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Cognitive Restructuring:

ReframingEverything can be taken away from man but one

thing—the last human freedom, to choose one’s

attitude in any given set of circumstances.—Viktor Frankl

A bounced check. The roommate from hell.

A flat tire. Alcoholic parents. Stressors come

in all shapes, sizes, and degrees of intensity.

Scholars concur that it is not the circum-

stance that is stressful, but the perception or interpretation

of the circumstance. We now know that if the perception

is negative, it can become both a mental and physical li-

ability. Whatever the event, perceptions can become

distorted and magnified entirely out of proportion to

their seriousness. This is referred to as cognitive distor-

tion (mole hills into mountains), and it turns everyday

problems into gigantic monsters. Attempts have been

made to deal with the “stress monster” from all angles,

including decreasing or manipulating sensory informa-

tion and teaching people to control the stress response

by employing various relaxation techniques. Perhaps

the coping skill most advocated—which goes right to

the heart of the matter but is initially very difficult to

employ—is favorably alter ing the stressful perception

of the circumstance that has precipitated feelings of

anger and/or fear. This alteration in perception is made

through changes in cognition. Cognition is the mental

process that includes an assortment of thinking and rea-

soning skills. Across the country, this coping technique

goes by several names: cognitive restructuring, cognitive

Cognitive distortion: Distorting a situation beyond how bad it actually is.Quotation reproduced from Man’s Search for Meaning by Viktor E. Frankl. Coypright © 1959, 1962, 1984,

1992 by Viktor E. Frankl. Reprinted by permission of Beacon Press, Boston and the Viktor Frankl Institute.

CHAPTER 9

Chapter 9 Cognitive Restructuring: Reframing 215

reappraisal, cognitive relabeling, cognitive reframing,

cognitive therapy, and attitude adjustment. Despite the

variations, they all suggest the same approach: to favor-

ably alter the current mind frame to a less threatening

perception, from a negative, self-defeating attitude to a

positive one, which may then allow the initiation of the

steps toward a peaceful resolution.

The seeds of cognitive therapy took root in 1962 with the

work of Albert Ellis in what he referred to as rational

emotive behavior therapy (REBT). The premise of El-

lis’s work was that stress-related behaviors are initiated

by perceptions and that these self-defeating perceptions

can be changed. He explained that all stimuli sent to

the brain go through a process of interpretation. When

enough stimulation is interpreted as threatening, it be-

comes a critical mass of negative thought. Ellis was of the

opinion that once a critical mass of perceived stress arises,

it dims the ability to think rationally. As a result, a self-

defeating attitude becomes reinforced day after day, year

after year, through internal dialogue that is scripted by the

tone of these irra tional thought processes. Ellis became

convinced that people could be educated and trained to

favorably alter negative or stress-related perceptions (ir-

rational thoughts) into positive attitudes, which in turn

would decrease the intensity of perceived stress. In a 2008

news briefing, author J.K. Rowling of the Harry Potter

series shared publicly her experience with depression and

thoughts of suicide, and she credited the use of REBT as

what pulled her though her darkest hour. The term cogni-

tive restructuring was coined by Meichenbaum in 1975 to

describe a coping technique for patients diagnosed with

stress-related disorders. This coping style aimed to modify

internal self-dialogue by tuning into the conversation

within the mind. The practice of cognitive restructuring

was an important step in what Meichenbaum referred to

as stress inoculation, a process to build up positive thoughts

when negatively perceived events are encountered. Work

by Bandura in 1977 and Beck in 1976 also supported the

concept of cognitive change of perceptions as a means to

effectively deal with stress. To understand how stimuli are

interpreted and how interpreted thoughts are structured

from stimuli, let us take a closer look at how the human

thought process works.

■ A Thinking-Process Model

The human mind is an extremely complex phenomenon,

and one that we are just beginning to comprehend. Schol-

ars in the discipline of cognitive science have created a

theory, the information-processing model, to attempt

to explain exactly how the mind processes information ( FIG. 9.1 ). This theory suggests that sensory input

(e.g., a flashing blue light in your rearview mirror), sen-

sory manipulation (e.g., danger, speeding vio lation, slow

down, court hearing), and cognitive/behavioral output

(e.g., foot on the brake, pull over to the side of the road,

pray), as well as a feedback system to correct or refine

this mechanism (e.g., several officers going to the scene

of an accident, calm down), are synthesized to produce

a linear progression of mental processes. Each cognitive

deciphering process begins with an interpretation of the

stimulus that comes into any of the five (possibly six)

senses to determine its threat potential. In simple terms,

stimuli can be interpreted as either threats or nonthreats.

Resulting attitudes can be labeled in one of three ways:

(1) defensive (negative), (2) neutral (innocuous), or (3)

offensive (positive). Fragments of information, as well

as memories of previous similar experiences, are then

Rational emotive behavior therapy (REBT):

Developed by Albert Ellis as a means to help people cope with anxiety by changing the perceptions associated with the stressor.

Cognitive restructuring: A coping technique; substi-tuting negative, self-defeating thoughts with posi-tive, affirming thoughts that change perceptions of stressors from threatening to nonthreatening.

Information-processing model: A model that reveals how we potentially perceive sensory information, for better or worse.

FIGURE 9.1 The information-processing model of human thought.

Phase 1: Input(sight, sound, etc.)

Phase 3: Output(action, behavior)

Consciousappraisal ofstimuli

Phase 2: Processing Input(a) Conscious interpretation(b) Reasoning(c) Analyzing(d) Memory

216 Part 3 Coping Strategies

manipulated in a process that results in the accessing and

utilization of either left- (analytical) or right- (receptive)

brain cognitive functions, or a combination of both. In the

final outcome, perceptions and attitudes are by-products

of the interpretation of all sensory information. It is

both the manipulation of stimuli and the subsequent

interpretation process that are targeted in cognitive

restructuring to convert negative thoughts into neutral

or positive ones.

The purpose of cognitive restructuring is to widen one’s

conscious perspective and thus allow room for a change in

perception. The ability to expand perception is not merely

a poetic expression. Research by optometrist Jacob Liber-

man (1991) shows that an individual’s perceptual field of

vision actually constricts (myopia) under stress. Thus, one

literally sees less than the whole picture. Data analysis by

Anderson and Williams (1989) corroborates this evidence,

showing a causal relationship between perceived stress and

loss of peripheral field of vision. As Liberman points out,

stress forces one to see through a small hole rather than

view the entire field of vision or whole picture.

