Distorted Cognitions

I watched as she hurried around the front office this morning. I was there early so it was interesting to see her move around the place. Normally I don’t see her until she comes out of her prior appointment. Eventually she acknowledges me.

“Sorry, I didn’t have my make-up on earlier. Please feel free to go on back.”

I gather my bag, water bottle and phone and head to her office. I make myself comfortable on her couch. I’ve been here several times so I’m comfortable here, but today I’m fidgety. I can’t quite place why though. I look around the room while waiting on her. My papers are on the small table by her chair already. I’m obviously her first client of the day. There’s a wall graphic on the outer wall to my right. There is a bird and a quote about Obstacles, but it is partially blocked from my view by a toy easel she uses with her child clients. On the drawing paper, are two swans, one right side up and one upside down. I’m staring at these when she enters the room.

She hurriedly takes her seat and apologizes again. ” Sorry again, some days the goal is getting out the door. Then I have to do everything else when I get here.” she almost sighs as she slides into her chair and grabs my paperwork. “Hey, I understand, we all have mornings like this.” I say cheerfully. She looks at me and my session begins. We talked about the past two weeks. It was a lot of ground to cover. The year mark of my miscarriage occurred since my last session. I told her of my poem, that instead of avoiding the emotions of the loss I decided to meet them head on and embrace them. She listened intently and remarked “It sounds like this was a positive approach to dealing with this aspect of what is going on.” I agreed with her.

Conversation then changed to the anxiety I’ve been having over the fact that my Rheumatologist wants me to see the Dermatologist for skin biopsies. I started fidgeting and could not sit still. That part basically has played out that I’ve decided that I will see the Dermatologist for the skin biopsies but I think after that at least for a while I’m done, I think that’s where I draw the line with tests for a while. Unless something comes up that they are absolutely needed. Of course this is all subject to change. We go over the fact that my Hematologist vetted the Dermatologist yesterday, that I won’t see the Hematologist for a year but I’ll still have to go to the same office building to see the Dermatologist anyways.

Next we discussed about my ongoing anxiety over taking pain medication and the newest issue of Aleve. See, my Rheumatologist wants me to take Aleve but my other doctors have told me not to in the past because I am on Warfarin. At my last appointment he said I had to take it so we knew if the anti-inflammatory action of it was beneficial.  So I’ve been taking them as needed, no that’s not quite true. If I took Aleve or pain meds as needed I’d take them all the time. I take them when the pain gets unbearable. We talked about how I’ve been gauging when I should take it and when I shouldn’t. AL said “Perhaps you shouldn’t wait until you are irritable and it is affecting your day so badly. What if you took it a step before that point?” I thought about it and nodded. “You are right, I should take it sooner.”

We also talked about the book I purchased for CBT. Luckily I purchased the right one. We went through the various distorted cognitions. “Which ones do you think fit you?” she asked as she took a sip from her coffee mug.  ” Oh hang on I marked them in my book, Overgeneralization, Mental Filter, Magnification and Minimization, and Should Statements.” I said. She peered up from the papers as she added softly, “Jumping to Conclusions perhaps?” I sighed heavily, as much as I hate to admit it, “:Yes that one as well.” We talk about this topic pretty much for the remainder of the appointment in some form or another. She asks for a few examples and I  can barely get the words out “I still have moments where I feel I should have seen this all coming.” That is a manifestation of  Should statements and Personalization. I still feel I am somehow responsible for getting sick. I know logically that makes no sense, but the thought process still happen. I would say emotions, but what I’m learning through CBT is that emotions are triggered by thoughts. We feel the way we do largely because of how we think. I feel responsible, and guilty over being sick because of the thoughts I have about being sick.

The session wrapped up with her telling me to continue reading my book and to continue challenging my distorted thoughts as they crop up. We headed back to the front office and she scheduled my next appointment for two weeks and took my payment. “OOOO Cash!” She is always so excited when I pay with cash.


16 thoughts on “Distorted Cognitions

  1. Totally identify withnshouldnhave statements and guilt over diabetes. I told myself I should have lost weight and then I wouldn’t have diabetes. My brother has it too, though and he’s never been oferweight. Endocrinologist says it’s probably genetic.

    Interesting going in with you and your therapist.


    1. I’m plagued with the Should have and Shouldn’t statements. I have a lot of guilt when it comes to this. I was around it from the time I was a kid on up. I knew the signs to watch out for when it came to Lupus. I have moments where I feel I should have seen myself getting sick, prior to the more serious things happening like the blood clots. The thing is, that’s not how autoimmune diseases work. I know that logically, at least when my brain is allowing me to think logically. It came out today that I feel responsible for this and that I feel that I should have known how to cope with this better. AL looked at me and said “Nicole, how could you have known how to deal with something you have never faced before?” I almost cried. It made so much sense when she said it, now I just hope my subconscious listens to that and takes it to heart. Diabetes runs in my family too, that’s something I need to start watching out for (see there I go again), seriously though I have some weight I need to lose and I’m working on it. Plus I’m on some medications that could cause it to be an issue sooner rather than later. So I feel it’s now or never to get what is left of my health back in check.
      Today was a good appointment to invite you guys into. It wasn’t too deep and heavy, and there was a lot of positive that came out of it. AL is pretty amazing. 🙂


  2. Be good to yourself , Nicole. I was a bunny in the headlights when I got run over with my arthritis. No way did I see it coming. This after my Mum suffered chronic pain since she was 11 years old. Never thought my turn was coming up. How could I know? And what would I do about it anyway? I take my painkillers when the pain starts to set in as I have been advised that once the pain takes hold it is very difficult to make it go away (as I well know). Glad the appointment went well. Peace and happiness to you, Nicole.


