Yesterday, we talked about cognitive distortions, ways of thinking that contribute to nursing school stress. We talked about a few of them; here are some additional examples.

Selective negative focus happens when a person picks out the negative details in any situation and dwells on them exclusively, which leads them to conclude that the whole situation is negative. Example: Maura Malcontent has moved to a different area of her state because the nursing school there has a reputation as the best in the region. She is used to big-city life, and the school is in a rural area. She spends her entire first semester complaining about the remote location of the school (“I’m afraid I’ll get mauled by a bear on my way to the dorm! They call this a movie theater? Where are the ATMs around here, anyway?”) This causes stress not only for herself, but also for everyone around her.

Disqualifying the positive occurs when a person is confronted with information that clearly contradicts the person’s negative self-image or pessimistic attitudes, and the person discounts the information or the source of the information. Example: Dorothy Diamide is convinced that she can’t communicate well with her patients in clinical. At the end of one clinical day, her instructor, Mr. Frankel, says, “You did really well explaining the nonpharmacologic interventions for constipation to your patient today. She was drinking water all morning and asked to go for a walk this afternoon.” Instead of enjoying the compliment, Dorothy thinks, “Oh, that stupid ol’ Mr. Frankel. He doesn’t know anything. Bet they didn’t even have constipation back when he was in school.”

In the cognitive distortion of mind reading, a person assumes that other folks are thinking something and becomes so convinced of the others’ thoughts that he or she doesn’t even bother to check out these supposed perceptions. Example: There was a question on the exam about a subject Brenda Butyric presented to her study group. She is certain that all the members of the group must have gotten the question wrong because she didn’t present the subject well enough. Brenda is so sure that everyone is mad at her that she runs from the room whenever she sees anyone from the study group approaching.

Emotional reasoning happens when a person takes the existence of a certain emotional state as evidence of fact. Example: Patrick Pachypodous is sitting in the lecture hall, calmly waiting for the faculty member to pass out the tests. When he receives his, he sees how long it is and begins to panic. His heart starts beating faster, his hands start to sweat so copiously he’s afraid he won’t be able to hold his pencil, and he suddenly feels like all the knowledge has been sucked out of his brain by a large, purple, fact-hungry alien. Terror-ridden, he thinks, “I feel like I’m going to fail . . . I must be going to fail!”

You can head these cognitive distortions off at the pass by being aware of their existence and recognizing whether there are certain ones that tend to affect you most frequently. Because it is hard to recognize when your thoughts are causing you stress, you should share this list with a classmate or friend and agree to look out for signs that the other person is the victim of a stress-causing cognitive distortion.