To wrap up my little triptych on the tragedy of prevention and cognitive distortions, I want to focus on two additional distortions that tie it all together. The tragedy isn’t actually about prevention, but about not noticing. Ellen Langer, the Harvard researcher and “mother of mindfulness” I quoted in the last blog, writes,
The word “mindfulness” has become ubiquitous since my early work in the 1970s. It’s hard to open a newspaper or magazine, or even listen to an interview, without the word “mindful” being used. Most of this usage presents mindfulness as a condition solely of the mind and often related to the practice of meditation. But mindfulness—as my students and I have shown—is instead the simple process of actively noticing things, no meditation required. When mindful, we notice things we didn’t notice before, and we come to see that we didn’t know the things we thought we knew as well as we thought we knew them. Everything becomes interesting and potentially useful in a new way.
Everything becomes interesting and potentially useful in a new way. Ain’t that the truth. When we take the time to notice the good happening to us, around us, and within us, life seems much more interesting and full of potential.
The cognitive distortions that I find get in the way of this mindfulness or seeing the good are minimizing and disqualifying the positive:
- Minimizing: the opposite of catastrophizing. This distortion downplays the significance of positive events, such as awards, recognition, and accolades, while often assigning more weight to the negative. It’s thinking, “I only passed that test because it was easy,” instead of acknowledging the hard work and preparation involved. You shrink the importance of positive events while exaggerating the negative ones.
- Disqualifying the positive: finding reasons to reject positive information. This cognitive distortion involves actively discounting or explaining away positive events, achievements, or compliments, thereby maintaining a more negative self-perception or worldview. You acknowledge a positive event but then invent reasons why it doesn’t count or matter.
These, to my mind, are exactly what is happening when we fail to notice how much harm is being prevented every day. Did you know the maternal death rate in Sierra Leone declined from 1 in 17 in 2019 to 1 in 74 today? I know this from the Vlogbrothers (John & Hank Green), who partnered with the Sierra Leone Ministry of Health and Partners in Health to begin improving the maternal care available at Koidu Government Hospital and to help build a new Maternal Center of Excellence. Though it’s still not where it should be, that’s a 60% reduction in mortality—thousands of mothers and infants who didn’t die. Why don’t we celebrate that? It’s not Instagram-ready work. It’s a lot of slow, sustained work to change systems and grow an infrastructure, and it takes time to see results. I think that’s what makes it so easy to disqualify the positive results.
That discounting is why we often have to fight to implement more long-term programs like this. I’ll put one more plug for John Green here. His recent book, Everything is Tuberculosis, examines the history of TB and chronicles the story of Henry Reider, a tuberculosis patient Green met in Sierra Leone, with whom he formed a close friendship. Green questions how tuberculosis killed 1.25 million people in 2023 despite being curable. The reason TB remains the deadliest infectious disease in the world, especially in low-income countries, isn’t a lack of knowledge or medication; it’s a lack of access due to failures of human-built systems. When we learn not to minimize the benefits of prevention, we’ll be more likely to work to make systemic changes that prevent preventable deaths, rather than minimizing the good that could be done.
On a more personal level, doing less minimizing might look like saying, “I’m so proud of myself for building Pilates into my everyday routine” instead of “I only go to Pilates because I paid for the session.” And what about being able to do more with the same amount of effort, or what used to take a lot of effort now feels a little easy? Don’t minimize these gains!
Instead of disqualifying a compliment from the instructor, “you guys are looking so strong today!” as being for everyone else except you, try to notice how it might be about you, too! And we’re often quick to say, “I’m so lucky that I can still hike in Yosemite… get on the floor with my grandkids… live independently… fill in the blank.” Don’t disqualify your health as luck. You’ve been working hard to stay fit and active, and your hard work is paying off, even if that work now feels routine. (and congrats if you’ve gotten to the point where it feels routine…YOU did that!)
The best way to stop any cognitive distortion is first to notice that it’s happening. Becoming aware is hard, and a huge first step! Once you recognize it, the next step is to challenge the distortion. That could be:
- asking yourself if your thought aligns with the facts of the situation.
- considering your hard work and preparation for achievements, instead of dismissing them.
- giving credit where it’s due by acknowledging your own positive qualities and successes.
Now, when I occasionally brush my teeth for less than the full two minutes, instead of skipping it completely, I actually feel a sense of accomplishment, knowing I’ve overcome a thought distortion. I wish you the same.