Unconsciously, many people use a nonproductive cop-

ing technique called rationalization that they think is

one and the same as cognitive restructuring. Cognitive

restructuring should not be confused with this defense

mechanism. Rationalization is making excuses, blam-

ing, and shifting responsibility away from oneself

toward someone or something else. Freud referred to

this as denial of reality. Cognitive restructuring, on the

other hand, involves assuming responsibility, facing

the reality of a situation, and taking the offensive to

resolve the issues causing stress. Creating and adopt-

ing a positive mind frame take some work. People

often find it simpler to avoid this responsibility and be

consumed by their own negative thinking styles, which

produce a preponderance of toxic thoughts.

■ Two Minds Are Better Than One

A documentary video called The Secret made international

headlines on the Oprah show and Larry King Live. Using

the Power of Attraction as its premise, several popular self-

help gurus spoke to the nature of achieving ultimate goals

of wealth and relationships merely by thinking positive

about these ideals. Countless examples were reenacted to

illustrate the abundance of the universe and the power of

intention. If they could do it, surely you could, too! The

problem is . . . it’s not this simple.

What the makers of the video failed to include (although

this may be revealed in subsequent sequels) is the power

of ego-driven thoughts from the subconscious mind

(a portion of the unconscious mind). So much of our

behavior (some experts think all of it) is directed by our

unconscious minds. Perhaps this concept is best illus-

trated by the famous actor Buster Keaton (and imitated

by Johnny Depp in the movie Benny and Joon) who tries

in vain to pick up his hat but repeatedly seems to kick

it out of his reach before he can grab it ( FIG. 9.2 ). If

the conscious mind and the unconscious mind are not

acting together, all the intentions and reframing in the

world aren’t going to help. In the field of psychology

this is known as the “unconscious resistance,” a self-

sabotaging effect that undermines the conscious mind’s best

efforts to make (positive) things happen. It is the foundation

of the negative self-fulfilling prophecy. Coaches see this

all the time with promising athletes. Physicians see this

in many of their patients too, specifically with patients

who say they want to be healed, yet have too much of

their identity wrapped up in the disease to leave it behind.

Here is another common example: Consciously, you want

to find that perfect person to go out with (or marry) and

you set your intention. Consciously, you believe you are

FIGURE 9.2 Silent film actor Buster Keaton was famous for his “kick the hat” routine, in which he would accidentally drop his hat and try to pick it up with his hand, only to repeatedly kick it out of reach before he could grab it. This routine is the perfect metaphor for how the conscious mind and one’s sub-sequent behavior (the hand) are greatly influenced by the unconscious mind (the foot kicking the hat). To change behavior, one has to unite the powers of both the conscious and unconscious minds.

© AP Photos.


attracting your soul mate. But nothing happens. Perhaps

the reason why is because unconsciously you like your

carefree lifestyle and really don’t want to change. Perhaps

unconsciously, you still believe that you are not worthy

of a quality relationship. Regardless of the reason, some

belief system (usually an ego, fear-based one) hidden in

the depths of the unconscious mind is holding on to old

ways, thus negating the law of attraction to its highest

potential. This is the real secret: The unconscious mind

governs 80 to 90 percent of human behavior (Lipton, 2009;

Mlodinow, 2012).

Experts suggest that these old beliefs and perceptions are

learned and adopted early in life (ages 2–6) when the child’s

brain, like a sponge, soaks up sensory stimuli from the

child’s environment (e.g., parents, teachers, siblings). As

the child matures into adulthood, behavior is directed by

these ingrained, subconscious thought patterns and beliefs.

Until they are erased and replaced with new beliefs and

perceptions, not much will change.

To use an apt metaphor, the mind is like a radio playing

music from two stations (the conscious and the unconscious),

but the station you want to hear is being drowned out by

the one you don’t want to hear. In the case of the radio,

fine-tuning is in order. In the case of the mind, it is coming

to terms with old, fear-based thought patterns that tend to

hold us back from reaching our highest potential. If you

have doubts as to the power of the unconscious mind’s

influence, listen to the choice of your words spoken. More

than just Freudian slips, our choice of words often reveals

the ego’s hidden agenda.

Experts in the field of psychology suggest that the secret to

harnessing the strength of your thoughts is to combine the

powers of the conscious and subconscious mind to achieve

one’s goals and aspirations (Taylor, 2013; Mlodinow, 2012;

Murphy, 2008; Hari, 2005). Bruce Lipton speaks of this

with regard to the health and healing process in which

we need to erase the subconscious messages and rerecord

new thoughts to help navigate the intended direction of

our lives. Some people erase and rewrite these messages

through hypnosis. Others do reprogram themselves by

listening to subliminal CDs. Consciously, it can be done

through neurolinguistic programming (NLP). Still oth-

ers do it in a relaxed state through meditation and guided

mental imagery or hypnotherapy. So, here is a question

for you: What goals and aspirations do you have that are

sabotaged by early childhood programming (e.g., trust is-

sues, self-esteem issues, confidence, perceptions of leisure,

money, or relationships)? How can you reprogram new

(positive) thoughts, beliefs, and perceptions of yourself

that can steer you in the direction and to the destination

you wish to go? When you can answer these questions

you have really discovered “the secret.”

■ Toxic Thoughts

Negative perceptions are often the result of low self-

esteem. They also perpetuate it by suppressing or

obliterating feelings of self-worth and self-acceptance.

It has been suggested (Canfield, 1988; Ingerman, 2007)

that toxic thoughts originate from repeated exposure to

feelings of shame and guilt in early childhood. Canfield

cites a study conducted at the University of Iowa where

parent–child interactions were observed over a period

of several days. Results revealed that, on average, there

were 400 negative comments for every positive one spo-

ken to the child. It was concluded that negative thoughts

are actually a conditioned (learned) response that is then

carried into adulthood. Catastrophic thoughts are also

reinforced in the messages we receive from the headlines—

rarely does a human interest story beat a cataclysmic event

on the six o’clock news. Disasters, world problems, and

crimes permeate the news, which tends to condition our

thinking toward the negative side of things. Many coun-

selors, therapists, and psychologists suggest that negative

thinking has an addictive quality to it.

