Cognitive Therapy, COVID-Style

When we encounter something new, it can take us some time to wrap our heads around it. Often, however, we apply the same thinking patterns that we’ve used in the past to the new situation. Right now, the newest kid on the block is the COVID-19 vaccine. There’s been so much anticipation and controversy surrounding the vaccine, it can be hard to make space to process your own thoughts about it.

We’ve noticed that many of the concerns that have been voiced about the COVID vaccine reflect more general thinking patterns that can be unhelpful. In cognitive-behavioral therapy (CBT), therapists work with patients to identify these unhelpful thinking patterns (also referred to as “cognitive distortions”) that often lead to biased perceptions and negative emotions. Becoming aware of these patterns and learning to adapt your thinking can help you see situations in a different, more positive, and hopefully more accurate light.

Below, we describe four unhelpful thinking patterns that could lead people to pass up the opportunity to get a COVID vaccine. Following each thinking pattern, we describe strategies to reevaluate the situation from a more balanced perspective. You don’t need a therapist to use these strategies—just a (much cheaper) piece of paper and a pen.

1. Mental Filtering (or Focusing on the Negative)

The problem: It’s true that there are potential negative side effects of the vaccine. However, while feeling achy or having a low fever is uncomfortable, we tend to magnify negative details of an experience at the expense of the full context. The positive consequences of receiving a vaccine may not be listed as “side effects,” yet they will likely outweigh the physical discomfort you may feel for a brief period after being vaccinated.

The solution: List all of the positive “side effects” of receiving a vaccine. These might include feeling more comfortable going grocery shopping or being at work, doing things you may have been avoiding or limiting, or contributing to the health of your household and community.

2. Catastrophizing

The problem: It’s easy to catastrophize (to be sure that something bad will happen), especially when something is unknown or scary, like a new vaccine. Although it’s theoretically possible that you will have a serious adverse reaction to the vaccine, the research indicates that is unlikely to happen.

The solution: Write down the serious adverse reactions you are scared of experiencing. If possible, look up the percentage of people who had that reaction in the studies conducted so far, or ask your doctor. If this isn’t possible, pretend you’re doing a science fair project and try to estimate the real chance of having that reaction. Then write down the chances of experiencing serious symptoms or long-term complications from COVID. Compare the two and see which one is higher.

3. All-or-Nothing Thinking

The problem: Health officials are still recommending that everyone wear masks and continue taking other precautions, so what’s the point of being vaccinated? This is a perfect example of all-or-nothing (or black-and-white) thinking. While it is true that you won’t go straight from your vaccine to an all-night rave with 850 of your closest friends, there are likely many steps between your current practices and all-night raving. Even if you won’t be able to do absolutely everything, you’ll still be able to do more.

The solution: Make a line on a piece of paper. On the left side, write down what you currently feel comfortable doing (this is your “nothing” side). On the right side, write down what you would like to do if COVID were no longer around (this is your “all” side). Now make three lines in the middle and write down activities that you will feel more comfortable doing when you are vaccinated (these are your shades of gray). Consider how these activities may positively impact your mood, activity level, and social interactions.

Next up: How to actually get a COVID vaccine if you want one … just joking, we have no idea! Good luck!

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