Using cognitive reframing to encourage behavior change

Helping patients change negative behaviors that are leading to negative outcomes in their lives can be incredibly difficult. One tool that can help is cognitive reframing, which focuses on changing distorted or dysfunctional thoughts in order to change negative emotions and maladaptive behaviors, as opposed to focusing exclusively on changing the behavior.

The premise of cognitive reframing is that our thoughts about our experiences drive our emotions, actions, and outcomes. Negative thoughts lead to negative behaviors; positive and productive thoughts lead to positive and productive behaviors. While we can't change negative experiences in our past and shouldn't deny their impact, we may need to change our thinking about the past if it is limiting our effectiveness in the present.

Some common cognitive distortions include the following:

• Filtering: An exclusive focus on a single negative aspect of a situation,
• Polarized thinking: A belief that something is all good or all bad,
• Overgeneralization: A broad conclusion based on a single incident or unpleasant event,
• Jumping to conclusions: A hasty conclusion about someone's thoughts or behavior,
• Catastrophizing: An expectation that disaster has struck,
• Blaming: Holding other people responsible for our outcomes.

Reframing allows us to interpret our experiences in more positive and productive ways. For example, a patient's thoughts about being overweight might be “This isn't fair. My spouse can eat anything and never gains weight.” This elicits emotions such as shame, fear, anger, and anxiety. The patient might blame the spouse, causing conflict and isolation. Reframing the experience opens the door for better outcomes. For example, the patient can choose to think “I can do this. I have a support system and the resources I need to eat better and start exercising.” This reframing elicits gratefulness and optimism, ultimately leading to a better result.

Read the full article in FPM: “Building Community Well-being Through Emotional Intelligence and Cognitive Reframing.”