The term toxic thoughts was coined in the early 1980s

by several psychologists to educate their clients about the

dangers of negative thinking. Pessimism, a personality

trait heavily grounded in negativism, promotes toxic

thoughts. To demonstrate just how destructive they could

be, Dr. Leslie Kaymen conducted a study at the University

of Pennsylvania in 1989 to determine the phy siological

responses to stress between individuals who identified

themselves (through a psychological survey) as either

optimists or pessimists. All subjects were exposed to

minute doses of pathogens (tetanus, mumps, and yeast),

which, when placed on the skin, would indicate their

stress-tolerance levels. Subjects were then divided by

attitude into two groups, and both groups were given

an impossible task to complete in a brief time period.

While the pessimists quickly gave up, the optimists con-

tinued until the last possible moment. Days later, the PNI

response (skin rashes) of the pessimists was significantly

greater than that of the optimists. These results revealed

Toxic thoughts: Repeated negative thought process-ing that tends to pollute our view of our lives and ourselves.


that an optimistic attitude was associated with sound

physical health, whereas a negative attitude perpetuated

the mental and physical stress response. In short, negative

thoughts can have a toxic effect on the body. Kaymen’s data

analysis confirms the hypothesis that negative thinking

can suppress the immune system.

In an updated version of Kaymen’s work, Andrew Steptoe

and colleagues (2008) designed a study with nearly 3,000

subjects to examine the biological links of positive thoughts

(mood). Results revealed that both men and women who

reported experiencing a happy mood had lower cortisol

levels, suggesting that happiness and optimism reduce

biological vulnerability. Moreover, female subjects indicated

significant decreased amounts of two proteins (C-reactive

protein and interleukin 6) that are associated with inflamma-

tion, a factor linked with heart disease and cancer. Steptoe

concluded that mood states are not merely hereditary, but

depend on social relationships and life purpose.

Dr. Lissa Rankin is a physician who has studied the ef-

fect that positive and negative thoughts have on health.

In her book, Mind over Medicine, she cites several studies

including one that investigated the early deaths of Chinese

Stress with a Human FaceA tribute to Allison Fisher: In the spring of 1991, I had a remarkable student named Allison Fisher. Allison was bright, energetic, and beaming with success. At the mid-point of each semester, I invite my students to do an exercise called “Confrontation of a Stressor.” I believe that the concepts of stress management remain only concepts if they are not practiced outside the classroom. In other words, to know and not to do is not to know. In this exercise, students are asked to pick one of their top three stressors and are given two weeks to resolve it—with the condition that they must enter the classroom with no bruises or broken bones. Although students are asked to write up this assignment, on the day it’s due we all sit in a circle with the lights down low and, one by one, under an agreement of confidentiality, we share our stories. This particular semester Allison went first.

“My stressor is breast cancer; it runs in the family,” she explained. “My mother has had it—my aunt and my grand mother, too. For many years I have been scared of breast cancer, because I know I am at risk. Upon hearing this assignment, I decided it was time to go for a mam-mogram. I was extremely nervous, but last week I made an appointment with my physician.”

The class was silent, all eyes fixed on Allison. With an air of confidence, she concluded her story with a smile: “I am happy to say that the test was negative!”

As a graduating senior with a major in broadcast journal-ism, Allison was looking forward to a promising broadcast-ing career. Less than a month after her graduation, she found herself working for a PBS affiliate. Within a year’s time, she took a job with Voice of America and then moved to Los Angeles to start a highly coveted job as an anchor/ reporter for Channel One, a cable program for high school youth. Several years later our paths would cross again,

when I found myself in Los Angeles for a book signing. We agreed to meet for lunch the next day. At that time, Allison confided in me that she was a cancer survivor.

To be a cancer survivor means you confront death face to face. You challenge it with a mindset rather than run from it with a defeatist attitude. Being a survivor means you adopt an attitude of realistic optimism. You acknowl-edge the problems at hand, but you focus on the positive. You live life in the present moment rather than reliving the past or worrying about what the future may hold. You break through the fear of dying, the fear of the unknown, and the fear of isolation, and you come through on the other side as a victor, not a victim—what Joseph Camp-bell called the hero of the hero’s journey.

“I had my first mastectomy over a year ago, my second one several months ago. The bad news is that the cancer is back and this time it has spread to my lungs. I’m okay, though,” Allison said confidently. Then Allison shared with me theories and concepts that I had taught her as a student—but now she was teaching me insights and wisdom known only from the perspective of a survivor.

“It’s all about attitude. I’m not sure how much time I have to live now, but I don’t have time for toxic thoughts, or the fear of what might happen. I chose to look at the bright side of life, because I discovered long ago that that’s all that really matters. I don’t know if I will be cured of my cancer, but I can tell you right now, I am healed of my disease, because I am at peace, and there is no greater feeling than this.”

Allison Fisher crossed the threshold of heaven on March 9, 1998 (www.allisonfisherfund.org).

Courtesy of Allison E. Fisher Mem

orial Fund, Inc./Pat and Ron Fisher.


Americans who considered themselves ill-fated by being

born under less than auspicious astrological signs. The

results revealed that the more closely they believed in

the power of astrology, the earlier they died—deaths

that could not be explained by genetic factors, lifestyle

choices, lifestyle behaviors, or any other variables. Stated

simply, the negative thoughts they associated with their

fate impacted their health. Rankin states that disease is

not just a consequence of our genetic make-up, patho-

gens, or even bad luck. For better or worse, our health

is greatly influenced by our mindset (attitude). Negative

thoughts can compromise one’s level of well-being. Bar-

bara Frederickson agrees. As one of the leaders in the

positive psychology movement, Frederickson coined the

term “positivity” to express the power of optimism, as

expressed through love. “The new science illuminates for

the first time how love, and its absences, fundamentally

alters the biochemicals in which your body is steeped”

(Frederickson, 2013).

What is your PQ? PQ stands for Positive Intelligence, a term

created by Stanford University lecturer, author, and CEO

of one of the largest coach training programs in the world,

Shirzad Chamine. The premise of Positive Intelligence is to

reclaim the power of your mind by disarming the saboteur

(the voice of the ego that offers a steady stream of nega-

tive thoughts). Chamine states that the reason why only

20 percent of people reach their true potential is because the

mind is held hostage by negative thinking. Positive Intel-

ligence is a program to learn to reframe one’s thoughts and

harness one’s highest potential.

