surprising to most people; rather, it is the realization that virtually all of us have bought in to this distortion at one time or another. Emotional reasoning refers to the acceptance of one’s emotions as fact. It can be described as “I feel it, therefore it must be true.” Of course, we know this isn’t a reasonable belief, but it is a common one nonetheless.
9. Should Statements
Another particularly damaging distortion is the tendency to make “should” statements. Should statements are statements that you make to yourself about what you “should” do, what you “ought” to do, or what you “must” do. They can also be applied to others, imposing a set of expectations that will likely not be met. When we hang on too tightly to our “should” statements about ourselves, the result is often guilt that we cannot live up to them. When he cling to our “should” statements about others, we are generally disappointed by the failure of the others to meet our expectations, leading to anger and resentment.
10. Labeling and Mislabeling
These tendencies are basically extreme forms of overgeneralization, in which we assign judgments of value to ourselves or to others based on one instance or experience. For example, a student who labels herself as “an utter fool” for failing an assignment is engaging in this distortion, as is the waiter who labels a customer “a grumpy old miser” if he fails to thank the waiter for bringing his food. Mislabeling refers to the application of highly emotional, loaded language when labeling.
11. Personalization
As the name implies, this distortion involves taking everything personally or assigning blame to yourself with no logical reason to believe you are to blame. This distortion covers a wide range of situations, from assuming you are the reason a friend did not enjoy the girl’s night out because of you, to the more severe examples of believing that you are the cause for every instance of moodiness or irritation in those around you.
In addition to these basic cognitive distortions, Beck and Burns have mentioned a few others (Beck, 1976; Burns, 1980):
12. Control Fallacies
A control fallacy manifests as one of two beliefs: (1) that we have no control over our lives and are helpless victims of fate, or (2) that we are in complete control of ourselves and our surroundings, giving us responsibility for the feelings of those around us. Both beliefs are damaging, and both are equally inaccurate. No one is in complete control of what happens to them, and no one has absolutely no control over their situation. Even in extreme situations where an individual seemingly has no choices in what they do, where they go, or what they say, they still have a certain amount of control over how they approach their situation mentally.
13. Fallacy of Fairness
While we would all probably prefer to operate in a world that is fair, this assumption is not based in reality and can foster negative feelings when we are faced with proof of life’s unfairness. A person who judges every experience by its perceived fairness has fallen for this fallacy, and will likely feel anger, resentment, and hopelessness when he inevitably encounters a situation that is not fair.
14. Fallacy of Change
Another fallacy distortion involves expecting others to change if we pressure or encourage them enough. This distortion is usually accompanied by a belief that our happiness and success rests on other people, leading us to believe that forcing those around us to change is the only way to get what we want. A man who thinks “If I just encourage my wife to stop doing the things that irritate me, I can be a better husband and a happier person” is exhibiting the fallacy of change.

15. Always Being Right
Perfectionists and those struggling with Imposter Syndrome will recognize this distortion – it is the belief that we must always be right, correct, or accurate. With this distortion, the idea that we could be wrong is absolutely unacceptable, and we will fight to the metaphorical death to prove that we are right. For example, the internet commenters who spends hours arguing with each other over an opinion or political issue far beyond the point where reasonable individuals would conclude that they should “agree to disagree” are engaging in the “Always Being Right” distortion. To them, it is not simply a matter of a difference of opinion, it is an intellectual battle that must be won at all costs.
16. Heaven’s Reward Fallacy
This distortion is a popular one, particularly with the myriad examples of this fallacy playing out on big and small screens across the world. The “Heaven’s Reward Fallacy” manifests as a belief that one’s struggles, one’s suffering, and one’s hard work will result in a just reward. It is obvious why this type of thinking is a distortion – how many examples can you think of, just within the realm of your personal acquaintances, where hard work and sacrifice did not pay off? Sometimes no matter how hard we work or how much we sacrifice, we will not achieve what we hope to achieve. To think otherwise is a potentially damaging pattern of thought that can result in disappointment, frustration, anger, and even depression when the awaited reward does not materialize.

