Disqualifying The Positive
This Disqualifying the Positive information handout forms part of the cognitive distortions series, designed to help clients and therapists work more effectively with common thinking biases.
A brief introduction to cognitive distortions
Cognitive distortions, cognitive biases, or ‘unhelpful thinking styles’ are the characteristic ways our thoughts become biased (Beck, 1963). We are always interpreting the world around us, trying to make sense of what is happening. Sometimes our brains take ‘shortcuts’ and we think things that are not completely accurate. Different cognitive short cuts result in different kinds of bias or distortions in our thinking. Sometimes we might jump to the worst possible conclusion (“this rough patch of skin is cancer!”), at other times we might blame ourselves for things that are not our fault (“If I hadn’t made him mad he wouldn’t have hit me”), and at other times we might rely on intuition and jump to conclusions (“I know that they all hate me even though they’re being nice”). These biases are often maintained by characteristic unhelpful assumptions (Beck et al., 1979).
Different cognitive biases are associated with different clinical presentations. For example, catastrophizing is associated with anxiety disorders (Nöel et al, 2012), dichotomous thinking has been linked to emotional instability (Veen & Arntz, 2000), and thought-action fusion is associated with obsessive compulsive disorder (Shafran et al., 1996).
Catching automatic thoughts and (re)appraising them is a core component of traditional cognitive therapy (Beck et al, 1979; Beck, 1995; Kennerley, Kirk, Westbrook, 2007). Identifying the presence and nature of cognitive biases is often a helpful way of introducing this concept – clients are usually quick to appreciate and identify with the concept of ‘unhelpful thinking styles’, and can easily be trained to notice the presence of biases in their own automatic thoughts. Once biases have been identified, clients can be taught to appraise the accuracy of these automatic thoughts and draw new conclusions.
Disqualifying the Positive
Disqualifying the positive is a well-known thinking style in which individuals ignore, dismiss, or discount their positive attributes and experiences. Many therapists will be familiar with clients who use this type of “yes, but…” reasoning. David Burns describes it as one of the most “spectacular mental illusions”:
You don’t just ignore positive experiences, you cleverly and swiftly turn them into their nightmarish opposite. I call this “reverse alchemy”. The medieval alchemists dreamed of finding some method for transmuting the baser metals into gold. If you have been depressed, you may have developed the talent for doing the exact opposite – you can instantly transform golden joy into emotional lead. (Burns, 1981)
Disqualifying the positive is especially pernicious because it can maintain negative beliefs in the face of overwhelming counter-evidence and contradictory everyday events. In other words, disqualification stops the client learning from experience (Leahy, 2017). This can manifest in three ways:
- The client ignores or dismisses contradictory information (“Having a loving family doesn’t count”).
- The client undermines or explains away disconfirmatory evidence (“It’s true that I passed the test, but that’s only because it was easy”).
- The client minimizes their improvements and successes (“Tidying my home seems so insignificant – I used to do so much more when I wasn’t depressed”).
While disqualifying the positive has been emphasized in cognitive models of depression (e.g., Gilbert, 2009), it plays a role in other disorders. For example, individuals with specific phobias often disqualify external rescue factors, such as the strength of physical structures (e.g., the robust design of aeroplanes) or the willingness of others to help in crisis situations (Kirk & Rouf, 2004). Likewise, individuals with perfectionism tend to ignore or discount positive aspects of their performance, leading them to think that their high standards prompt continued striving (Egan et al., 2014).
Difficulties associated with disqualifying the positive include:
- Anxiety (Covin et al., 2011).
- Body dysmorphic disorder (Olivardia, 2001; Veale, 2004).
- Depression (Covin et al., 2011; Ozdel et al., 2014).
- Low self-esteem (Fennell & Jenkins, 2004).
- Obsessive compulsive disorder (Darvishi et al., 2020).
- Perfectionism (Riley & Shafran, 2005).
- Psychosis (Franceschi, 2020)
- Relationship problems (Young et al., 2003)
- Specific phobias (Kirk & Rouf, 2004)
- Social anxiety (Weeks et al., 2008).
