All-or-Nothing Thinking - What It Is, and How to Challenge It (2/2)
Relational trauma may create an inner critic that magnifies flaws in our performance, thereby exacerbating feelings like shame and anxiety. All-or-Nothing thinking is a common way our inner critics speak to us.
The therapist/author Pete Walker wrote about how relational trauma, such as emotional abuse or neglect, may create an inner critic that magnifies errors or flaws in our performance, thereby exacerbating feelings such as shame and anxiety. All-or-Nothing thinking is a common way our inner critics speak to us, making our internal states a treacherous minefield that blows up at any hint of failure.
The Potential Impact of Traumatic Experiences
A study looked at how military veterans interpreted facial expressions compared to civilians who have not been exposed to combat. What they found was that veterans tend to rate full-on expressions of happiness as being happier compared to civilians who rated the same photos, and to differentiate less between moderately angry and full-on angry expressions.
The authors explained that the tendency towards All-or-Nothing Thinking for veterans may serve an adaptive function during combat, where soldiers have to make snap judgements of threats versus safety. The cost of tolerating ambiguity in this context is simply too high (injury/ death). But when the soldiers return home, what they are faced with is regular social interactions, not life or death. Veterans who have PTSD and/or other related disorders often generate inaccurate interpretations of social cues and other people's intentions, making it very difficult for them to connect with others and reintegrate to civilian life. So they tend to avoid such interactions, which only further reinforces the idea that "the world is not safe for me anymore", making their symptoms worse.
Relational trauma works in remarkably similar ways. Repeated abuse, neglect and/or let-downs from primary caregivers instills in the individual the core belief that they are "unworthy" or fundamentally unlovable. Survivors of relational trauma would then try to cope by attempting to eliminate uncertainty in future relationships, or by avoiding emotional closeness altogether. With plenty of opportunities for practice, survivors develop a hypersensitivity towards threatening cues such as facial expressions that indicate disappointment/ anger, or signs that their partners are distancing themselves. In other words, they live in constant fear of re-experiencing traumatic relationships.
To people who have experienced relational trauma, coldness equates with criticism, anger indicates rejection, and distance amounts to abandonment. Even though objectively, there may be alternative and realistic explanations for a shift in attitude or behavior in their partners. These alternatives are often ignored in the process of All-or-Nothing Thinking. That is to say, the very coping mechanisms that people develop due to trauma actually may negatively impact their current relationships when these coping strategies are employed indiscriminately. In the business, we call that an "unlayered" response.
Becoming a therapist in Taiwan already is challenging. For instance, we are the only medical professional who are required to have at least a master's degree prior to licensure. It's even more complicated if you obtained training abroad. There are miles of red tape to cut through (on both sides), not to mention navigating completely different systems and cultures, and having to forge your own path almost completely due to there being so few of us in the first place.
One of the main reasons I was putting myself under so much pressure was not wanting to let my family or myself down. I made the decision to study overseas, and it felt like if I couldn't finish this last stretch of the journey, it would have been all for nothing.
During one of our bi-weekly check-ins with my classmates and professor, I brought up what had happened with my supervisor, and how I felt about it. Because all of my classmates obtained our degrees in the U.S., they were sympathetic about my situation. Some of them offered empathy and encouragement. Others shared their own experiences dealing with negative feedback. My professor first acknowledged my feelings, then she helped me metabolize my supervisor's message. "She said 'that's' not counseling. She didn't say 'you're a bad therapist'." It was then that I realized that I was having an "unlayered response" myself. I was reacting to not just the feedback about my technique, but also my insecurities and anxiety about something else entirely.
Challenging All-or-Nothing Thinking Through Cognitive Coping
There is more than one way to challenge All-or-Nothing thinking. Cognitive Coping is the process of identifying thoughts that are making us feel worse, and examining them to see if a) they are accurate and b) that they are helpful. In my practice, I help my clients identify All-or-Nothing Thinking, and try to challenge those thoughts by asking them the following questions (from Mind Over Mood by Dennis Greenberger and Christine A. Padesky, 2016):
- Have I had any experiences or is there any information that suggests that this thought is not completely true all the time?
- Are there any small pieces of information that contradict my thought that I may be ignoring or discounting as not important?
- Have I been in this type of situation before? What happened? Is there anything different between this situation and previous ones? What have I learned from prior experiences that could help me understand this situation differently?
By walking through this process, I work with my clients reframe their problems, and come up with a different, more constructive way of viewing their situations.
Afterwards, I tried to incorporate my supervisor's advice into my work. Unsurprisingly, my clients reacted positively. They felt more heard and opened up even more during their sessions. I also tried to check myself from engaging in cognitive distortions during our meetings, which also directly improved the relationship I had with my supervisor. In the end, I confronted my inner critic, and in the process learned to appreciate those in my life that offered blunt but constructive feedback about myself.
The path toward healing is long. Whether you're dealing with mood disorders, or attempting to recover from traumatic experiences/ relationships. But the journey of a thousand miles starts with a single step. For healing, that first step usually is awareness. And you have taken that first step today, which is truly a major achievement. Pat yourself on the back, and allow yourself to feel some appreciation for learning about yourself, whatever that may mean to you. And remember, you are never alone. I didn't do it by myself. And you don't have to, either. Find your tribe, in your chosen family, in your friends, partners, teachers, coaches, and therapists, and invest in those relationships. And when we catch ourselves engaging in All-or-Nothing Thinking again, may we begin to treat ourselves, not with criticism and self-deprecation, but simply with awareness, patience and self-compassion.
Let's practice together.
Gebhardt, C. Alliger-Horn, C. Mitte, K. & Glaesmer H. (2017). All-or-nothing thinking: The processing of emotional expressions in traumatized post-deployment soldiers. Journal of Anxiety Disorders, 47, 69-74.
Giusti, L., Salza, A., Mammarella, S., Bianco, D., Ussorio, D., Casacchia M. & Roncone R. (2020). #Everything will be fine. Duration of home confinement and "All-or-Nothing" cognitive thinking style as predictors of traumatic distress in young university students on a digital platform during the COVID-19 Italian lockdown. Frontiers in Psychiatry, 11, article 574812. DOI: 10.3389/fpsyt.2020.574812
Pirbaglou, M., Cribbie, R., Irvine, J., Radhu, N., Vora, K. & Ritvo, P. (2013). Perfectionism, anxiety, and depressive distress: Evidence for the mediating role of negative automatic thoughts and anxiety sensitivity. Journal of American College Health, 61(8), 477-483.
Photo by Vijay Sadasivuni: https://www.pexels.com/photo/grayscale-photo-of-person-covering-his-face-with-balloon-3601491/