Adversity is not a gift

Nov 29 JDN 2459183

For the last several weeks I’ve been participating in a program called “positive intelligence” (which they abbreviate “PQ” even though that doesn’t make sense); it’s basically a self-help program that is designed to improve mood and increase productivity. I am generally skeptical of such things, and I could tell from the start that it was being massively oversold, but I had the opportunity to participate for free, and I looked into the techniques involved and most of them seem to be borrowed from cognitive-behavioral therapy and mindfulness meditation.

Overall, I would say that the program has had small but genuine benefits for me. I think the most helpful part was actually getting the chance to participate in group sessions (via Zoom of course) with others also going through the program. That kind of mutual social support can make a big difference. The group I joined was all comprised of fellow economists (some other grad students, some faculty), so we had a lot of shared experiences.

Some of the techniques feel very foolish, and others just don’t seem to work for me; but I did find at least some of the meditation techniques (which they annoyingly insist on calling by the silly name “PQ reps”) have helped me relax.

But there’s one part of the PQ program in particular that I just can’t buy into, and this is the idea that adversity is a gift and an opportunity.

They call it the “Sage perspective”: You observe the world without judging what is good or bad, and any time you think something is bad, you find a way to transform it into a gift and an opportunity. The claim is that everything—or nearly everything—that happens to you can make you better off. There’s a lot of overlap here with the attitude “Everything happens for a reason”.

I don’t doubt that sincerely believing this would make you happier. Nevertheless, it is obviously false.

If indeed adversity were a gift, we would seek it out. If getting fired or going bankrupt or getting sick were a gift and an opportunity, we’d work to make these things happen.

Yes, it’s true that sometimes an event which seems bad at the time can turn out to have good consequences in the long run. This is simply because we are unable to foresee all future ramifications. Sometimes things turn out differently than you think they will. But most of the time, when something seems bad, it is actually bad.

There might be some small amount of discomfort or risk that would be preferable to a life of complete safety and complacency; but we are perfectly capable of seeking out whatever discomfort or risk we choose. Most of us live with far more discomfort and risk than we would prefer, and simply have no choice in the matter.

If adversity were a gift, people would thank you for giving it to them. “Thanks for dumping me!” “Thanks for firing me!” “Thanks for punching me!” These aren’t the sort of thing we hear very often (at least not sincerely).

I think this is fairly obvious, honestly, so I won’t belabor it any further. But it raises a question: Is there a way to salvage the mental health benefits of this attitude while abandoning its obvious falsehood?

“Everything happens for a reason” doesn’t work; we live in a universe of deep randomness, ruled by the blind idiot gods of natural law.

“Every cloud has a silver lining” is better; but clearly not every bad thing has an upside, or if it does the upside can be so small as to be utterly negligible. (What was the upside of Rwandan genocide?) Restricted to ordinary events like getting fired this one works pretty well; but it obviously fails for the most extreme traumas, and doesn’t seem particularly helpful for the death of a loved one either.

“What doesn’t kill me makes me stronger” is better still, but clearly not true in every case; some bad events that don’t actually kill us can traumatize us and make the rest of our lives harder. Perhaps “What doesn’t permanently damage me makes me stronger”?

I think the version of this attitude that I have found closest to the truth is “Everything is raw material”. Sometimes bad things just happen: Bad luck, or bad actions, can harm just about anyone at just about any time. But it is within our power to decide how we will respond to what happens to us, and wallowing in despair is almost never the best response.

Thus, while it is foolish to see adversity as a gift, it is not so foolish to see it as an opportunity. Don’t try to pretend that bad things aren’t bad. There’s no sense in denying that we would prefer some outcomes over others, and we feel hurt or disappointed when things don’t turn out how we wanted. Yet even what is bad can still contain within it chances to learn or make things better.

What’s wrong with “should”?

Nov 8 JDN 2459162

I have been a patient in cognitive behavioral therapy (CBT) for many years now. The central premise that thoughts can influence emotions is well-founded, and the results of CBT are empirically well supported.

One of the central concepts in CBT is cognitive distortions: There are certain systematic patterns in how we tend to think, which often results in beliefs and emotions that are disproportionate with reality.

Most of the cognitive distortions CBT deals with make sense to me—and I am well aware that my mind applies them frequently: All-or-nothing, jumping to conclusions, overgeneralization, magnification and minimization, mental filtering, discounting the positive, personalization, emotional reasoning, and labeling are all clearly distorted modes of thinking that nevertheless are extremely common.

But there’s one “distortion” on CBT lists that always bothers me: “should statements”.