Certain early maladaptive schemas (EMS) may make individuals prone to disqualifying the positive. Young and colleagues (2003) describe a negativity / pessimism EMS characterized by “a pervasive, lifelong focus on the negative aspects of life, such as pain, death, loss, disappointment… while minimizing the positive aspects” (p. 256). This EMS has a variety of childhood origins, including parental pessimism or punitiveness, early adversity, and limited opportunities for playfulness and optimism. At its most extreme, it may cause some individuals to present in therapy as ‘help-rejecting complainers’ (Frank et al., 1952), which Young and colleagues (2003) suggest may be a non-conscious attempt to elicit care and nurturance from others.
Examples of disqualifying the positive include:
- Disqualifying personal attributes (“Being sensitive isn’t a strength”).
- Disqualifying personal successes (“Anyone can do that”).
- Disqualifying positive experiences (“When they complimented me, they didn’t mean it”).
- Disqualifying personal safety (“Lifts might be well designed, but sometimes they go wrong”).
- Disqualifying by making comparisons (“That might be an achievement for others, but it isn’t an achievement for me”).
- Disqualifying via self-expectations (“I’m supposed to be polite, so it doesn’t count”).
Individuals might also discount positive comments from others. This is discussed in more detail in the Psychology Tools Disqualifying Others resources.
People who disqualify the positive may have ‘blind spots’ when it comes to:
- Recognizing their strengths, talents, and resources.
- Acknowledging their achievements, progress, and improvements.
- Adopting an optimistic attitude toward themselves, the world, and their future.
- Accepting praise, compliments, and other positive feedback.
- Setting reasonable self-expectations.
As with many cognitive biases, there may be evolutionary reasons why people disqualify the positive. Clark and Beck (2010) suggest that minimizing personal resources may have prompted humans to focus on dangers (e.g., the proximity, probability, and severity of threats) to survive. Gilbert (1998) also highlights the potential benefits of self-referent minimization, such as preventing complacency, avoiding envious attacks, eliciting care and support, reducing the burden of others’ expectations, and enhancing one’s attractiveness by signaling modesty.
Many people struggle with disqualifying the positive, and it sounds as though it might be relevant to you too. Would you be willing to explore it with me?
Clinicians might begin by providing psychoeducation about disqualifying the positive and automatic thoughts more generally. Consider sharing some of these important details:
- Automatic thoughts spring up spontaneously in our minds, usually in the form of words or images.
- They are often on the ‘sidelines’ of our awareness. With practice, we can become more aware of them. It is a bit like a theatre – we can bring our automatic thoughts ‘centre stage’.
- Automatic thoughts are not always accurate: just because you think something, it doesn’t make it true.
- Automatic thoughts are often inaccurate in characteristic ways. One common type of bias in automatic thoughts is ‘disqualifying the positive’: we sometimes overlook, discount, or dismiss our positive attributes and experiences. This can make it difficult to change negative thoughts and beliefs about ourselves and our future.
- Signs that you are disqualifying the positive include downplaying your achievements, finding faults in positive experiences, and pessimism about the future.
- It can be useful to disqualify your positives in some circumstances. Discounting your positive traits can keep you focused on potential threats and prepared for danger. You might believe that downplaying your positives helps you in some way (e.g., it makes you modest, motivates you, or lowers other peoples’ expectations). However, disqualifying the positive too much or too often can be upsetting, counter-productive, and give you an inaccurate impression of yourself.
Many treatment techniques can be used to address disqualifying the positive:
- Decentering. Meta-cognitive awareness, or decentering, describes the ability to stand back and view a thought as a cognitive event: as an opinion, and not necessarily a fact (Flavell, 1979). Help clients to practice labeling the process present in the thinking rather than engaging with the content. For instance, they might say to themselves, “I’m disqualifying again”, whenever they notice these thoughts.
- Cognitive restructuring with thought records. Self-monitoring can be used to capture and re-evaluate thoughts subject to the disqualifying bias as they occur. Useful prompts include:
- If you took the ‘disqualifying’ glasses off, how would you see this differently?
- Are you limiting yourself to evidence that supports your negative beliefs? Is there anything you might be discounting or ignoring?
