What Is Dichotomous Thinking, And What Does It Mean For You?

Medically reviewed by Andrea Brant, LMHC
Updated February 22, 2024by BetterHelp Editorial Team

The term “dichotomous thinking,” often called “black and white thinking,” discusses a pattern of thought that views everything as an either-or situation. In other words, someone prone to dichotomous thinking may often see situations as all “good” or all “bad,” or all “right” and all “wrong” with no in-between or a grey area.  

While anyone can experience dichotomous thinking, it can indicate a mental health condition or underlying challenge if it persists in the long term and negatively impacts work, school, and relationships. Because there is no room for a “grey area” with this type of thinking, extreme outcomes can seem the only possible scenario to those experiencing it, which can make many areas of life feel stressful or unpredictable.

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Mental health and dichotomous thinking 

While dichotomous thinking may not indicate an underlying mental health condition, it can be a symptom of a few.

For example, “all-or-nothing” thought patterns are often present in borderline personality disorder (BPD), other personality disorders, bipolar disorder, depression, and a few other mental health conditions. It can also be common for neurodivergent adults who are autistic or have an ADHD diagnosis. 

Dichotomous thinking is often considered a type of cognitive distortion, which may skew one’s perception of an expected outcome rather than what might occur. Cognitive distortions are often the result of an attempt to simplify, understand, or reduce the impacts of a distressing situation. The brain takes past information and can form related associations, allowing individuals to experience cognitive distortions whenever a similar situation or stimulus arises.

Examples of dichotomous thinking 

If you’re looking to apply for a job but are prone to dichotomous thinking, you might feel your only options are to get the first job you interview for or remain unemployed. You may not be aware that your mind is relying on these two options. The result, though, can be intense anxiety about the interview, self-doubt, and fear. Because you’ve placed so much weight on the interview as the only alternative to your worst possible outcome, your stress may impact your performance at the interview, further solidifying your belief that you are not cut out for any job, whereas you may be qualified for many jobs. 

Dichotomous thinking may be subtle and go unnoticed, but it can also make celebrating your successes and improving your self-esteem challenging. For example, perhaps you had a goal to finish ten projects at work by the end of the week. At the end of the week, you accomplished eight. For many people, a slight disappointment might arise, but not enough to change the conclusion that accomplishing eight projects can be a positive start.

For someone who experiences dichotomous thinking, there is no grey area. Instead, they may only see success and failure. If you’re experiencing dichotomous thinking and complete only eight projects out of ten, you might consider yourself a failure, start panicking about losing your job, or feel that you are flawed in some way. These thoughts can cause anxiety, stress, and depression. 

The impacts of dichotomous thinking 

Thinking only of success or total failure can lead to stress, low self-esteem, and the development of mental illnesses like depression and generalized anxiety disorder (GAD). Spending time thinking that you’ve failed, even when you’ve made a valiant effort, can feel like self-punishment. If you can view a problem as it is, with the option of having a “grey area,” you may feel more motivated to change your strategies to do better next time. If you believe you are a failure, you might want to give up without trying again, even if you have the potential to better yourself.


Why do some mental illnesses cause dichotomous thinking?

Dichotomous thinking is a symptom of many mental health conditions, including borderline personality disorder. However, it can happen to anyone. For many people, dichotomous thinking occurs because they have no other frame of reference. For some, growing up and having life experiences removes these opinions that there are only two sides to the story. Many people can reframe their thoughts and find a middle ground. However, those with borderline personality disorder and other mental illnesses may struggle to develop this understanding at first due to their mental health symptoms. 

Extreme mood swings, risky or impulsive behavior, and bursts of anger can make life situations seem extreme and lacking in subjectivity. The same cognitive distortions that may stem from or contribute to mental health symptoms can play a role in perpetuating dichotomous thinking. However, by developing problem-solving and positive self-talk skills, among other treatment techniques, it can be possible to manage these symptoms and learn to take control of dichotomous thinking. 

How to find support for dichotomous thinking

There are different ways to go about treatment for dichotomous thinking. For many, the first step involves understanding and recognizing that it is occurring. Many people don’t know they’re experiencing all-or-nothing thought patterns because the process is often subconscious. Making cognitive distortions a conscious thought process can help you address them long-term.  

When you finish a task, think about it consciously; take a step back to process your feelings. It may help to jot your thoughts into a journal or discuss them with a loved one. Doing so may allow you to recognize whether you’re reflecting on what you’ve done or thinking in black and white. Often, you might find that your fear, stress, or anger stems from assumptions about right and wrong, good and bad, or success and failure. 

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Counseling options 

Anyone can seek professional support for dichotomous thinking, regardless of diagnostic status or mental health. Having a supportive professional that you can work through your thoughts with can provide perspective, encouragement, and support. For many, online therapy is one of the most effective ways to receive this type of support, as it can be done from the safety and comfort of your own home. In addition, many online therapists can offer worksheets that can be printed out or filled out during or after the session, allowing the lessons in the session to stay fresh in your mind. 

Online therapy can also focus on much more than dichotomous thinking and is as effective as in-person therapy for managing mental health conditions. When you work with an online therapist, you can target specific goals like developing positive self-talk, improving your self-esteem, or re-training your mind to find the grey area in situations where you might have struggled before. If you want to speak to a therapist about cognitive distortions, an online platform like BetterHelp can match you with an expert in cognitive-behavioral therapy (CBT) to support you.  


Dichotomous thinking may make it challenging to see the nuance in life, but it can be addressed with the guidance of a mental health professional. Whether it stems from a mental illness or is a habitual pattern of thought you’ve developed over time, dichotomous thinking may have serious implications for self-esteem and behavior. For many, it is worth taking the time to understand why these thoughts occur so they can be dealt with. Consider reaching out to a therapist for further guidance and discussion.
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