Self-Blame

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.

Self-blame

Self-blame is a common form of cognitive distortion or ‘unhelpful thinking style’. Characterized by the incorrect assignment of blame or responsibility for adverse events (Beck et al., 1979), it is often associated with self-criticism (Westbrook et al., 2011) and accompanied by feelings of guilt, shame, regret, and self-directed frustration.

You find fault and blame yourself for some shortcoming, flaw, error, or screwup, so you use up all your energy feeling guilty or frustrated.

Burns, 2020

At its most extreme, self-blame can lead individuals to “take the notion of self-causality to seemingly absurd extremes” (Beck et al., 1979, 192): Beck (1963) provides the example of a depressed individual who blamed themselves for an unpleasant picnic after it was cut short by an unexpected thunderstorm.

Examples of self-blame include:

• Routinely blaming oneself for negative events.
• Unfairly relating adverse events to personal deficiencies (‘characterological self-blame’) or personal actions (‘behavioral self-blame’) (Janoff-Bulman, 1979).
• Believing that negative outcomes could have (or should have) been foreseen.
• Feeling overly responsible for negative outcomes.

People who habitually engage in a self-blaming thinking style may have ‘blind spots’ when it comes to:

• Making attributions for events that are not self-referential.
• Assigning responsibility to both themselves and others.
• Seeing the ‘bigger picture’ when it comes to explaining events.
• Setting reasonable standards and expectations for themselves.
• Self-forgiveness and self-compassion.

As with many other cognitive biases, there are evolutionary reasons why people might think in self-blaming ways. Gilbert (1998) suggests that self-blame might be functional insofar as it (a) provides an illusion of control, (b) avoids blaming the ‘other’ which carries the risk of counter-attack, (c) elicits support, and (d) helps protect relationships that the client is dependent upon.

Self-blame is associated with a wide range of clinical problems, including:

• Depression (Beck et al., 1979).
• Post-traumatic stress disorder (Kline et al., 2021).
• Obsessive-compulsive disorder (Clark, 2002). 
• Perfectionism (Rudolph et al., 2007).
• Generalized anxiety disorder (Nasiri et al., 2020).

Other difficulties associated with self-blame include self-criticism, rumination, guilt, and shame (Beck et al., 1979; Roberts et al., 1998; Tilghman et al., 2008).

"Many people struggle with self-blaming thinking, and it sounds like you experience this as well. Would you be willing to explore it with me?"

Clinicians may consider giving clients helpful psychoeducation about automatic thoughts more generally and self-blame in particular. Consider sharing some of these important details:

• Automatic thoughts spring up spontaneously in your mind 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 ‘center stage’.
• Automatic thoughts are not always accurate: just because you think something it doesn’t make it true, and they are often inaccurate in characteristic ways.
• One common type of bias in automatic thoughts is thinking in a way that is self-blaming. In other words, we tend to look back at events and blame ourselves for things that have happened.
• Self-blaming thoughts are often self-critical and fault-finding. Signs that they are occurring include feeling guilty, ashamed, or regretful.
• In some circumstances, it might seem helpful to self-blame. Assuming that you are to blame might help you feel more in control or stop you blaming other people, which could be painful or risky if they attack or reject you in response.

Many treatment techniques are helpful for working with self-blame, including:

• 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 “I’m self-blaming again” to themselves whenever they notice this style of thinking.
• Reattribution. Reattribution aims to identify all the factors that may have contributed to an adverse event or outcome, aside from the client (Burns, 2020). The relative contribution of each factor can then be explored using percentage ratings (“how much did this factor contribute to the outcome?”; Leahy, 2017). Alternatively, the relative contribution of each factor can be depicted using a pie chart, allocating a differently sized ‘slice’ of the pie chart to each factor depending on how influential it was (Beck, 2011). Note that the client should consider their contribution to the outcome last.
• Cognitive restructuring with thought records. Self-monitoring can be used to help clients capture their automatic thoughts. Thought re-evaluation records include prompts encouraging the client to consider the evidence supporting self-blame and reflect on whether it is a helpful position to take. Prompts that can be helpful with self-blaming thinking include:
  • "If you took the ‘self-blame’ glasses off, what would you see?"
  • "Are there other explanations or contributing factors you might be missing with this interpretation of events?"
  • "If a stranger observed what happened in this situation, would they think it was entirely your fault? Why not?"
  • "How could we explain what happened in this situation in a non-judgmental way?
  • "If a friend had the same experience and similarly blamed themselves, what would you say to them?"
  • "Suppose you were partly to blame. What were your intentions in this situation? Do you always behave in that way?
  • "How does blaming yourself for this fit with your goal?"
• Cost-benefit analysis. Cost-benefits analysis of self-blaming thinking highlights the negative consequences of excessive self-reproach. The costs of self-blaming thinking can be explored with reference to the client’s therapy goals, personal values, and life ambitions. Close inspection of the benefits of self-blaming thinking sometimes reveals metacognitive beliefs that perpetuate self-blame (e.g., “Self-blame will stop me from making similar mistakes in the future”). These beliefs can also be re-evaluated and subjected to cost-benefit analysis.
• Pie charts. These are useful way to explore multiple factors that may have contributed to a given outcome (Beck, 1995). Ask the client to make a list of potential causes and allocate a ‘slice’ of the pie chart to each one. Note that the client should add the self-attribution to chart last (e.g., “The way I treated my brother led to his suicide”) so that the other explanations can be fully considered.
• Historical review. Reviewing past experiences of being blamed can contextualize this thinking style. For example, some clients may have been excessively blamed as children or witnessed others blaming themselves (“Does your self-blame remind you of anyone from your past?”). Alternatively, the client may have learned to blame themselves to elicit support, avoid conflict, or protect their relationship with attachment figures (Gilbert, 1998). If the client links their self-blame to being blamed by others, the ‘credentials’ of these critical individuals can also be scrutinized (“Was your mother always right when she blamed you? Was she always right in general?”) (Lee, 2005).
• Role-play. Role-playing can be a powerful way to shift cognitive biases (Pugh, 2019). For example, the therapist might present the client’s self-blaming thoughts in the first person (“It’s all my fault”), while the client tries to help the therapist see the situation differently (Beck et al., 1979). If the client gets ‘stuck’ at any point, roles are reversed so the therapist can model the process of counter-responding to self-blaming thoughts.
• Testing beliefs and assumptions. If a client habitually self-blames, it may be helpful to explore whether they hold beliefs or assumptions about this thinking style, such as “If I blame myself, I am more in control” or “If I blame myself, other people are less likely to attack me”. If such assumptions are identified, clients can explore their accuracy and helpfulness. Their attitudes toward healthier assumptions (e.g., “Responsibility can be fairly shared – other people won’t attack me for it”) can also be explored. Dysfunctional assumptions and self-blaming thoughts can be reality-tested through behavioral experiments, including surveys (e.g., “After reading this scenario, do you think the main character is completely to blame for what happened? Why not?”).

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