Is it really possible to change the programming in our

minds to break the habit of negative thinking? Accord-

ing to Richard Bandler and John Grinder (Andreas and

Faulkven, 1994), the answer is a definitive yes! Years ago,

Bandler, a psychologist, and Grinder, a linguist, combined

their efforts to create and teach the theory and applica-

tion of changing our mental language. They called it

neurolinguistic programming (NLP). The premise of

NLP is based on the concept of uncovering hidden gram-

mar woven in the unconscious and conscious thoughts of

our vernacular, systematically removing these expressions

as we think or speak, and learning to develop a language

of affirmative thoughts to positively change the direction

of our lives. NLP is an empowering skill to reprogram

the software of human linguistics so that our human ener-

gies can be focused in the direction of our highest human

potential or human excellence. Part sel ective awareness,

part self-hypnosis, the dynamics of NLP work to eliminate

the self-defeating thoughts that inhibit our energies and

keep us from reaching our goals. Over the years, NLP

has proven quite successful and is used by athletes, actors,

executives, business associates, lawyers, and professionals

from all walks of life. By encouraging reprogramming

and eliminating from daily vernacular words, phrases, and

thoughts that reinforce stress-prone behaviors, NLP helps

one to unlearn old thoughts and learn a new approach

toward optimal excellence. NLP Comprehensive, based

in Boulder, Colorado, offers seminars and workshops in the

dyna mics of NLP. Understanding that one cannot change

behaviors quickly as a result of a one- or two-day workshop,

the NLP training coaches participants through a 21-day

Achievement Program to help decondition and reprogram

the human thought process.

Far more than lauding creative and optimistic thinking

styles, Western culture rewards and praises critical think-

ing, the ability to judge and analyze situations, breaking

them down into smaller, more manageable parts. In theory,

when problems are dismantled into smaller pieces, they

are easier to understand. Under stress, an emotional side

effect of critical thinking is that smaller pieces of stressful

stimuli may be considered less threatening to the ego and

thus help to minimize emotional pain. In practice, though,

when critical thought pro cesses are directed toward the self,

judgmental and analytical thoughts often nurture a negative

perspective about yourself, making you more vulnerable to

the perceptions of stress ( BOX 9.1 ). When threatened,

critical thought can become a defensive weapon to protect

the components of your identity. In addition to critical think-

ing, a common mental attitude seen in American culture is

victimization. Victim ization is a perceptual attitude wherein

one feels specifically targeted by events or circumstances and

has no choice but to suffer the consequences. In dividuals

who see themselves as victims often seek pity and sympathy

from their friends as a means of coping with the stressors at

hand. Through the sympathy of others, they validate their

own perceptions of personal violation. People who express

feelings of victimization apply what psychologists refer to

as attribution theory, blaming other people or factors for

perceived injustices (Taylor, 2011).

The concept of victimization is closely associated with

Rotter’s concept of locus of control, where people who

Neurolinguistic programming (NLP): A program designed to look at how our thoughts control our lan-guage and how our language influences our behavior.

Victimization: A mindset of continually seeing your-self as a victim.


life’s victims (a characteristic of codependency) often see

themselves as martyrs. This is a socially rewarding role,

so they find it difficult to change their perceptions.

Can optimism be learned? According to Martin Selig-

man the answer is yes! In his much-acclaimed book

Learned Optimism, Seligman states that we are most likely

to learn the traits of optimism or pessimism from our

parents, but even if the environment in which we were

raised was a negative one, we can cultivate the aspect of

optimistic thinking and gravitate toward a positive ap-

proach to life. Seligman studied several nationally ranked

swimmers prior to the 1988 Olympics and soon realized

that optimism is not only an inherent trait, but one that

can be augmented or learned. Using a term he coined,

feel violated by stressors are more greatly influenced

by external sources than by internal strength and

inspiration. Here is a simple test to detect use of the vic-

timization attitude: During the next casual conversation

you encounter, listen objectively to what is said and notice

how often people appear to fall victim to their bosses,

spouses, roommates, kids, traffic, the weather, or any other

circumstance in the vicinity. Next, listen objectively to how

you present your perceptions to others when you describe

your own levels of stress. Do you consciously or uncon-

sciously label yourself as a victim? Many people take great

comfort in being a victim because it fulfills an immediate

need to feel needed, as well as the instant gratification of

sympathy and pity. People who take on the role of one of

BOX 9.1 Cognitive Distortions: Stop the Insanity!

The human mind can be our greatest asset or our worst liability. Under the influence of the ego, the mind becomes misguided and heads down a path of self-sabotage. All of this is exacerbated in times of stress. This behavior in psychological circles is known as cognitive distortion. It can be said that cognitive distortions are spin-offs of Freud’s defense mechanisms. More than the ego’s intent to decrease pain or increase pleasure, over time these distor-tions become a habitual mindset that can sabotage our best efforts. David Burns writes in great detail about this phenomenon in The Feeling Good Handbook where he describes the ten distinct styles of cognitive distortion that perpetuate perceptions of stress. Mental thought pro-cesses and the behaviors they elicit cannot be changed until they can first be identified. (It should be noted that the benefit of meditation is to become the observer of your thoughts.) As you read through this list, ask yourself if one or more styles sound all too familiar to your way of stress-based thinking. If you don’t see these in yourself, ask a trusted friend to give you feedback.

1. All-or-none thinking: There is only good or bad, black or white, no middle ground (e.g., there is only one way to solve this problem).

2. Overgeneralization: One single negative circum-stance manifests into a life pattern (e.g., A flat tire elicits the comment, “This always happens to me!”).

3. Mental filter: A solitary negative detail becomes the focus of your attention, obscuring the bigger picture (e.g., an hour drive is tainted by one driver early on who cut you off).

4. Disqualifying the positive: A negative belief pat-tern that eclipses positive circumstances, reduc-ing any that surface as insignificant all the while focusing on the negative.

5. Jumping to conclusions: Affirming a negative interpretation without supporting facts often by insisting on a strong intuitive feel, which is little more than projection of one’s own feelings.

6. Magnification: The classic story of making a mountain out of a mole hill, by exaggerating facts with the end result in a myopic vision of the situation and thus missing the big picture.

