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Thought-Action Fusion

The Thought-Action Fusion information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively with common thinking biases.

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Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Client version

Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.

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Languages this resource is available in

  • Arabic
  • English (GB)
  • English (US)
  • German
  • Hindi
  • Portuguese (Brazilian)
  • Spanish (International)

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Introduction & Theoretical Background

A brief introduction to cognitive distortions

Cognitive distortions, cognitive biases, or ‘unhelpful thinking styles’ are characteristic ways in which our thoughts can become biased (Beck, 1963). As conscious beings we are always interpreting the world around us, trying to make sense of what is happening. Sometimes our brains take ‘short cuts’ and we think things that are not completely accurate, and 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 angry 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”).

Different cognitive biases are associated with different clinical

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Therapist Guidance

Many people struggle with thought-action fusion, and it sounds like it is something you experience too. Would you be willing to explore it with me?

Clinicians might begin by providing psychoeducation about thought action fusion and automatic thoughts more generally. Consider sharing some of these important details:

  • Automatic thoughts spring up spontaneously in your mind, 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 ‘center stage’.
  • Automatic thoughts are not always accurate: just because you think something, doesn’t make it true.
  • Automatic thoughts are often inaccurate in characteristic ways. One common type of bias in automatic thoughts is ‘thought-action fusion’: you assume that something is likely to happen because you thought about it, or that you’re bad in

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References And Further Reading

  • Amir, N., Freshman, M., Ramsey, B., Neary, E., & Brigidi, B. (2001). Thought–action fusion in individuals with OCD symptoms. Behaviour Research and Therapy, 39, 765-776. DOI: 10.1016/S0005-7967(00)00056-5.
  • Arnáez, S., García-Soriano, G., López-Santiago, J., & Belloch, A. (2020). Dysfunctional beliefs as mediators between illness-related intrusive thoughts and health anxiety symptoms. Behavioural and Cognitive Psychotherapy, 48, 315-326. DOI: 10.1017/S1352465819000535.
  • 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.
  • Berle, D., & Starcevic, V. (2005). Thought–action fusion: Review of the literature and future directions. Clinical Psychology Review, 25, 263-284. DOI: 10.1016/j.cpr.2004.12.001.
  • Brashier, N. M., & Multhaup, K. S. (2017). Magical thinking decreases across adulthood. Psychology and Aging, 32, 681–688.

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