Cognitive Behaviour Therapy A peer reviewed, multidisciplinary journal devoted to the application of behavioural and cognitive sciences to clinical psychology and psychotherapy.
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Do painful or negative thoughts get in your way? Try holding them lightly.
There is widespread consensus in modern cognitive behavior therapy (CBT) that thought processes play a large role in mental health. For example, we know that people who experience more negative thoughts about themselves and their lives are more likely to experience depression over time. However, experts disagree on how negative thoughts are connected with mental health and well-being. Knowing how thought processes and mental health are related can help to answer core questions like: What is the most effective way for each of us to respond to negative thoughts? And what types of skills should mental health workers teach to their clients?
We decided to explore this question by looking at the effects of two different cognitive processes over time. The first, cognitive fusion, is the tendency to take one’s thoughts literally or seriously, as rules that must be listened to. When a person is high in cognitive fusion, they see their thoughts as important and having a lot of control over their behavior. For example, someone high in cognitive fusion would think, “I can’t ask for help, I’ll be too embarrassed” and refrain from asking for help. In contrast, people who are low in cognitive fusion see their thoughts more like mental chatter, and don’t take them so seriously—choosing to listen to their thoughts when it’s helpful and tune out when it’s not. A person low in cognitive fusion might still have the thought “I can’t ask for help, I’ll be too embarrassed” but choose to ask for help anyway.
The second process we studied, called cognitive reappraisal, is the process of changing your thoughts in order to make them more realistic or helpful. For instance, someone who uses cognitive reappraisal might have the thought, “I can’t ask for help, I’ll be too embarrassed,” then reevaluate that thought, and change it to something more realistic or helpful like “Even if I feel embarrassed, I’ll probably get over it quickly” or “Professors have always been nice to me when I’ve asked for help before.”
To sum up, cognitive reappraisal involves what thoughts you have, while cognitive fusion involves how you see your thoughts. Previous studies have shown that interventions to increase cognitive reappraisal and decrease cognitive fusion are both helpful, but some studies have found changing cognitive fusion to be especially helpful. We set out to study a new part of this question—whether or not people’s natural level of reappraisal and fusion influences their mental health over time. We tested this question in a sample of 339 college students over a 1-month period.
What we found was that after statistically controlling for cognitive reappraisal and how students were doing initially, higher cognitive fusion was associated with higher overall distress, depression, anxiety, hostility, distress about academics, and problems as a student over time. In contrast, levels of cognitive reappraisal were only associated with problems as a student after controlling for how students were doing initially and their levels of cognitive fusion. What this means is that being low in cognitive fusion seems to be helpful for many different parts of mental health and wellbeing, while the effects of people’s natural levels of cognitive reappraisal are somewhat more limited. Of course, this study needs to be replicated with more diverse groups to be sure that these results apply more broadly. But what it suggests is that it may be particularly helpful to hold difficult thoughts lightly rather than treating them as literal truths and letting them control how you act.
Text: Jennifer Krafft
Photo credit: Per Carlbring
Read the full paper:
Jennifer Krafft, Jack A. Haeger & Michael E. Levin (2018) Comparing cognitive fusion and cognitive reappraisal as predictors of college student mental health, Cognitive Behaviour Therapy, DOI: 10.1080/16506073.2018.1513556
Jennifer Krafft