7. Emotional reasoning: Living the assumption that one’s negative emotions are a true reflection of how things really are.

8. Should statements: A thought process influenced by a “rewards and punishment” mentality in which one motivates oneself with the words should, must, ought. This behavior often results in feelings of guilt or resentment toward others.

9. Labeling and mislabeling: Considered an extreme form of overgeneralization, statements such as “I’m a loser,” or “He’s always a jerk,” are exam-ples in which mislabeling involves words that are highly charged or emotionally loaded.

10. Personalization: Taking credit or blame for events that you had little or nothing to do with.


flexible optimism, Seligman states that although the trait

of optimism is not a panacea for the bumps in the road of

life, we can harness the power of positive thinking to help

us achieve our goals and promote a greater state of health

and well-being ( FIG. 9.3 ).

The dialogue mentioned earlier that seems to run non-

stop in our minds is referred to as self-talk, and it has

been observed that the preponderance of this is negative

self-thoughts. Schafer (1999) has identified several types

of negative self-talk thinking patterns that produce and/

or perpetuate the toxic-thought process. He lists them

in the following categories: pessimism, or looking at the

worst of almost every situation; catastrophizing, making

the worst of a situation; blaming, shifting the responsi-

bility for circumstances to someone other than yourself;

perfectionism, imposing above-human standards on

yourself; polarized thinking, where everything is seen

as an extreme (good versus bad) and there is no middle

ground; should-ing, reprimanding yourself for things you

should have done; and magnifying, blowing problems

out of proportion.

One technique to convert negative thoughts to

neutral thoughts, similar to Ellis’s REBT, is called

thought stopping. When you catch yourself thinking

negatively, you interrupt the flow of conscious ness and

say to yourself, “Stop this thought.” With practice,

thought stopping can help to disarm your negative critic

and give balance to your emotional thoughts.

As you can see, toxic thoughts are very real. Over time,

these can have consequential effects on the body as well.

But stimulation received by the brain is open to reinter-

pretation, and perceptions can change. Metaphorically

speaking, some people appreciate the beauty of the rose

petals, some people sense the pain of the thorns. Cog-

nitive restructuring is a way to focus on the rose petals.

Here is the lesson: Every situation has a good side and a

bad side. Each moment . . . you decide! During World

War II, a song by Johnny Mercer and Harold Arlen hit

the air waves and quickly became a national hit. It was

called “Accentuate the Positive, Eli minate the Negative,”

and this song was one of many credited with helping the

nation deal with the consequences of war ( FIG. 9.4 ).

■ The Choice to Choose

Our Thoughts

In his book Man’s Search for Meaning, Frankl credited

his survival in Auschwitz to his ability to find meaning

in his suffering, a meaning that strengthened his will-

power and choice of attitude. Frankl noted that despite

the fact that prisoners were stripped of all their material

possessions and many essential human rights, the one

thing concentration camp officials could not take away

was the ability of prisoners to choose their perceptions

of their circumstances.

Flexible optimism: A term coined by Seligman to convey that we can all harness the power of opti-mism into positive thinking.

Self-talk: The perpetual conversation heard in the mind, usually negative and coming from the critical (ego), which rarely has anything good to say.

Pessimism: Looking at the worst of every situation.

Catastrophizing: Making the worst out of every situation.

Blaming: Shifting the responsibility of a problem away from yourself.

Perfectionism: Perpetually imposing above-human standards on oneself.

Polarized thinking: A condition where things are always viewed in extremes, either extremely good or horribly bad.

Should-ing: Reprimanding yourself for things you “should” have done.

Magnifying: A term to describe blowing things out of proportion.

Thought stopping: A coping technique where one consciously stops the run of negative thoughts going through one’s head.

FIGURE 9.3

© Randy Glasbergen, used w

ith permission from

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meaning in the suffering) and then move on to personal

resolution and growth. When many people are introduced

to the concept of cognitive restructuring, they incorrectly

sense they must adopt a “Pollyanna” or cheerful attitude and

that grief is not an appropriate sensation to acknowledge.

As a result, they reject the entire idea of looking at the

“brighter side” of a situation. Until feelings of suffering, no

matter how big or small, are brought to awareness, it will

be difficult to adopt a new frame of mind. Frankl wrote

that even in suffering there can be tragic optimism; the

discovery of light-hearted moments and personal mean-

ing in the saddest of times. Even in the death-grip of the

concentration camp, Frankl found it possible to laugh at

many of life’s absurdities. Moments like these helped him

get through his ordeal.

Comparisons between war and sports are not uncommon.

A winning attitude is everything. Tennis champion Andre

Agassi explained his reframing style from an athlete’s

perspective in his best-selling book Open: “I’ve won 869

matches in my career, fifth on the all time list, and many

were won during the afternoon shower.”

In her classic book Minding the Body, Mending the Mind,

Borysenko refers to the preponderance of negative thoughts

as awfulizing. The process of awfulizing consists of judg-

mental and analytical thoughts that greatly narrow one’s

perspective and put our mental processes into a shallow,

one-track mode. The result is what Borysenko calls re-

gressive coping, a nonproductive coping skill. Awful izing

creates worst-case scenarios for every situation. Although it

is good to prepare for all possibilities, a worst-case scenario

is only one in a wide spectrum of possibilities.

Psychologists use the term self-fulfilling prophecy to describe

the link between perceptions/beliefs and their related

behaviors. The self-fulfilling prophecy can work to one’s

advantage as well as one’s disadvantage. Sports events are

filled with stories of athletes who believed they were winners

and proved that indeed they were. In highly competitive

events like the Olympics, the difference between a gold

medal and a silver or bronze is not only a super lative athletic

body, but an accompanying winning attitude. Many an

athlete has lost an event, and thus failed to meet an expec-

tation, because a seed of self-doubt took root somewhere

between the starting block and the finish line. Individuals

who harbor negative thoughts about themselves or the

situations they encounter promote behaviors generated by

these perceptions. The result can be a negative cycle that

sets the stage for recurring stressful perceptions and what

appears to be a stagnant black cloud over one’s head; this

is the fulfillment of the self-fulfilling prophecy.