END PART TWO

dianeseattle · Jul 11, 2020

Changing Your Thinking: Examples of Techniques to Combat Cognitive Distortions
These distortions, while common and potentially extremely damaging, are not something we must simply resign ourselves to living with. Beck, Burns, and other researchers in this area have developed numerous ways to identify, challenge, minimize, or erase these distortions from our thinking.
Some of the most effective and evidence-backed techniques and resources are listed below.
Unhelpful Thinking Styles
Since you must first identify the distortions you struggle with before you can effectively challenge them, this resource is a must-have.
The Unhelpful Thinking Styles handout lists and describes several types of cognitive distortions to help you figure out which ones you might be dealing with.
The distortions listed include:

All or Nothing Thinking
Overgeneralizing
Mental Filter
Disqualifying the Positive
Jumping to Conclusions: Mind Reading/Fortune Telling
Magnification (Catastrophizing) and Minimization
Emotional Reasoning
Should/Must Statements
Labelling
Personalization

The descriptions are accompanied by engaging depictions of the distortions in action.
This handout will be available for download soon.
CBT Thought Record
This worksheet is an excellent tool for identifying cognitive distortions. Our automatic, negative thoughts are often related to a distortion that we may or may not realize we have. Completing this exercise can help you to figure out where you are making inaccurate assumptions or jumping to false conclusions.
The worksheet opens with space to describe the situation in which the negative automatic thought arose. The instructions are to identify where you were and what you were doing, as well as any other pertinent contextual information.
Next, you are instructed to rate the strength of the emotion or feeling the situation evoked on a scale from 0% (weakest) to 100% (strongest).
The third component of the worksheet directs you to write down the negative automatic thought, including any images or feelings that accompanied the thought.
After you have identified the thought, the worksheet instructs you to note the evidence, both for the accuracy of the thought and against the accuracy of the thought. This is a classic mechanism used in many situations and can help you to make an informed decision about the accuracy of your thoughts.
Next, you have an opportunity to create an alternative thought that can replace the automatic negative thought. Using the evidence for and against the initial thought, you can come up with a thought that is more accurate.
Finally, you are instructed to rate the strength of the emotion or feeling once again. The hope is that the intensity of the feeling has decreased due to the evidence-based evaluation of its accuracy.
This worksheet will be available for download soon.
Decatastrophizing
This is a particularly good tool for talking yourself out of catastrophizing a situation.
The worksheet begins with space to identify the catastrophe that you are worrying about. You should clearly state the predicted catastrophe and avoid using “What if…?” statements. You can also rate how terrible you believe this catastrophe will be on a scale from 0% (not so bad) to 100% (absolutely awful).
Once you have articulated the catastrophe that is worrying you, you can move on to thinking about how likely the event is to actually happen. Consider whether a similar event has occurred in your past and, if so, how often it occurred. With the frequency of this catastrophe in mind, make an educated guess of how likely it is to happen.
Next, think about how terrible it would be if the catastrophe actually came to pass. Consider the worst case scenario as well as the best case scenario. Try to put yourself in a friend’s shoes and think about what you would say to yourself about your worry.
Once you have a good idea of how bad the catastrophe would actually be, think about how you would cope with the fallout. Note whether this has come to pass before and, if so, how you coped when it happened. Consider the resources you have at your disposal to help you cope, including friends and loved ones, skills or abilities you have, and methods or techniques that help you cope in other situations.
Finally, you are directed to put together a narrative about the “catastrophe” based on the work you have done. Think about what you would like to hear in order to feel reassured, and what kind of tone would be most helpful. Once you have come up with something positive and reassuring to say to yourself about the potential catastrophe, rate how terrible you think the catastrophe will be once again.
Just as the repeated rating in the previous exercise is intended to do, this repeated rating should show a decrease in negative thinking.
This worksheet can be an excellent resource for anyone who is worrying excessively about a potentially negative event.
This worksheet will be available for download soon.
Modifying Rules and Assumptions
Cognitive distortions include assumptions and rules that we hold dearly or have decided we must live by. Sometimes these rules or assumptions help us to stick to our values or our moral code, but often they can limit and frustrate us.
This exercise can help you to think more critically about an assumption or rule that may be harmful.
First, you list the rule or assumption that you live by but would like to modify.
Next, you describe how the rule or assumption affects you in your day to day life.
Once you have explained how the rule or assumption impacts you, you are directed to think about where it came from. Consider when you acquired this rule, how you learned about it, and what was happening in your life that encouraged you to adopt it.
Now that you have outlined a definition of the rule or assumption and its origins and impact on your life, you can move on to comparing its advantages and disadvantages. Every rule or assumption we follow will likely have both advantages and disadvantages. The presence of one advantage does not mean the rule or assumption is necessarily a good one, just as the presence of one disadvantage does not automatically make the rule or assumption a bad one. This is where you must think critically about how the rule or assumption helps and/or hurts you.
Finally, you have an opportunity to think about everything you have listed and come up with a potential alternative rule or assumption that would suit you better. This may be a small change or a big modification. However you decide to change the rule or assumption, the new version should maximize the advantages of the rule, minimize or limit the disadvantages, or both. Consider how you can put this new and improved rule into practice in your daily life.
Fact or Opinion
This is one of the first lessons that participants in cognitive behavioral therapy (CBT) learn – that facts are not opinions. As obvious as this seems, it can be difficult to remember and adhere to this fact in your day to day life.
This exercise can help you learn the difference between fact and opinion, and prepare you to distinguish between your own opinions and facts.

