Tips for Helping Someone With Cognitive Distortions See Around Them to the Truth

A friend with anorexia is convinced she is fat, even though she's underweight and looks unwell. How can you help her see she isn't fat after all, and that she should consider seeing a psychiatrist or a doctor? Your depressed friend really believes he is worthless, no matter how many friends he has or how he lights up a room when he enters it. How do you help him see people love him and respect him and that he's absolutely not worthless? An acquaintance in your orchestral class believes she is one of the best clarinet players in the world and has begun to talk down to the other players and treat them as inferior. How can you help her come back down to earth and have a more realistic perception of her skills?

These are examples of what it can look like when a person has cognitive distortions, and the answer of how to help someone with CDs is to recognize their thinking is distorted, and to speak about these subjects in ways that expose the distortion and bring it to light.

You can't force the person to get help. It's not your place to do that. Unless of course the person is an imminent danger to themselves or others and then calling the police for a welfare check on them is a valid option. But in most situations, you do not have the right or the power to force them to get psychiatric help.

But what you can do, is paint a picture of reality that is accurate.

Learn the "Language" of Their Cognitive Distortions

Your friend with disordered eating keeps saying she is fat. Open up a conversation about it. "You keep saying you are fat, but no one else sees it. You look underweight to us. What do you mean by "fat" anyway?"

She may tell you that being fat means being a worthless loser in all areas of life who does not deserve to take up space.

Find Out What Their Definitions are
You can see from this admission that "fat" to her is not a size; it's a feeling and a sense of identity. Thus it makes sense that no matter how much she shrinks her body down in size, she will still conclude she is fat, as fat was never just a size to begin with.

Your friend doesn't know she has the wrong definition of "fat." That's what cognitive distortions do, they warp your thinking so that you're not aware that another definition of these subjects exists, and you don't even think to question your definition.

Make Her Aware There's Another Definition of "Fat" So Her Brain Can See Discrepancy

The key to seeing around cognitive distortions is to be able to see the discrepancy between their definition, and the other definition, the one based in reality.

As long as they only see one definition of "fat", they'll never know they are having cognitive distortions.

So to help your friend see this concept of discrepancy, at this point you could say something like "Fat is just a size; it's not all those other things. Those other things sound like depression or cognitive distortions; have you ever thought of seeing a psychiatrist?" The friend doesn't really know fat is just a size. She's slipped into the maze of mirrors that is anorexia, and she can't see the real world. Suggesting to her that there is another way of seeing things, can help her see not everyone shares her perceptions and feelings, and thus there could be an underlying condition beneath these feelings. It opens the doors to let light in from the other world, the one that isn't the maze of mirrors. When someone first develops anorexia it feels like their personal perception of themselves and the world. You don't know when you first get it that this perception is a condition.

Keep Finding Little Ways to Add Brushstrokes to the Picture of Reality

As you talk with her and keep up your friendship, remember what her cognitive distortions are, and find little ways to speak about some of the more minor details of reality, that shed light on what the true meanings of words are. It's actually really simple how to do this.

Don't just use the words themselves. Add a couple adjectives and descriptors that show what the words really mean.

"Eating" which has lots of negative connotations with it in your friend's mind and is basically synonymous with "active failing or desecrating of oneself" you can refer to as "fuel." If you say things like "Wow, this food looks tasty, aren't you excited to try it?!" all your friend hears is gluttonous desire, which she isn't going to want to take part in. But you could say something like "This bar is packed with nutrition that is going to give us a lot of energy as we hit the slopes today, here try some."

I'm not saying your friend will quickly get on board with eating just from doing this, but it will get her thinking. She'll start to understand there is another way to look at food that is more accurate.

Keep a Conversational, Not Argumentative Tone
It's important to keep a conversational tone that respects her as a person, and her free will. Talk about ideas, and bring her into the conversation in a way where she understands that you're not going to force your view of reality on her, you're going to share your views and compare them beside hers, and the choice is hers which to embrace.

As Christians God asks us to greatly respect people's free will. Our approach according to the Bible is to win them over with love and truth, not force them in any way. So have winning conversations, where you do your job well in a way that draws people in, and leave it up to her how to respond to these conversations and what choices to make in her life.

"You Look Healthy" Equals "You Look Fat"
Let's say she returns from an eating disorder clinic, and she's now closer to a healthy weight and looks great. People are telling her "You look so healthy!" but she doesn't respond well to this at all, and goes and hides in a corner. You catch her there crying and ask what's wrong. "When people say I look so healthy, all I hear is how fat I look. I don't want to be healthy if being healthy means being fat."

So here you can see the way the cognitive distortions are altering her perception and her psychology. Fat means being a worthless loser, and "healthy" means fat, thus gaining weight and looking healthy means being worthless and acting in a loser kind of way that is shameful and embarrassing.

You can respond by using a short description that explains what "healthy" really means. When you see her say "You look trim and determined. I'm proud of you for coming such a long way." Or "You look lean and empowered, like a winner, even though you might not feel that way yet. We're proud of you."

A healthy person is a trim or lean one. This is the part of the perception that your friend's brain is missing. To her health means being a fat blob of a person who is a total loser. But all truly healthy women are lean and trim; they aren't overweight. Also health and being a winner go together. To care about health and works towards it makes someone a winner as they are walking in obedience to God and His health laws. She's equating health with being a loser, which isn't accurate.

So learning the language of the different disorders can really help in making statements and starting up conversations that address the distortion and replace it with the truth, helping her see around the distortion.

When people just keep saying "You look healthy, you look healthy" which is the right thing to say to someone without cognitive distortions, all she hears is "You are so fat and worthless" because these statements don't help her see around her flawed thinking to the truth.