FIGURE 9.4 In this photo, a recording of opera singer Luciano Pavarotti is projected into a small sample of water. The wave trains in the water reveal the delicate harmonic pattern of the audio frequencies of his voice. From this, and many similar images, one can begin to appreciate the impact (either harmonious or discordant) that spoken words and even our thoughts—which are more subtle forms of vibration—can have on our bod-ies, which are composed mostly of water.

Brief grief: A concept that suggests that some grieving is appropriate and healthy, versus unhealthy, prolonged grieving.

Awfulizing: A mindset where one tends to see (or hope for) the bad in every situation.

One concept that evolved from Frankl’s theory of logo-

therapy is brief grief, which means acknowledging and

mourning an unmet expectation but not prolonging the

grieving process beyond a reasonable period of time. Death-

education experts suggest there are three basic stages of

grief: shock (denial), anger (depression), and understanding

(acceptance). The time for each stage will vary depending

on the person as well as the magnitude of loss. Feelings of

loss, sadness, anger, pain, and fear are all natural, but not

for prolonged periods of time. To deny these feelings is

unhealthy, just as it is abnormal to prolong these feelings

beyond their purpose. Brief grief is a strategy to allocate

the correct amount of time to the grieving process (finding

© 2002 Alexander Lauterw

asser. Reprinted with perm

ission from W

ater Sound Images.

© 2005 M

ACROmedia Publishing, Eliot, M

E. Availabe at: ww

w.cym

aticsource.com.


An example of this concept occurred in the 1990 hit movie

Pretty Woman, when actress Julia Roberts, in the role of

a Hollywood hooker, described to actor Richard Gere

how she fell into her “career rut.” She stated that while

growing up she received a lot of negative feedback from

her parents and peers, and that these were so much easier

to believe, eroding her self-esteem. Another example is

John Travolta’s character, Edna Turnblad, in the movie

Hairspray; he plays an overweight woman who refuses

to leave the house for many years because of her struggle

with obesity. This “underdog” trait in both Roberts’s and

Travolta’s characters was one many audience members

could identify with and relate to, perhaps because this

attitude is so prevalent in American society.

To break this self-defeating thought cycle, Borysenko

suggests employing the concept of reframing. Reframing

involves looking at the same situation from a new refer-

ence or vantage point and finding some good aspect in it.

Quite often, stubbornness and the comfort of our own

opinions become obstacles to the reframing process. Tools

to initiate the process and dismantle the obstacles include

the use of humor, positive affirmations, and creativity.

Positive affirmations are designed to bolster self-esteem.

Confidence building through self-praise in the form of

positive feedback tends to counterbalance the voice of the

inner critic constantly telling us we’re not up to standards

when we compare ourselves with others.

For example, as a health promotion and stress-management

consultant, I meet many people from all parts of the country

and all walks of life. During one workshop in 2007, I met

a remarkable woman from New Orleans who shared her

story of the terrible devastating experience she endured

(and continues to endure). My interactions with her and

others from New Orleans have allowed me to experience

first-hand the expression of the hardy personality, which

scholars Kobassa and Maddi describe as the stress-resistant

personality. Here is Chris’s story:

Chris is a native New Orleanian. It is a city she loves

with a passion. From the Dixieland jazz and Mardi

Gras to Cajun cooking, New Orleans is loaded with a

unique culture all its own. Living on the Gulf Coast,

however, has its perils. Louisiana is no stranger to

hurricanes. They are as much a given, Chris said, as

snow storms are in New England. When Katrina was

forming in the Gulf of Mexico, Chris and her hus-

band boarded up the house, packed up the car, and

headed north to Baton Rouge. With gale forces up to

150 miles per hour, they expected some wind damage

to the house, but no one expected the levees to break

and cause massive flooding. When they were allowed

to go back to their home weeks later, they found

water damage clear up to the second floor. Chris lost

priceless heirlooms, family portraits, computers, and

a manuscript of a book she had been working on for

5 years—practically everything she owned.

To lose everything in a flood can be devastating. How

do you rebuild your life at the age 35? Chris said it

would have been easy to play the role of victim, but

what good would that serve? “You take stock of what

you do have and build from there. I may have lost my

house and my belongings, but I have my health and my

wits. I am resilient. I will get through this, and I am

determined not to give up, but to rise above the situa-

tion and move on.” And that she has. Rebuilding her

life and rebuilding her house move on parallel tracks,

but within a year’s time she regained her sense of bal-

ance. She says, “Losing everything is both devastating

and liberating. I chose to focus on the positive and that

is what has gotten me through the tough times.”

One final thought about reframing ( FIG. 9.5 ). Bor-

ysenko recounts the story of an Australian friend, Ian

Reframing: The name given to the thought process where a negative perception is substituted for a neu-tral or positive one, without denying the situation.

FIGURE 9.5 According to some experts, the unconscious mind does not acknowledge negative thoughts. Thoughts such as “I won’t get nervous,” are interpreted as “I will get nervous,” which then often results in nervous behavior. Thinking positively allows the conscious and unconscious minds to work together.

Conscious

Unconscious

The unconscious mind does notunderstand negative thoughts


Gawlen, who was diagnosed with bone cancer and given

2 weeks to live. This man adopted the attitude that if he had

2 weeks to live, he was going to make the best of it. So, he

proposed to his girlfriend, got married, and went off on a

honeymoon to the South Pacific. Twenty years later, telling

of his experiences to Borysenko, he explained why he was

still alive. He discovered for himself that the unconscious

mind does not respond to negative thoughts such as “can-

not,” “won’t,” and “don’t.” There fore, rather than telling

himself, “I cannot die,” which the unconscious mind would

understand as “I can die,” he fed himself a flood of positive

thoughts, such as “I will live,” and he has ( BOX 9.2 ).

■ Acceptance: An Alternative

Choice

Many times we encounter situations we have no abil-

ity to control: a manipulative boss, an obnoxious

Acceptance: Often the final outcome of reframing a situation: Accepting that which you cannot change and moving on with your life.

Serenity Prayer: A popular short prayer encourag-ing acceptance and wisdom, attributed to Reinhold Niebuhr.

BOX 9.2 Optimism and Pessimism

Over the years I have asked my students for their defi-nitions of optimists and pessimists. All clichés aside, here are some of their answers:

An optimist is someone who:

■ doesn’t let failure limit his growth as a human being.

■ can find redeeming qualities in just about everyone.

