Distortion vs Reality

Correcting cognitive distortions is a requirement for recovery. The depressed are given to negative thought patterns that not only send them down the path to depression but keep them mired in the bog of despair.

Drawing negative conclusions about themselves, engaging in all-or-nothing or black-and-white thinking, focusing on problems rather than solutions, generalizing catastrophic outcomes from one specific bad event-all are manifestations of the depressed state of mind. It is necessary-and possible-for the depressed to change the quality of their thinking in order to change their mood.

But the hardest domain in which to do that is the interpersonal sphere. While depressed people need to shape up their distorted thinking, there is an interpersonal reality that they also must come to terms with. A common cognitive distortion that sustains depression is "people don't like me." But the fact is, there is a lot about depressed behavior that is aversive to other people-things they do and things that they don't do that are genuinely off-putting. It is a terrible struggle to sort out the distinctions-yet necessary, as supportive relationships with others are critical for recovery.

Among the behaviors typical of depression that commonly alienate others and elicit overt or subtle rejection:

• absence of expression, including limited facial expressiveness, lack of gesturing and nodding, minimal eye contact, in combination with slow speech, many pauses, slow responses.

• self-preoccupation and limited interested in the other person

• lack of reciprocity

• tendency to focus on negative content

• seeking of negative feedback congruent with their self-image or

• excessive reassurance-seeking

• anger and hostility.

Becoming aware of the behaviors that alienate others is a precondition for controlling them. That is likely to make interactions more rewarding and supportive.