- What evidence supports your disqualifications? Is that evidence good quality?
- Would you discount these positives if they related to someone you cared about? Why not?
- Would someone who cared about you disqualify these positives? Why not? What do you imagine they would say about this?
- How does responding to positive things with ‘yes, but’ make you feel? How would you prefer to feel? What would you need to think and do to feel that way?
- Cost-benefit analysis. Explore the advantages and disadvantages of disqualifying positives. Note that some clients may believe that disqualifying the positive is functional in some way (e.g., “I’ll become complacent if I accept the positives”). Useful prompts include:
- What problems does disqualifying the positive cause you?
- How would things improve if you accepted the positive?
- Does thinking this way fit or conflict with your goals?
- What are the consequences of continuing to disqualify your positive?
- Counting the positives. Disqualifying can become automatic or habitual. Help the client notice and acknowledge their positive attributes and experiences, whether currently or in their past. This might take the form of a daily or historical positive data log. Clients who often disqualify are likely to find this task difficult, in which case, consider asking them to:
- Record the data even though they might not fully believe it.
- Record data that they think would ‘count’ for another person.
- Take on the perspective of a caring individual who supports the positive data while completing their log.
- Compare themselves against a negative model (e.g., when they were at their worst, or someone with no positive qualities).
- Accepting the positives. Encourage the client to experiment with responding differently to positive experiences. For example, the client might express gratitude for positive experiences and complimentary feedback. How does the client feel when they change their response, and how do others react?
- Using metaphors. Padesky (1993) has outlined a ‘self-prejudice’ metaphor that highlights the negative consequences of disqualifying the positive. The metaphor is introduced Socratically:
- Ask the client to identify someone who holds a prejudice (e.g., a friend who believes their sports team is the best in the world).
- Explore how this individual would respond to evidence that supports their prejudice (e.g., when their team wins a match).
- Explore how this individual would respond to contradictory evidence (e.g., when their team loses a match).
- Discuss how the individual maintains their prejudiced belief in both scenarios (e.g., confirmatory evidence is noticed and accepted, while disconfirmatory evidence is ignored, dismissed, or discounted).
- Discuss how this applies to the client’s thinking style and underlying beliefs (e.g., continuing to disqualify the positives will strengthen and broaden the client’s negative beliefs).
- Testing beliefs and assumptions. It can be helpful to explore whether the client holds beliefs or assumptions which drive disqualifying the positives, such as, “Accepting the positives makes me vulnerable [to disappointment, egotism, etc.]” and “Negative experiences are most important”. If assumptions like these are identified, clients can assess how accurate and helpful they are. Their attitudes toward healthier assumptions can be explored, such as “Accepting the positives gives me a balanced perspective” and “Positive experiences are just as important as negative experiences”. Assumptions can also be tested using behavioral experiments, including surveys (e.g., “Let’s see if other people think that accepting the positives is a risky thing to do”).
- Beck, A. T. (1963). Thinking and depression: I. Idiosyncratic content and cognitive distortions. Archives of General Psychiatry, 9, 324-333. DOI: 10.1001/archpsyc.1963.01720160014002.
- Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. Guilford Press.
- Beck, J. S. (1995). Cognitive behavior therapy: Basics and beyond. Guilford Press.
- Burns, D. D. (1980). Feeling good: The new mood therapy. New American Library.
- Clark, D. A., & Beck, A. T. (2010). Cognitive therapy of anxiety disorders: Science and practice. Guilford Press.
- Covin, R., Dozois, D. J., Ogniewicz, A., & Seeds, P. M. (2011). Measuring cognitive errors: Initial development of the Cognitive Distortions Scale (CDS). International Journal of Cognitive Therapy, 4, 297-322. DOI: 10.1521/ijct.2011.4.3.297.
- Darvishi, E., Golestan, S., Demehri, F., & Jamalnia, S. (2020). A cross-sectional study on cognitive errors and obsessive-compulsive disorders among young people during the outbreak of coronavirus disease 2019. Activitas Nervosa Superior, 62, 137-142. DOI: 10.1007/s41470-020-00077-x.
