Panic Disorder Coping How to Overcome All-or-Nothing Thinking By Katharina Star, PhD Katharina Star, PhD Facebook LinkedIn Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. Learn about our editorial process Updated on January 31, 2023 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Carly Snyder, MD Medically reviewed by Carly Snyder, MD Facebook LinkedIn Twitter Carly Snyder, MD is a reproductive and perinatal psychiatrist who combines traditional psychiatry with integrative medicine-based treatments. Learn about our Medical Review Board Print Hero Images/Getty Images Table of Contents View All Table of Contents Definition Examples Effects How to Overcome It All-or-nothing thinking, also known as dichotomous thinking or black-and-white thinking, is a type of cognitive distortion that involves thinking in extremes and using absolute terms, such as never or ever. All-or-nothing thinking is a negative thinking pattern common in people with panic disorder, depression, or other anxiety-related issues. Here's an explanation of what it is and ways to overcome this common cognitive distortion. Understanding All-Or-Nothing Thinking All-or-nothing thinking is one of many negative thought processes, known as cognitive distortions, that are common among people with anxiety and depression. When thinking in all-or-nothing terms, you split your views into extremes. Everything—from your view of yourself to your life experiences—is divided into black-or-white terms. This leaves room for little, if any, gray area in between. This type of faulty thinking can also include an inability to see the alternatives in a situation or solutions to a problem. For people with anxiety or depression, this often means only seeing the downside to any given situation. People who fall victim to all-or-nothing thinking believe that they're either successful or a complete failure in life. People with panic disorder are often susceptible to this type of thinking. If you have frequent panic attacks, you may view yourself as unworthy or inadequate because of your condition. You may also overlook how valuable you are in other roles, such as a friend, employee, or parent. Press Play for Advice On Healing Your Inner Critic Hosted by Editor-in-Chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast, featuring actor Kevin Hart, discusses how to minimize negative self-talk. Click below to listen now. Follow Now: Apple Podcasts / Spotify / Google Podcasts / Amazon Music Examples of All-or-Nothing Thinking It can be helpful to look at some examples of all-or-nothing thinking to learn more about how it works. Here are some hypothetical situation where an individual engages in all-or-nothing thinking and how it affects their mood, motivation, and behavior. Social Interactions Roger decided to face his anxiety and ask a woman out on a date. He left her a voicemail message. A few days go by and Roger hasn't heard back from her. He thinks, “I'm a total loser with nothing to offer ... No one wants to go out with me ... I will never find the right person, so why bother?” He starts to feel nervous and upset as he considers a future alone. Anxiety Elaine was diagnosed with panic disorder with agoraphobia about seven years ago. Since then, she has sought out psychotherapy, regularly takes her prescribed antidepressant, and frequently practices self-care. Elaine’s symptoms have greatly improved and she feels ready to go to a concert with a friend, a situation that has caused her fearful avoidance in the past. When Elaine arrives at the concert, she begins to experience physical symptoms of panic and anxiety. She tries a deep breathing technique but still has a panic attack. Elaine leaves the concert early, telling herself that she will never overcome her condition and that she lets her nervousness ruin every situation. Recap In both of these examples, people see the situation in absolute terms. In Roger's case, it affects his confidence and ability to engage in a relationship. In Elaine's situation, impairs her ability to manage symptoms of her anxiety condition. Effects of All-or-Nothing Thinking All-or-nothing thinking can have various effects. Like other cognitive distortions, it can have a serious impact on emotions and mood. Decreased Motivation All-or-nothing thinking can also be very unrealistic, which can contribute to excessively high standards that are impossible to meet. As a result, people often avoid pursing goals because they don't think the results will match their expectations. They might think, "I can't do this perfectly, so I just won't do it at all." Poor Self-Perception All-or-nothing thinking can also contribute to poor perception of yourself. If you always think thought like, "I can never do anything right," it is difficult to see yourself in a positive light. This can lead to low confidence and a lack of self-esteem. Feelings of Hopelessness Seeing things in extremes can also contribute to feelings of hopelessness. If you can only see the negatives in a situation, you might feel that there is nothing that you can do to change the situation. Increased Risk of Anxiety and Depression Cognitive distortions such as all-or-nothing thinking can contribute to an increased risk for anxiety and depression. One study also found that such thinking is connected to increases in suicidal thinking. All-or-nothing thinking can play a part in the onset and maintenance of eating disorders, personality disorders, post-traumatic stress disorder (PTSD), and substance use disorders (SUD). Overcoming All-or-Nothing Thinking The problem with all-or-nothing thinking is that there is no middle ground because people think only in extremes. In order to overcome all-or-nothing thinking, it is important to avoid thinking in negative, absolute terms. Some strategies that can help include: Considering Alternatives One way to change it is to replace negative self-defeating thoughts with more realistic ones. This involves considering the alternatives and thinking about alternative explanations. Cognitive Reframing Cognitive reframing is a strategy that involves changing how you think about a situation. Changing your perspective can alter how you think, feel, and behave. To do this, start noticing when you engage in all-or-nothing thinking. After identifying this type of thinking, challenge your thoughts. Are they true? Are there other explanations? Finally, replace that thought with one that is more positive and realistic. Challenging Negative thoughts An important part of cognitive reframing involves actively challenging your negative thoughts. Accepting your thoughts as the truth skews your perspective and can lead to poor interpretations of different situations. Some things you can do to challenge your thoughts include: Practicing mindfulness, which involves focusing fully on the present momentTalking to yourself the same way you would talk to a friendShowing yourself compassion and kindnessCultivating gratitudeFocusing on the positive Get Social Support When you can only see one side of any situation, it can help to seek out the support of trusted friends or family. A support network may be able to assist you in finding solutions and thinking beyond absolute terms. Talking to a Professional While self-help strategies can be helpful in combatting all-or-nothing thinking, you may also want to consider talking to a mental health professional. A therapist can help you identify triggers that contribute to this type of thinking and practice new coping strategies that can reduce negative thinking. Dos Recognize strengths Understand that setbacks happen Find the positive in situations Don'ts Focus on faults Dwell on self-defeating thoughts Use unconditional terms such as "never" or "nothing" A Word From Verywell All-or-nothing thinking can make it hard to see the middle ground. If you tend to engage in this type of cognitive distortion, there are steps you can take to change. Identifying your negative thoughts and challenging them are important steps. Once you recognize this type of thinking, you'll be better able to replace dichotomous thoughts with more realistic ones. 5 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Rnic K, Dozois DJ, Martin RA. Cognitive distortions, humor styles, and depression. Eur J Psychol. 2016;12(3):348-362. doi:10.5964/ejop.v12i3.1118 The Pennsylvania Child Welfare Resource Center. Thinking About Thinking: Patterns of Cognitive Distortions. The Resilience Alliance. 2011. Bonfá‐Araujo B, Oshio A, Hauck‐Filho N. Seeing things in black‐and‐white : A scoping review on dichotomous thinking style. Jpn Psychol Res. 2022;64(4):461-472. doi:10.1111/jpr.12328 Mercan N, Bulut M, Yüksel Ç. Investigation of the relatedness of cognitive distortions with emotional expression, anxiety, and depression. Curr Psychol. 2021. doi:10.1007/s12144-021-02251-z Fazakas-DeHoog LL, Rnic K, Dozois DJA. A cognitive distortions and deficits model of suicide ideation. Eur J Psychol. 2017;13(2):178-193. doi:10.5964/ejop.v13i2.1238 By Katharina Star, PhD Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. 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