Black and White Thinking in Adults: Signs, Causes, and Solutions

Daniel Hoadley
November 19, 2025
Authored by: Daniel Hoadley, B.S. Psychology
Edited by: Jemma Strain, B.S. Psychology
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Rigid thinking might be more common than many people think. For instance, let’s say you’ve just had a dispute with a colleague, and you’re still feeling angry about how it unfolded. But after a moment to reflect, you remind yourself that everyone’s under pressure with a deadline approaching, and sometimes emotions spill over. Yet for someone who sees the world in black and white ways, this space for understanding doesn’t exist. In their mind, the argument means one thing: They must hate me.

This is what’s known as “dichotomous thinking,” a way of seeing situations and people through all-or-nothing lenses, where something is either entirely good or completely bad, with nothing in between.

While there’s nothing wrong with occasionally thinking like this, if observed frequently, it could be a sign of underlying mental health concerns. If you’re worried about a loved one, or perhaps even yourself, the black and white thinking mental health issues can cause may be worth exploring with a professional.

This page can also help you better understand cognitive distortions like black and white thinking by discussing:

  • What dichotomous thinking is
  • The mental health conditions linked to black and white thinking
  • When to consider treatment for dichotomous thinking
  • Therapies that help address black and white thinking
  • How Mission Connection can support recovery and lasting change
Woman with her hands up looking confused due to black and white thinking in adults

What Is Meant By Dichotomous Thinking?

Dichotomous thinking, sometimes called “black and white thinking,” is when you view the world in extremes rather than shades of grey. This state of thinking means there’s no room for the colours in between, and things are either “good or bad,” “right or wrong,” or “successes or failures.”1

Someone caught in this mindset might feel they’ve completely failed a project because it didn’t go perfectly, rather than recognizing the effort and progress made along the way. 

Another person might think a friend who cancels plans no longer cares about them, rather than considering that life sometimes gets in the way. 

Both examples show how quickly the mind can jump to extremes when it struggles to hold two opposing truths at once.

The truth is, we all fall into dichotomous thinking at times, but it would be unfair to label this way of thinking as entirely bad. Sometimes, it helps us make quick decisions or gives us a sense of clarity in uncertain situations.2 But when black and white thinking becomes your main way of interpreting the world, it can cause some genuine problems that often need to be addressed.

For instance, it may be a sign that something deeper is going on beneath the surface, as it can be linked to mental health conditions that affect how thoughts are processed and balanced.3 The next section will look at which of these conditions are most commonly associated with persistent dichotomous thinking.

What Mental Health Conditions Are Linked to Black and White Thinking?

There are some mental health conditions in which dichotomous thinking tends to appear as part of the picture. In many cases, it feeds the condition itself, keeping you stuck in the same patterns that cause distress. When you’re able to recognize and work on this black and white way of thinking, it can become easier to treat the root issue underneath. But before this can happen, it helps to know which conditions are most commonly linked with this thought style.

The following sections cover the conditions most associated with rigid thinking.

Borderline Personality Disorder

People with BPD tend to see the world in extremes, though in this context, the pattern is more commonly known as “splitting.”4 Research suggests that “splitting” sets the scene for how people with BPD and rigid thinking patterns interpret others, and it goes beyond negativity or a lack of thought complexity. It’s a way of thinking that divides people and experiences into all good or all bad, making emotional balance difficult to maintain.5

When every situation feels like one extreme or the other, relationships can become incredibly strained. A good example of this is how someone with BPD might one week idealize a loved one, then feel deeply hurt or betrayed by them the next. In therapy, this can make progress challenging, as the same therapist who was once seen as supportive can suddenly be viewed as the source of frustration or misunderstanding. 

Major Depressive Disorder

All or nothing thinking is very well documented in those with MDD and has been shown to intensify the symptoms of depression.6 People experiencing depression may view themselves and their circumstances through absolute terms, leaving no space for balance or nuance. 

These types of dichotomous thoughts can worsen feelings of hopelessness and low self-worth,7 which then can make every setback feel as though it’s a complete catastrophe. 

Interestingly enough, research has found that when these thought patterns are addressed, this correlates with improved outcomes for those coping with depression.7

OCD

People with OCD have been observed to engage in negative thinking cycles, largely because of the difficulty they experience tolerating uncertainty.8 For someone living with OCD, anything less than total certainty or perfection can feel completely unacceptable. Research has found that this rigid mindset can feed obsessive patterns, where even the slightest imperfection is seen as failure.