■ takes personal setbacks as only a temporary inconvenience.

■ counts blessings instead of misfortunes.

■ loses a job and says there is a better one waiting.

■ has the ability to reevaluate her expectations so as not to become depressed when she falls short.

■ describes a pessimist as a person with potential.

■ continually explores new areas of life and can accept others who are different as unique.

■ has enough faith in herself to see her through a crisis.

■ on his deathbed, says, “I have no regrets.”

A pessimist is someone who:

■ cannot accept opposing viewpoints or thoughts as valid.

■ enjoys nothing more than finding out that his nega-tive view is right.

■ typically prejudges and pigeonholes others before getting to know them.

■ delights in Murphy’s law that anything can and will go wrong, at the worst possible moment.

■ constantly sees obstacles in her way, which are usually put there by herself.

■ gains energy by drawing on a negative perspective.

■ claims to be a realist, but he’s not fooling anybody.

■ describes an optimist as being out of touch with reality.

■ not only has a black cloud of negativity over her head, but created the thunderhead as well.

roommate, or a significant personal loss. The reality

of the situation is not pleasant in the best of moments.

A common theme found among the theories of many

psy cho logists in these cases is acceptance. The accep-

tance of situations we have no control over is thought

to be paramount as a stress-management strategy, yet

it is perhaps the hardest frame of mind to adopt. There

is a fine line between control and acceptance. This is

the essence of Reinhold Niebuhr’s Serenity Prayer for

Al co hol ics Anony mous: “Lord, grant me the serenity to

accept the things I cannot change, the courage to change

the things I can, and the wisdom to know the differ-

ence.” Acceptance is not an “overnight sensation,” but

rather an attitude that may take several days, weeks, or

months to adopt and implement. Often, acceptance involves

some aspect of forgiveness. The concept of acceptance is

very similar to one described by Lao Tzu in the Tao Teh

Ching. Lao suggested that we move in rhythm with the

universal energy, not against it. Denial and manipula-

tion, like spinning car wheels in the dirt, prove fruit less

because they go against the rhythm of natural energy.

Swimming against the tide can prove exhausting, and

sometimes fatal. As the saying goes, sometimes it takes

more strength to let go than to hang on. Finally, the use

of acceptance or forgiveness appears to be a greater tool

in the face of anger than of fear.


There have been thousands of empirical studies to

determine the effectiveness of cognitive restructur-

ing on health-related problems associated with stress.

These studies have focused on both mismanaged anger

(coping skills for men who battered their wives and

children) and anxiety disturbances, most notably sub-

stance abuse and eating disorders. The results of these

studies indicate that thought processes can be changed

to produce a better state of health, although this is not

effective in all cases.

■ Steps to Initiate

Cognitive Restructuring

A simple, four-stage process introduced by the field of

behavioral medicine is a model for implementing changes

in lifestyle behaviors through cognition to promote health.

The following model explains how cognitive restructur-

ing can be implemented as a coping technique to reduce

stress. Initially, this pro cess does not appear to take a lot

of time. Thoughts last less than seconds, yet they may

resurface often in the course of a day. And the feelings

these perceptions generate can last for days and weeks.

A closer look suggests that cognitive restructuring is a

refinement of the continuous dialogue of the mind, and

as a result is, for the most part, an ongoing process. The

stages are as follows:

1. Awareness: The awareness process has three

steps. In the first, stressors are identified and

acknowledged. This may include writing down

what is on your mind, including all frustrations

and worries. The second step of the awareness

process is to identify why these situations and

events are stressors and, more specifically, what

emotional attitudes are associated with each. In

the last step, a primary appraisal is given to the

main stressor and acknowledgment of the feel-

ings associated with it. If the original perception

appears to be defensive or negative, and inhibits

you from resolving this issue, then the next stage

is reappraisal.

2. Reappraisal of the situation: A secondary appraisal,

or reappraisal, is a “second opinion” you generate in

your mind to offer a different (objective) viewpoint.

A reappraisal is a new assembly or restructuring

of the factors involved, and the openness to ac-

cept a new frame of mind ( FIG. 9.6 ). At this

stage, a second or third opinion involves choosing

a neutral, or preferably positive, stance to favorably

deal with the issues at hand. Remember, a new

appraisal isn’t a rationalization process, nor is it a

suppression of emotions. Also, remember exactly

what factors you can control and what you must

accept as out of your control.

3. Adoption and substitution: The most difficult part

of any attitudinal change is its implementation.

Once a new frame of mind is created, it must then

be adopted and implemented. Humans tend to

be creatures of habit, finding comfort in known

entities even if the “known” is less than desirable.

Pessimism is a defense mechanism, and although it

is not seen as enhancing human potential, there is

comfort in the familiarity of old ways, and change

does not come easily. There are risks involved in

change. Substituting a positive attitude for a nega-

tive perception may make you feel vulnerable at

first, but like other skills that improve with prac-

tice, a new comfort will emerge. With cognitive

restructuring, the new mind frame must often be

substituted when the stress is encountered, and

repeated again and again.

4. Evaluation: The test of any new venture is to

measure its effectiveness. Did this new attitude

work? Initially, it may not. The first attempt to

shoot a basket through the hoop may result in

an embarrassing miss. Evaluate the new attitude

and decide how beneficial it was. If it turns out

that the new mind frame was a complete failure,

return to stage 2 and create a new reappraisal. If

the new mind frame worked, repeat this process

with stressors that demand a change in attitude

to resolve and bring closure.

FIGURE 9.6

© Randy Glasbergen, used w

ith permission from

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■ Some Additional Tips for

Cognitive Restructuring

1. Initiate a relaxation technique to calm your mind.

When a relaxation technique is employed, the

mind begins to unwind and consciousness shifts

from an analytical mode to one of receptivity. In

this unwinding process, unimportant thoughts

begging the conscious mind for attention are

dismissed, allowing greater receptivity to a wider

perspective on the issue at hand. A wider perspec-

tive in turn fosters personal enlightenment and

opens up room for positive thoughts.

2. Take responsibility for your own thoughts. In times

of stress we may feel victimized. We may also feel

that things are out of our control. A way to gain

temporary control is to blame others for the personal

injustice of the perceived stressor. Blame is associated

with guilt and guilt can be a toxic thought. If you

find yourself blaming others for events that make

you feel victimized, ask yourself how you can turn

this blame into personal responsibility for your own

thoughts and feelings without feeling guilty.

