Monday, August 15, 2016

Cognitive Disorders

Medical training and life in general is overflowing with cognitive mistakes. I've been meaning to blog about them since fourth year of medical school. Here are ten common cognitive mistakes; look how close to the truth each one is. (This is reprinted from some handout I got some time in med school. If I'm plagiarizing, let me know and I'll take it down.)
  1. All-or-nothing thinking: you see things in black-and white categories. If your performance falls short of perfect, you see yourself as a total failure.
  2. Overgeneralization: you see a single negative event as a never-ending pattern of defeat.
  3. Mental filter: you pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that discolors the entire beaker of water.
  4. Disqualifying the positive: you reject positive experiences by insisting that they "don't count" for some reason. In this way you can maintain a negative belief that is contradicted by your everyday experiences.
  5. Jumping to conclusions: you make a negative interpretation even though there are no definite facts that convincingly support your conclusion.
    1. Mind reading: you arbitrarily conclude that someone is reacting negatively to you, and you don't bother to check this out.
    2. The fortuneteller error: you can anticipate that things will turn out badly, and you feel convinced that your prediction is an already-established fact.
  6. Magnification (catastrophizing) or minimization (also called "the binocular trick"): you exaggerate the importance of things (such as your goof-up or someone else's achievement), or you inappropriately shrink things until they appear tiny (your own desirable qualities or another person's imperfections).
  7. Emotional reasoning: you assume that your negative emotions necessarily reflect the way things really are.
  8. Should statements: you try to motivate yourself with "should" and "shouldn't," as if you had to be whipped and punished before you could be expected to do anything. "Musts" and "oughts" are also offenders. the emotional consequences are guilt. When you direct "should" statements toward others, you feel anger, frustration, and resentment.
  9. Labeling and mislabeling: this is an extreme form of overgeneralization. Instead of describing your error, you attach a negative label to yourself. "I'm a loser." When someone else's behavior rubs you the wrong way, you attach a negative label to him. "He's a louse." Mislabeling involves describing an event with language that is highly colored and emotional labeled.
  10. Personalization: you see yourself as the cause of some negative external event, for which in fact you were not primarily responsible.


  1. Hi there, just came across your blog.

    I know this post has nothing to do with the abortion issue, but I have been struggling greatly with the topic recently. And I'd like to clarify that I am not religious. I've always been pro life but recently have started to believe that the absolutist no exception (as in never ever allowable) position is destructive to women. Was wondering if I could ask u some questions about your medical knowledge of certain issues and so forth

    1. Thanks for reading, Matthew. Yes, I'd be more than happy to help! If you prefer to discuss by email, please send a message to medicalmatins(a)