“All-Or- Nothing” Thinking Is Unhealthy”

Dear Dr. LeCrone:

One of my friends and co-workers has some problems that interfere with her ability to work with other people and keep her from enjoying relationships with her friends and family.

Because she doesn’t have a college degree, she thinks that everyone considers her dumb. She believes that every time there is a problem at work, it is a reflection on her. Our boss is not one to provide much praise, and she interprets this as his believing that she doesn’t do a good job.

Although she is attractive, she believes that no one thinks that she is pretty. Her husband is my brother and is very attentive to her in spite of having to work two jobs. She says that he is always too busy and never pays any attention to her.

Because she had an unhappy childhood, she feels that she can never be happy. I think that she is depressed and has a very poor self-concept. Would counseling help?

—A reader in Florida

Dear Reader:

An assessment of your friend’s mental health by a professional would certainly seem warranted. These results could then determine if she could benefit from therapy.

Your description of her thinking, including her beliefs and assumptions, strike me as indicative of someone who may suffer from a predilection for overgeneralized thinking.

Words like no one, every time, everything, never, always and everyone are examples of cognitive distortions. These thinking styles separate the individual from reality and fail to acknowledge the gradations in life.

Healthy thinkers recognize the many possibilities that exist between always and never, everyone and no one, all and none, and everything and nothing.

Those who think in “either–or” or “all-or-nothing” base their perceptions on emotional rather than rational processes. They use absolutes to close the doors of possibility. Life becomes more and more confining as the magnitude of overgeneralized thinking increases. Those who overgeneralize take one instance, experience and occurrence, and make it a rule. To the overgeneralizer, one mistake or less-than-completely satisfactory performance means complete failure.

Changing overgeneralized thinking patterns requires challenging and refuting beliefs and assumptions that underlie the absolutes.

Cognitive Behavior Therapy, a type of psychotherapy, includes helping people who suffer from cognitive distortions, which your friend appears to have, improve their mental health. Although the positive changes do not occur overnight, positive gains often occur in a relatively brief period of time.