BPD Symptoms and Diagnosis What Is Dichotomous Thinking? This type of thinking is common in borderline personality disorder By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. Learn about our editorial process Updated on March 11, 2024 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Jamie Grill / Getty Images Table of Contents View All Table of Contents Characteristics Related Conditions Examples Treatment Close 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. At a Glance When people engage in dichotomous thinking, they see things in extremes—it's all or nothing; black or white; this or that. It's a common feature of borderline personality disorder, but it can also take place in other conditions like anxiety, depression, OCD, and some types of eating disorders. Keep reading to learn more about how to recognize the signs and treatments that can help combat this type of thinking. Characteristics of Dichotomous Thinking Signs of dichotomous thinking include: Use absolute language like "always" and "never" to describe thingsRuminating over extreme feelingsSeeing things as either perfect or uselessBeing unable to see the middle groundShifting between seeing things as good or badEngaging 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. If most of your thoughts break down to black or white, good or bad, and all or nothing, then it is possible that you have a strong tendency towards dichotomous thinking. 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 disordersDepressionBorderline personality disorder (BPD)Eating disordersNarcissistic 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. People with BPD are more likely to display dichotomous thinking than people who do not have BPD. 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. People with dichotomous thinking tend to have favorites and to believe that everything about a favorite person or thing is superior to others. However, as time goes on, someone with dichotomous thinking may suddenly swing to the opposite extreme. 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) If you have symptoms, it is recommended that you seek out a healthcare professional who is trained and experienced in treating borderline personality disorder. 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? By taking a step back, you can build the skills necessary to learn to form a more realistic perception of your relationships and your environment. 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. 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Lewis JA, Fraga KJ, Erickson TM. Dichotomous thinking. In: Zeigler-Hill V, Shackelford TK, eds. Encyclopedia of Personality and Individual Differences. Springer International Publishing; 2019:1-5. doi:10.1007/978-3-319-28099-8_651-1 Rowland TA, Jainer AK, Panchal R. Living with obsessional personality. BJPsych Bull. 2017;41(6):366-367. doi:10.1192/pb.41.6.366a Beeney JE, Hallquist MN, Ellison WD, Levy KN. Self-other disturbance in borderline personality disorder: Neural, self-report, and performance-based evidence. Personal Disord. 2016;7(1):28-39. doi:10.1037/per0000127 Jeong H, Jin MJ, Hyun MH. Understanding a mutually destructive relationship between individuals with borderline personality disorder and their favorite person. Psychiatry Investig. 2022;19(12):1069-1077. doi:10.30773/pi.2022.0079 Choi-Kain LW, Finch EF, Masland SR, Jenkins JA, Unruh BT. What works in the treatment of borderline personality disorder. Curr Behav Neurosci Rep. 2017;4(1):21–30. doi:10.1007/s40473-017-0103-z National Institute of Mental Health. Borderline personality disorder: Treatments and therapies. By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Helpful Report an Error Other Submit