"Should" Statements

A brief introduction to cognitive distortions

Cognitive distortions, cognitive biases, or ‘unhelpful thinking styles’ are the characteristic ways our thoughts become biased (Beck, 1963). We are always interpreting the world around us, trying to make sense of what is happening. Sometimes our brains take ‘shortcuts’ and we think things that are not completely accurate. Different cognitive short cuts result in different kinds of bias or distortions in our thinking. Sometimes we might jump to the worst possible conclusion (“this rough patch of skin is cancer!”), at other times we might blame ourselves for things that are not our fault (“If I hadn’t made him mad he wouldn’t have hit me”), and at other times we might rely on intuition and jump to conclusions (“I know that they all hate me even though they’re being nice”). These biases are often maintained by characteristic unhelpful assumptions (Beck et al., 1979).

Different cognitive biases are associated with different clinical presentations. For example, catastrophizing is associated with anxiety disorders (Nöel et al., 2012), dichotomous thinking has been linked to emotional instability (Veen & Arntz, 2000), and thought-action fusion is associated with obsessive compulsive disorder (Shafran et al., 1996).

Catching automatic thoughts and (re)appraising them is a core component of traditional cognitive therapy (Beck et al, 1979; Beck, 1995; Kennerley, Kirk, Westbrook, 2007). Identifying the presence and nature of cognitive biases is often a helpful way of introducing this concept – clients are usually quick to appreciate and identify with the concept of ‘unhelpful thinking styles’, and can easily be trained to notice the presence of biases in their own automatic thoughts. Once biases have been identified, clients can be taught to appraise the accuracy of these automatic thoughts and draw new conclusions. 

“Should” statements

“Should” statements (sometimes referred to as ‘musturbation’, ‘necessitous thinking’, ‘self-commands’, and ‘injunctions’) are a common cognitive distortion or ‘unhelpful thinking style’. “Should” statements are characterized by imposing fixed ‘rules’ on how the self, others, and the world should operate, coupled with overestimations of how awful it would be if these expectations are not met. Terms such as “should”, “must”, and “ought to” often appear in this style of thinking. 

Burns (2020) identifies four types of “should” statement:

• Self-directed ‘shoulds’: self-imposed standards which, lead to anxiety, guilt, and shame.
• Other-directed ‘shoulds’: expectations of others which, lead to anger and conflict. 
• World-directed ‘shoulds’: expectations around how the world should work, which can lead to frustration and entitlement.
• Hidden ‘shoulds’: implicit standards revealed in our reactions (e.g., getting frustrated with oneself after making a mistake).  

Albert Ellis (the creator of rational emotive behavior therapy, also known by the acronym “REBT”) identified demanding thinking or ‘musturbation’ as the primary irrational belief in emotional disorders, and believed it played a central role in depressive thinking (Dryden, 2020; Ellis, 1987). Conversely, cognitive therapy views demanding thinking as common in depression but not necessarily fundamental (Brown & Beck, 1989).  

Other clinical problems that are associated with “should” statements include: 

• Anxiety disorders (Darvishi et al., 2019; Kuru et al., 2018).
• Perfectionism (Egan et al., 2014; Horney, 1950).
• Problematic anger.
• Interpersonal difficulties (Beck et al., 1979). 

Examples of should-focused thinking include:

• “Must” statements (“I must get it right’).
• “Should” statements (“I shouldn’t feel this way”).
• “Ought to” statements (“She ought to be kinder toward me”).
• “Have to” statements (“The world has to be fair”).

People who habitually utilize “should” statements may have ‘blind spots’ when it comes to:

• Tolerating imperfection or unfairness.
• Striving and being excessively demanding (toward themselves or others).
• Self-acceptance and self-compassion.
• Thinking flexibly or in ‘shades of grey’. 

As with many other cognitive biases, there are evolutionary reasons why people use “should” statements. For example, necessitous thinking may have proved useful in securing resources, avoiding threats, and managing relationships and social hierarchies.

Many people struggle with “should” statements. It sounds as though this might also be relevant to you. Would you be willing to explore it with me?