- Egan, S. J., Wade, T. D., Shafran, R., & Antony, M. M. (2014). Cognitive-behavioral treatment of perfectionism. Guilford Press.
- Fennell, M., & Jenkins, H. (2004). Low self-esteem. In In J. Bennett-Levy, G. Butler, M. Fennell, A. Hackman, M. Mueller, & D. Westbrook (Eds), Oxford guide to behavioural experiments in cognitive therapy (pp.413-431). Oxford University Press.
- Franceschi, P. (2020). For a typology of auditory verbal hallucinations based on their content. Activitas Nervosa Superior, 62, 104-109. DOI: 10.1007/s41470-020-00073-1.
- Frank, J. D., Margolin, J., Nash, H. T., Stone, A. R., Varon, E., & Ascher, E. (1952). Two behavior patterns in therapeutic groups and their apparent motivation. Human Relations, 5, 289-317. DOI: 10.1177/001872675200500304.
- Gilbert, P. (1998). The evolved basis and adaptive functions of cognitive distortions. British Journal of Medical Psychology, 71, 447-463. DOI: 10.1111/j.2044-8341.1998.tb01002.x.
- Gilbert, P. (2009). Overcoming depression. A self-help guide using cognitive behavioral techniques. Robinson.
- Kirk, J., & Rouf, K. (2004). Specific phobias. In J. Bennett-Levy, G. Butler, M. Fennell, A. Hackman, M. Mueller, & D. Westbrook (Eds), Oxford guide to behavioural experiments in cognitive therapy (pp.161-181). Oxford University Press.
- Leahy, R. L. (2017). Cognitive therapy techniques: A practitioner’s guide. Guilford Press.
- Noël, V. A., Francis, S. E., Williams-Outerbridge, K., & Fung, S. L. (2012). Catastrophizing as a predictor of depressive and anxious symptoms in children. Cognitive Therapy and Research, 36, 311-320. DOI: 10.1007/s10608-011-9370-2.
- Olivardia, R. (2001). Mirror, mirror on the wall, who’s the largest of them all? The features and phenomenology of muscle dysmorphia. Harvard Review of Psychiatry, 9, 254-259.
- Özdel, K., Taymur, İ., Guriz, S. O., Tulaci, R. G., Kuru, E., & Turkcapar, M. H. (2014). Measuring cognitive errors using the Cognitive Distortions Scale (CDS): Psychometric properties in clinical and non-clinical samples. PloS One, 9, e105956. DOI: 10.1371/journal.pone.0105956.
- Padesky, C. A. (1990). Schema as self-prejudice. International Cognitive Therapy Newsletter, 6, 6-7.
- Riley, C., & Shafran, R. (2005). Clinical perfectionism: A preliminary qualitative analysis. Behavioural and Cognitive Psychotherapy, 33, 369-374. DOI: 10.1017/S1352465805002122.
- Shafran, R., Thordarson, D. S., & Rachman, S. (1996). Thought-action fusion in obsessive compulsive disorder. Journal of Anxiety Disorders, 10, 379-391. DOI: 10.1016/0887-6185(96)00018-7.
- Veale, D. (2004). Advances in a cognitive behavioural model of body dysmorphic disorder. Body Image, 1, 113-125. DOI: 10.1016/S1740-1445(03)00009-3.
- Veen, G., & Arntz, A. (2000). Multidimensional dichotomous thinking characterizes borderline personality disorder. Cognitive Therapy and Research, 24, 23-45. DOI: 10.1023/A:1005498824175.
- Weeks, J. W., Heimberg, R. G., Rodebaugh, T. L., & Norton, P. J. (2008). Exploring the relationship between fear of positive evaluation and social anxiety. Journal of Anxiety Disorders, 22, 386-400. DOI: 10.1016/j.janxdis.2007.04.009.
- Westbrook, D., Kennerley, H., & Kirk, J. (2011). An introduction to cognitive behaviour therapy: Skills and applications (2nd ed.). Sage.
- Young, J. E., Klosko, J. S., & Weishaar, M. E. (2013). Schema therapy: A practitioner’s guide. Guilford Press.