END PART THREE

dianeseattle · Jul 11, 2020

The worksheet lists the following fifteen statements and asks the reader to decide whether they are fact or opinion:

I’m a bad person.
Sam told me that she didn’t like what I said about her.
Nothing ever goes right.
This will be a disaster.
I’m not as attractive as they are.
I failed the test.
I am overweight.
He shouted at me.
I’m selfish.
There’s something wrong with me.
I’m lazy.
I didn’t lend my friend money when they asked.
My feet are too big.
I’m ugly.
No-one will ever love me.

Practicing making this distinction between fact and opinion can improve your ability to quickly differentiate between the two when they pop up in your own thoughts.
In case you’re wondering which is which, here is the key:

I’m a bad person. Opinion
Sam told me that she didn’t like what I said about her. Fact
Nothing ever goes right. Opinion
This will be a disaster. Opinion
I’m not as attractive as they are. Opinion
I failed the test. Fact
I am overweight. Fact
He shouted at me. Fact
I’m selfish. Opinion
There’s something wrong with me. Opinion
I’m lazy. Opinion
I didn’t lend my friend money when they asked. Fact
My feet are too big. Opinion
I’m ugly. Opinion
No-one will ever love me. Opinion

Putting Thoughts on Trial
This exercise uses CBT theory and techniques to help you examine your irrational thoughts. You will act as the defense attorney, prosecutor, and judge all at once, providing evidence for and against the irrational thought and evaluating the merit of the thought based on this evidence.
The worksheet begins with an explanation of the exercise and a description of the roles you will be playing.
The first box to be completed is “The Thought.” This is where you write down the irrational thought that is being put on trial.
Next, you fill out “The Defense” box with evidence that corroborates or supports the thought.
Once you have listed all of defense’s evidence, do the same for “The Prosecution” box. Write down all of the evidence calling the thought into question or instilling doubt in its accuracy.
When you have listed all of the evidence you can think of, both for and against the thought, evaluate the evidence and write down the results of your evaluation in “The Judge’s Verdict” box.
This worksheet is a fun and engaging way to think critically about your negative or irrational thoughts and make good decisions about which thoughts to modify and which to embrace.
A Take Home Message
Hopefully this piece has given you a good understanding of cognitive distortions. These sneaky, inaccurate patterns of thinking and believing are common, but their potential impact should not be underestimated.
Even if you are not struggling with depression, anxiety, or another serious mental health issue, it doesn’t hurt to evaluate your own thoughts every now and then. The sooner you catch a cognitive distortion and mount a defense against it, the less likely it is to make a negative impact on your life.

END

Roni · Feb 8, 2021

Wow Diane that is impressive.

FinallyMe · Oct 17, 2023

Thank you for the article on Misconceptions of Bariatric Surgery and Obesity. Some of that was new information I needed to hear in more detail. The surgeon assuring my I was on the right track and was an excellent candidate for surgery for some of those reason in brief had already helped, but it was nice to read the scope of the research here.

Bariatric Surgery Misconceptions

Bariatric Surgery Misconceptions | ASMBS

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