    1. Thanks Maria. The guilt comes from seeing several family members suffer with it for years, knowing the warning signs and having it drilled in my head for years. Then there’s the clotting disorder, that came out of nowhere so I have no idea why I feel guilty over that but I do. Therapy is helping a lot over this.
      As for the pain, I know I put off taking pain meds too long. That comes from battling with being the child of an addict. I saw what my Dad’s addictions did to him and I don’t want to fall into the same trap. I know I won’t, I actually need the meds but I have built an anxiety over taking them to the point I talk myself out of taking them more often than not. I have a perscription for Tramadol that has 2 refills and if I was taking it as prescribed I would have have already used them all, I still have part of the first bottle left. It is something I battle with every time I have to take one. Which logically I know means I’ll never allow myself to be an addict but it’s still an anxiety that has built up in me due to my Dad’s issues. It’s funny how long lasting and far spread the impact that addictions can be. I didn’t realize it had impacted me this bad until I got sick. Now I’m having to deal with the repercussions of someone else’s decisions. This is next on the list of things to discuss with my therapist. Perhaps at my next session.
      I hope your week is going well!


      1. Pain is an emotional thing. It can cloud your thoughts and make it more difficult to think things through. Sometimes all I can do is take some time out and rest and relax. Pain creates tension which can make more pain. If I relax I can live with things better and it can actually ease the pain.

        At times I just lie on the bed and wait for the pain to ease. I don’t feel guilty. I am not lazy. And when I am on top of things again I will get more done anyway. Really hope things are going okay for you, Nicole.


      2. Maria,
        Thanks. You are right pain is an emotional thing. It affects more than just ‘ouch I hurt’. Especially when it is a chronic thing. I had a few days of being basically pain free. They were great. Today I’m back to intense pain. We have storms moving through, and that makes me hurt. This evening will be spent on the couch catching up on blogging and stuff I have missed while being able to be active. Hope you are doing well and that you had a great weekend.


      3. Rainy weather affects me too. Usually before it happens. Glad you had some relatively pain free days and sorry to hear you are having pain now. Hopefully the pain will soon ease.

        I have had some achy days lately but I had a good day today and went swimming. Rest up and happy blogging, Nicole.


  3. I was told not to take any nsaids (which aleve is in the family of) for the same reason because of the wafrin and also all the other medications we take filter through the kidneys and nsaids are rough on the kidneys. Have you tried Trammadol? It’s classified as a narcotic but it’s not. It works pretty good.


    1. I have Tramadol for when the pain gets really bad but it does nothing for the inflammation of my joints because it isn’t an anti-inflammatory. It is a synthetic opiod. I had a long talk about it with my doctor. I have severe anxiety over pain medications because my dad was an addict and I don’t want to be on them so he prescribed that one because it is ‘safer’. He also gave me a prescription for Voltaren Gel which is a topical NSAID. It is magic. It’s basically like rubbing an aleve into my joints…without the systemic issues taking an aleve causes. Then my Rheumatologist once I got established with him told me he needed me to take the aleve to see if it would help with the inflammation. He said as long as my doctor (PCP) was monitoring my INR closely, I was taking it with food and taking it as needed I would be fine. I was reluctant to take it at first, then after this last appointment we had a long discussion about it and he explained why he needed to know. Basically he needs to know if what I’m experiencing is pain from inflammation or just pain. If a pain med is wiping out my pain, but an anti-inflammatory is more effective, he needs to know this. So I’ve been taking aleve as needed, with food. He said I could take 1-2 in the mornings and 1-2 in the evenings with food and I’d be fine. I coordinated that with my PCP as well and he said just to let him know at my INR checks if I’ve had to take it during that time frame (2 weeks) so he could factor it in when we have to make adjustments to my Warfarin doses.
      So now I have several options, and when I see my Rheumy in July I can tell him that Aleve is affective, but not enough. Then at least he will know I’m willing to listen to him 😛 ….he was a little upset last time.


  4. This was great Nicole, I could really see you in the room, and her, as well. Nice descriptions, you did a great job, thanks for sharing that. I specifically loved this line: “I’m learning through CBT is that emotions are triggered by thoughts. We feel the way we do largely because of how we think.” It makes so much sense to me and really drove home the point that we can control our thoughts, then our emotions will follow the way we would like them to be. You’re so strong and brave – never forget that! 🙂


    1. Thanks Liz. I had a lot of fun with this assignment! CBT is teaching me a new way of looking at things. If you want to learn more about it I highly recommend the book Feeling Good the new mood therapy by David D Burns, MD. There’s a picture of it on my Instagram as well. It’s a great reference/self help guide and is the book my therapist recommended I start with. Thanks, I try to remind myself that I’m strong, even when I’m having trouble believing it. It helps to have folks that remind me of it from time to time. 🙂


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