by Carolyn Thomas ♥ @HeartSisters
The freshly-diagnosed heart patient has plenty of opportunity to start thinking thoughts that are new, bizarre and often frightening. Any life-altering medical condition can throw us off-balance emotionally, but after a cardiac diagnosis, even the tiniest twinge of new chest pain can paralyze us. Is this something? Is it nothing? Should I call 911 again? As Australian cardiac psychologist (and more importantly, a heart patient himself) Len Gould likes to say: “Before a heart attack, every twinge is just indigestion. After a heart attack, every twinge is another heart attack!”
It’s only much later when we can truly reflect on how exhausting this twisted thinking is. Before they settle in too comfortably, let’s try to untwist the most common of these responses. .
These understandable reactions are examples of what behaviour scientists call cognitive distortion. (This means your mind is trying to convince you to believe negative things about yourself and your world that are not necessarily true). One of the experts who teaches and researches this subject at Stanford University is psychiatrist Dr. David Burns (author of The Feeling Good Handbook – which truly captured my own twisted thinking after I’d survived a misdiagnosed “widow maker” heart attack). For example:
1. All-or-nothing thinking (no grey areas): You look at your life now in absolute, black-and-white categories. Not “Oh, I feel a little twinge in my chest” but “OH MY GOD! ANOTHER HEART ATTACK!”
2. Over-generalization (using words like “always” or “never”): You view recuperation setbacks as signs of permanent defeat.
3. Mental filter: You pick out even the smallest of negative events and ruminate on them over and over.
4. Discounting the positives (“Yeah, but . . . “): You minimize your early progress by pointing out what you still aren’t able to do well yet.
5. Jumping to conclusions (without clear facts to support those conclusions): You become a mind-reader (assuming that people are reacting negatively to you) or a fortune-teller (“I’ll never get back to my old self!”).
6. Magnification or minimization (also called “the binocular trick”): You exaggerate the significance of each symptom, or minimize your progress by shrinking its importance.
7. Emotional reasoning (If X, then Y. . . ): You reason from how you feel. “I feel angry, so this proves I’m being treated unfairly!”
8. “Should” statements (if directed at yourself, can lead to guilt or shame; if directed at others, can lead to resentment): Many of us try to motivate ourselves (and others) with shoulds and shouldn’ts.
9. Labeling (an extreme form of #1): Instead of saying, “I ate a piece of cake last night!”, you attach a negative label: “I was so bad last night!” And you might also tend to label the character of others, instead of just their behaviours, which can lead to feeling hostile or hopeless about relationships.
10. Personalization and blame (“It’s all my fault” vs. “It’s all YOUR fault!”): You hold yourself personally responsible for an event that’s not under your control, or you blame other people or their circumstances for problems, and may overlook ways that you contributed to a problem.
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So what can you do if you recognize one or more of these twisted thinking patterns in your own life? Here are some of Dr. Burns’ suggestions:
♥ Identify the distortion: Write down your negative thoughts so you can track which of these cognitive distortions have become your favourites.
♥ The Double Standard Method: Instead of self-talk that’s harsh or condemning, talk to yourself in the same kind and compassionate way you would talk to your Mum or sister or daughter in a similar situation.
♥ Thinking in shades of grey: Instead of thinking about your problems in either black or white, evaluate them on a scale of 0-100. Start thinking of things that don’t work out exactly as you’d hoped as a partial success, not a complete failure.
♥ The Survey Method: Ask others questions to see if your thoughts or attitudes are realistic. For example, ask other heart patients (in person or in online support communities) if they have experienced similar situations.
♥ Cost-Benefit Analysis: List the advantages and disadvantages of a feeling (e.g.getting upset when you’re running late) or a behaviour pattern (e.g. overeating). Use this method to modify a self-defeating belief like “I must always be perfect!”
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Q: Did any of the examples of twisted thinking seem familiar to you?
This article is Part 5 of “What I Wish I Knew Back Then” – a back-to-basics summer series here on Heart Sisters that will revisit some of the most frequently asked questions from new heart patients. You can find more of these unique posts here.
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NOTE FROM CAROLYN: I wrote more about becoming a heart patient in my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local library or favourite bookshop (please support your neighbourhood independent booksellers!) or order it online (paperback, hardcover or e-book) at Amazon – or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 30% off the list price).
Heart Sisters 
You asked if any of these examples of cognitive distortion seemed familiar…
Yes, whether before or after a cardiac event. I’ve experienced all of them at one time or another.
Decades ago when I was in a phase of life where I was questioning myself from every angle, I found a book by Wayne Dyer called “Pulling Your Own Strings”. I didn’t even finish the book because I realized, early on, its premise: The only thing getting in the way of my own happiness was me and my own “twisted thinking”.
Looking within, dropping shame and blame, and weeding out these twisted thought forms can become a daily practice that helps us find the treasure of who we truly are behind all the distortion.
Blessings and Thank You for your summer review!
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Hello Jill – I’m so glad you mentioned the late Dr. Wayne Dyer. I’ve been a fan since I read his first book back in the 70s (Your Erroneous Zones – also about staring down those negative thoughts). I was fortunate to hear him speak in person at a conference in Chicago a few years after I read that book – what an amazing speaker! He was a born storyteller who used stories to simplify and illuminate his messages! (He spoke for 2 straight hours that day without a single “um” or “ah” – and we were spellboung! It was a remarkable experience I’ll never forget.
I think you’re so right about the “daily practice” you mentioned to keep us on track, Jill. Two valuable lessons I learned from Dr. Dyer’s book: 1. if you can’t fix or change something that’s outside of your control (i.e. “not on your life pile”) – don’t spend precious time worrying about it, and 2. you are what you choose today, not what you’ve chosen before!
Take care, stay cool out there. . . ♥
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