Listen to this definition of what is allegedly a cognitive distortion:

Another particularly damaging distortion is the tendency to make “should” statements. Should statements are statements that you make to yourself about what you “should” do, what you “ought” to do, or what you “must” do. They can also be applied to others, imposing a set of expectations that will likely not be met.

When we hang on too tightly to our “should” statements about ourselves, the result is often guilt that we cannot live up to them. When we cling to our “should” statements about others, we are generally disappointed by their failure to meet our expectations, leading to anger and resentment.

So any time we use “should”, “ought”, or “must”, we are guilty of distorted thinking? In other words, all of ethics is a cognitive distortion? The entire concept of obligation is a symptom of a mental disorder?

Different sources on CBT will define “should statements” differently, and sometimes they offer a more nuanced definition that doesn’t have such extreme implications:

Individuals thinking in ‘shoulds’, ‘oughts; or ‘musts’ have an ironclad view of how they and others ‘should’ and ‘ought’ to be. These rigid views or rules can generate feels of anger, frustration, resentment, disappointment and guilt if not followed.

Example: You don’t like playing tennis but take lessons as you feel you ‘should’, and that you ‘shouldn’t’ make so many mistakes on the court, and that your coach ‘ought to’ be stricter on you. You also feel that you ‘must’ please him by trying harder.

This is particularly problematic, I think, because of the All-or-Nothing distortion which does genuinely seem to be common among people with depression: Unless you are very clear from the start about where to draw the line, our minds will leap to saying that all statements involving the word “should” are wrong.

I think what therapists are trying to capture with this concept is something like having unrealistic expectations, or focusing too much on what could or should have happened instead of dealing with the actual situation you are in. But many seem to be unable to articulate that clearly, and instead end up asserting that entire concept of moral obligation is a cognitive distortion.

There may be a deeper error here as well: The way we study mental illness doesn’t involve enough comparison with the control group. Psychologists are accustomed to asking the question, “How do people with depression think?”; but they are not accustomed to asking the question, “How do people with depression think compared to people who don’t?” If you want to establish that A causes B, it’s not enough to show that those with B have A; you must also show that those who don’t have B also don’t have A.

This is an extreme example for illustration, but suppose someone became convinced that depression is caused by having a liver. They studied a bunch of people with depression, and found that they all had livers; hypothesis confirmed! Clearly, we need to remove the livers, and that will cure the depression.

The best example I can find of a study that actually asked that question compared nursing students and found that cognitive distortions explain about 20% of the variance in depression. This is a significant amount—but still leaves a lot unexplained. And most of the research on depression doesn’t even seem to think to compare against people without depression.

My impression is that some cognitive distortions are genuinely more common among people with depression—but not all of them. There is an ongoing controversy over what’s called the depressive realism effect, which is the finding that in at least some circumstances the beliefs of people with mild depression seem to be more accurate than the beliefs of people with no depression at all. The result is controversial both because it seems to threaten the paradigm that depression is caused by distortions, and because it seems to be very dependent on context; sometimes depression makes people more accurate in their beliefs, other times it makes them less accurate.

Overall, I am inclined to think that most people have a variety of cognitive distortions, but we only tend to notice when those distortions begin causing distress—such when are they involved in depression. Human thinking in general seems to be a muddled mess of heuristics, and the wonder is that we function as well as we do.

Does this mean that we should stop trying to remove cognitive distortions? Not at all. Distorted thinking can be harmful even if it doesn’t cause you distress: The obvious example is a fanatical religious or political belief that leads you to harm others. And indeed, recognizing and challenging cognitive distortions is a highly effective treatment for depression.

Actually I created a simple cognitive distortion worksheet based on the TEAM-CBT approach developed by David Burns that has helped me a great deal in a remarkably short time. You can download the worksheet yourself and try it out. Start with a blank page and write down as many negative thoughts as you can, and then pick 3-5 that seem particularly extreme or unlikely. Then make a copy of the cognitive distortion worksheet for each of those thoughts and follow through it step by step. Particularly do not ignore the step “This thought shows the following good things about me and my core values:”; that often feels the strangest, but it’s a critical part of what makes the TEAM-CBT approach better than conventional CBT.

So yes, we should try to challenge our cognitive distortions. But the mere fact that a thought is distressing doesn’t imply that it is wrong, and giving up on the entire concept of “should” and “ought” is throwing out a lot of babies with that bathwater.

We should be careful about labeling any thoughts that depressed people have as cognitive distortions—and “should statements” is a clear example where many psychologists have overreached in what they characterize as a distortion.