In a traditional CBT model, cognitive distortions are irrational patterns of thinking that cause a person to have an inaccurate perception of reality. Cognitive distortions encountered with chronically traumatized children are not necessarily “distortions of reality.” Sometimes, they are rigid patterns of belief that are shaped by previous traumatic experiences. In other words, these thoughts, beliefs, or attitudes are natural responses to unnatural circumstances. They were adaptive in that particular context but are unhelpful in current domains of functioning in a safe environment, such as the home, school, or community.
For example, if the child thinks that ‘the world is a dangerous place’ and they grew up in a chronically dangerous and threatening environment—this thought is an adaptive learning response to reality, the way they make sense of the traumatic experience. However, being alert and hyper-vigilant all the time because “the world is a dangerous place” when the real danger is over is maladaptive and can seriously impair functioning (e.g., avoidance of certain places or people). If unchallenged, these unhelpful thoughts and consequent maladaptive responses may persist into adulthood.
The goal is not to change a thought or belief. Rather, the aim is to help children understand why they are thinking this way and to gain cognitive flexibility so that they can consider multiple perspectives on their experience(s), and differentiate between circumstances when this thought is helpful (adaptive), versus times when it is unhelpful (getting in the way). While providing hope is important, exercise caution in changing the child’s perspective to an overly positive outlook. Cognitive restructuring addresses the crippling rigidity of “black and white thinking” that is common in children with chronic trauma, allowing for more self-compassion and a more flexible approach to life and reality.