What Is Dichotomous Thinking?

Dichotomous thinking, also known as "black or white thinking," is a symptom of many psychiatric conditions and personality disorders, including borderline personality disorder (BPD). Dichotomous thinking contributes to interpersonal problems and emotional and behavioral instability.

Characteristics of Dichotomous Thinking

Signs of dichotomous thinking include:

• Use absolute language like "always" and "never" to describe things
• Ruminating over extreme feelings
• Seeing things as either perfect or useless
• Being unable to see the middle ground
• Shifting between seeing things as good or bad
• Engaging in impulsive behaviors due to sudden shifts in how you see a person or situation

Many people experience dichotomous thinking sometimes, but it can be a problem when extreme conclusions about yourself, others, or circumstances interfere with your emotional stability, relationships, and decisions.

This extreme thinking can cause serious overreactions or emotional responses and may result in significant consequences if you tend to behave impulsively in response to your extreme feelings. Whether it's breaking off a relationship or poor work performance, dichotomous thinking can affect your quality of life.

Dichotomous Thinking and Mental Health Disorders

Dichotomous thinking can happen to anyone from time to time, but it is also a common type of cognitive distortion associated with certain mental health conditions. Some disorders that often feature dichotomous thinking include:

• Anxiety disorders
• Depression
• Borderline personality disorder (BPD)
• Eating disorders
• Narcissistic personality disorder (NPD)
• Obsessive-compulsive disorder (OCD)

Borderline personality disorder (BPD) is a condition that is commonly associated with this type of thinking. BPD can be difficult to live with and is often difficult to diagnose because people who have it may experience extreme mood swings and erratic behavior but generally cannot see themselves as having a problem and instead view others as the problem.

Examples of Dichotomous Thinking

Dichotomous thinking can cause conflicts and agitation, disrupting your own inner sense of peace and disrupting peace between yourself and others. If you have BPD, you may experience dichotomous thinking without even realizing it. 

For example, you might frequently flip-flop between seeing yourself as a remarkable success or a major failure based on the praise or criticism of others. 

A person with dichotomous thinking may meet a new coworker at work. In the beginning, the coworker is viewed as amazing, perfect, and better than any other coworker or friend ever encountered before.

If ignored by the coworker, or if the coworker behaves in a disappointing way, a person with dichotomous thinking may lose respect for or hate this formerly favorite coworker, unable to sustain relationships that are not distinctly "love" or "hate". This can lead to being easily manipulated by those who are viewed as "good" or to abrupt breakups in friendships and romantic relationships. 

In some instances, dichotomous thinking can result in financial problems. Impulsive purchases and a lack of balanced judgment at work and in one's personal life can have serious consequences. 

Treatment of Dichotomous Thinking

Dichotomous thinking and BPD can be very detrimental, holding you back from living a rich, full life. However, there are treatments that can help people better learn to manage dichotomous thinking. There are also effective treatments available to help people who have BPD.

Types of therapy that are often used to treat dichotomous thinking and borderline personality disorder include:

• Cognitive behavioral therapy (CBT)
• Dialectical behavior therapy (DBT)
• Acceptance and commitment therapy (ACT)
  

How Therapy Can Help

During your therapy sessions, your therapist or psychologist may ask you to discuss examples of your daily experience and talk about different perspectives. If you often think in extremes, your therapist can help you identify the middle ground, introducing you to a new, more balanced way of thought. As you progress, you will learn to consider your own assumptions by asking yourself the following questions before you allow your thoughts to upset you:

• Is there evidence that supports my thoughts?
• Am I considering all angles or am I leaving things out?
• Could my assumption be challenged by someone else? How?
• Does everyone else see it this way?
• Am I being fair to others in making this opinion?

Treatment for dichotomous thinking often focuses on helping people identify and reframe their thoughts. It also encourages more realistic self-talk that avoids absolute language like "always" and "never." It may also help people learn to better tolerate distress and accept that there are things they cannot change.

Keep in Mind

If you recognize that you have a tendency to dichotomous thinking, it is also important to avoid acting on your extreme thoughts or making sudden decisions. You might want to write things down or discuss them with a trusted friend or therapist. These steps can give you time to consider your decisions and to get feedback from a neutral source before you take action that could cause harm to your relationships or your finances.