Clinicians may consider giving clients helpful psychoeducation about automatic thoughts more generally and “should” statements in particular. Consider sharing some of these important details:

• Automatic thoughts spring up spontaneously in your mind in the form of words or images.
• They are often on the ‘sidelines’ of our awareness. With practice, we can become more aware of them. It is a bit like a theatre – we can bring our automatic thoughts ‘center stage’.
• Automatic thoughts are not always accurate: just because you think something, it doesn’t make it true, and they are often inaccurate in characteristic ways.
• A common type of bias that can show up in our automatic thoughts are “should” statements. In other words, we use fixed rules to judge or describe how we, other people, or the world should operate.
• “Should” statements often contain words like “must”, “should”, “ought to”, or “have to”. They are usually accompanied by feelings like guilt, shame, or anger.
• In some situations, it can be good to use “should” statements. It can sometimes help motivate us, set expectations, and judge what is acceptable versus unacceptable behavior.

Many treatment techniques are helpful for working with “should” statements:

• Decentering. Meta-cognitive awareness, or decentering, describes the ability to stand back and view a thought as a cognitive event: as an opinion, and not necessarily a fact (Flavell, 1979). Help clients to practice labeling the process present in the thinking rather than engaging with the content. For instance, they might say “I’m using should statements again” to themselves whenever they notice this style of thinking.
• Cognitive restructuring with thought records. Self-monitoring can be used to help clients capture their automatic thoughts. Thought re-evaluation records include prompts to encourage the client to consider the evidence supporting their “should” statements and reflect on whether these are helpful judgments. Prompts that can be helpful with should-focused thinking include:
  • "If you took the ‘should’ glasses off, how would you approach this situation differently?"
  • "What evidence supports and disconfirms the idea that you must [‘should’ statement]?"
  • "It is really true that you absolutely must [‘should’ statement] or would it be more accurate to say this is a preference you hold?"
  • "Where do these ‘should’ statements come from? Did you learn them from someone? If so, does that mean you have to hold the same expectations of yourself or other people, or could you have different expectations?"
  • "Do you hold other people to this standard? Why not?"
  • "Do other people tell themselves that they must be this way too? How do they approach situations like this?"
  • "How does this ‘should’ statement fit with your goal?"
• Cost-benefit analysis. Cost-benefit analysis of “should” statements can highlight the negative consequences of this style of thinking. The therapist might ask:
  • "What are the pros and cons of thinking in ‘shoulds’? How do you react when these ‘rules’ get broken?"
  • "What problems come with approaching situations in a should-focused way?"
  • "Do ‘should’ statements like these motivate you or discourage you?"
  • "How would your thoughts, feelings, and behaviors change for the better if you were less ‘must’ focused?"
• Changing the terms. Encourage the client to experiment with substituting words like “should” or “must” with more flexible terms like “prefer” or “wish”. In other words, clients are asked to retain their preferences and ideals but abandon the rigid demands and expectations that lead to distress (Branch & Wilson, 2020).
• Response prevention. Like working with compulsive behaviors, Beck and colleagues (1979) encourage clients to experiment with not acting on their “should” statements. What are the positive and negative consequences of this, and do the client’s anxious predictions come true? For example, a client who worries about arriving on time may be encouraged to deliberately arrive five minutes late to a meeting.
• Testing beliefs and assumptions. If a client habitually thinks in ‘shoulds’, it may be helpful to explore whether they hold beliefs or assumptions that maintain this thinking style, such as “In every situation, there are rules for behaving in the ‘right’ way or the ‘wrong’ way”, or “Good standards are strict and absolute”. If such assumptions are identified, clients can explore their accuracy and helpfulness. Their attitudes toward healthier assumptions can also be explored, such as, “My standards aren’t universal – other people and the world sometimes operate differently”. Dysfunctional assumptions related to “should” statements can also be reality-tested through behavioral experiments, including surveys (e.g., “To what extent do you agree with the following statement: [“should” statement]. Do you have similar rules in this area of your life? Why not?”).

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