3. Fine-tune expectations. It is believed to be easier

to refine expectations prior to meeting a stressor

than to reframe an attitude after the fact. Many

times we walk into situations with preconceived

expectations. When these expectations are not

met to our satisfaction, then negative feelings are

generated. Fine-tuning expectations doesn’t mean

abandoning ideals or lowering self-esteem. Rather,

it means running your perceptions through a real-

ity check, questioning their validity, and allowing

them to match the given situation.

4. Give yourself positive affirmations. The constant

internal conversation going on within the conscious

mind tends to be dominated by negative thoughts

generated by the ego to defend itself. Although

created with good intentions, a preponderance of

negative self-feedback erodes self-esteem. Positive

affirmations balance this internal conversation

with good thoughts to enhance self-confidence and

self-esteem. Repeat a phrase to yourself that boosts

your self-esteem (e.g., “I am a lovable person” or

“I am a winner”).

5. Accentuate the positive. There is a difference between

positive thinking and focusing on the positive. Posi-

tive thinking is an expression of hope concerning

future events. It is often characterized by setting

goals, wishful thinking, and dreaming. Although

positive thinking can be healthy, done to excess it

can be a form of denial. Focusing on the positive is

reframing the current situation. It is an appreciation

of the present moment. Acknowledge the negative.

Learn from it, but don’t dwell on it. Focus on the

positive aspects and build on them.

Best Application of Reframing

When you find yourself stressed out and are perhaps

entertaining toxic thoughts, first identify what makes

you stressed, and then ask yourself why you feel this

way. Get in the habit of then asking yourself, “What

good can come from this situation?” In other words,

what positive aspect can you learn from that which

stresses you out? Recognize what feelings of anger and

fear surface, and then shift your thinking to a proactive

stance so you do not become the victim of your own

thoughts and perceptions.


1. What is the thinking process model?

2. What role does the unconscious mind play in

changing behavior?

3. How can you best describe toxic thoughts?

4. List the steps to initiate cognitive restructuring.

5. What is cognitive restructuring?

6. What role does the unconscious mind play in the

process of restructuring?

7. What effect does attitude have on human

physiology?

STUDY GUIDE QUESTIONS

SUMMARY ■ All stimuli received by the brain are processed through

interpretation and classified as negative, neutral, or

positive; this process is called perception.

■ When the interpretation is exaggerated, it is referred

to as cognitive distortion.

■ Cognitive restructuring means changing a percep-

tion from a negative interpretation to a neutral or

positive one, making it less stressful. This process

is also called reappraisal, relabeling, reframing, and

attitude adjustment.

■ The seeds of this coping technique were planted by

Ellis in rational emotive behavior therapy (REBT);

the term cognitive restructuring was coined by

Meichenbaum in 1975.

■ The information-processing model describing how

stimuli are interpreted consists of four components:

sensory input, sensory manipulation, cognitive/be-

havioral output, and a feedback system.

■ Negative thoughts are often called toxic thoughts.

Research has now substantiated the hypothesis that

negative thoughts can suppress the immune system.

■ Negative thoughts are a conditioned response, starting

as early as childhood, to negative feedback given by

parents, which is transformed into guilt and shame.

■ Toxic thoughts come in various styles, including

pessimism, catastrophizing, blaming, perfectionism,

polarized thinking, should-ing, magnifying, and

self-victimizing.

■ Frankl brought to light the fact that we have the abil-

ity to choose our own thoughts, to alter our thinking

process and adopt new perspectives.

■ Borysenko calls creating negative thoughts “awful-

izing,” and explains that the way to change these

thoughts is through reframing, wherein the stressful

event is reframed in a positive light.

■ Positive psychology is an emerging field that focuses

on using human attributes to cope with stress.

■ When there seems to be no positive light available,

acceptance of the situation (not to be confused with

giving in) is suggested. Acceptance means to go with,

rather than against, the flow that you cannot control.

■ A four-point plan to reconstruct negative thoughts

includes the following: (1) awareness, (2) reappraisal

of the situation, (3) adoption of a new frame of mind,

and (4) evaluation of the new mind frame.

■ Additional hints for cognitive restructuring include

meditation to clear your mind, taking responsibility

for your own thoughts, fine-tuning expectations, giv-

ing yourself positive affirmations, and accentuating

the positive aspects of any situation.


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REFERENCES AND RESOURCES

Image © Brent Hofacker/Shutterstock.

Healthy boundaries promote great health; a lack of such

boundaries sets the stage for poor health and well-being.

Take a look around today and you will notice that there

are flagrant violations of healthy boundaries everywhere:

poor eating habits, rude technology habits, questionable

drinking habits, abysmal financial habits, and dysfunctional

relationships. The list goes on and on. Poor boundaries

often lead to a sense of victimization. At some point ev-

eryone trips and falls. Some people stay face down and

dig a hole, hit rock bottom, and keep on digging. Others

hit rock bottom and decided to make a course correction,

get out of the hole, stand up, and start walking again.

Healthy boundaries are guidelines for healthy living,

and behavior modification is the strategy to keep you on

the road, rather than driving off a cliff. The key to life is

structure and flexibility, that is, healthy boundaries and

behavior modification.

Good parents give their children healthy

boundaries, essential rules to live by, such

as “Eat your vegetables,” “No phone calls

after 9:00 p.m.,” “Dessert comes after dinner,

not before,” and so on. Simply stated, healthy boundar-

ies are codes of appropriate and responsible behavior

that one should follow to live a healthy and productive

life. We learn these boundaries from our parents and/or

loved ones as we grow up. But as we mature into adults

we must create and maintain our own adult behaviors.

Consider basic cell physiology as a metaphor for healthy

boundaries: Each cell has a cell membrane, a gatekeeper

to keep things in that must stay in (e.g., nucleus, DNA)

and keep those things out that do not belong inside the

cell, while regulating what comes in (oxygen) and what

leaves (waste products). Healthy cells have great cell

membranes. Cells with impaired cell membranes have

all kinds of problems. Human beings are no different.

Healthy Boundaries: Behavior Modification

How many psychiatrists does it take to change a

light bulb? One, but the light bulb has really

got to want to change.—Anonymous

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