For example, a person with contamination OCD might think, If everything isn’t perfectly clean, then it’s completely dirty and unsafe. In their mind, an object is either entirely germ-free or utterly contaminated, with no space for something in between.8 This kind of thinking can make daily life feel exhausting because the constant pressure for perfection leaves little room for relief.

Anorexia Nervosa

Research suggests that people with anorexia nervosa commonly divide foods into extremes, with nothing existing in between.9 This rigid mindset shapes daily food choices and creates an unforgiving standard for what counts as healthy or unhealthy food.

Absolutist thinking like this fuels strict dietary rules and perfectionistic standards for weight and shape, but these rules rarely hold up when life becomes unpredictable.9 So, someone with anorexia nervosa might believe, Unless I stick to my diet 100%, I’ve failed completely.

In this way, eating one cookie can feel like a total collapse of self-control and could spiral into guilt or binge-eating because the day already feels “ruined.” 

Research has even found that a strong dichotomous thinking style predicts a higher risk of relapse after weight restoration.9 This shows how deeply this way of thinking can undermine recovery for someone living with anorexia.

Anxiety and Perfectionism

Anxiety and perfectionism are deeply linked and could lead to rigid patterns of thinking. Perfectionism isn’t considered a mental health condition on its own, but a personality trait that can strongly connect with certain mental health issues. It goes hand in hand with dichotomous thinking, which is why understanding how the two interact can help explain why they frequently appear together.

Black and white thinking is widely recognized as a key part of perfectionism, particularly the maladaptive form that tends to cause distress rather than drive improvement.9 When someone evaluates their self-worth through all-or-nothing thinking, even a small mistake can feel like complete failure. This extreme mindset is intertwined with how perfectionists set high standards for themselves and how they respond when those standards aren’t met.10

In fact, cognitive behavioral theories describe dichotomous thinking as one of the mechanisms that keep perfectionistic habits in motion.11 It creates a loop where unrealistic goals lead to disappointment, which then strengthens the urge to try harder next time, feeding the same rigid thought process again. 

Studies have also shown that people with self-critical or clinical perfectionism display stronger patterns of all-or-nothing thinking, showing that these rigid beliefs play a major role in maintaining perfectionistic behavior.9

Should I Seek Treatment For Dichotomous Thinking?

If you’ve noticed that you, or someone close to you, tends to view situations in all-or-nothing terms, it could be worth exploring what’s behind this. Because this type of thinking connects with other mental health conditions, understanding where it comes from can be valuable in knowing what you’re really dealing with. 

Many people seek help changing rigid beliefs after noticing how this way of thinking affects their relationships or fuels perfectionism. If you’re unsure whether dichotomous thinking stems from something deeper, reaching out to a therapist for an assessment could be a good first step. 

Once understanding is established, therapy can begin focusing on the thought patterns that keep feeding the extremes, easing relationship conflict, and helping you move toward a more balanced perspective.

What Therapies Are Used to Treat Black and White Thinking?

Because dichotomous thinking is a trait or symptom and not a standalone disorder, there isn’t a single exclusive dichotomous thinking therapy. However, several well-established therapies specifically target distorted thought patterns like all-or-nothing thinking, while also treating the underlying conditions linked to it. These include:

Cognitive Behavioral Therapy

CBT is one of the most recognized approaches for addressing cognitive distortions, including the kind that drives all-or-nothing thinking. It helps you identify extreme thoughts and replace them with perspectives that are more realistic and balanced.12 

In practice, a CBT therapist may help you catch all-or-nothing thoughts, such as I’ve failed completely or I have to be perfect, and look at the evidence with more fairness. With continued practice within a clinical setting or even at home, this reframing can uncover solid coping strategies for rigid thinking.

CBT is also a leading treatment for conditions such as depression and anxiety, both of which are shaped by absolutist thought patterns. So, by learning CBT techniques, you can begin to recognize how these thoughts feed distress and start developing coping strategies for them.

Dialectical Behavioral Therapy 

A key principle of DBT is dialectics, which means recognizing that two opposing things can both hold truth.13 Rather than viewing situations as completely “right” or completely “wrong,” DBT helps you find the middle path and recognize that balance exists between the two.

This approach could ease the emotional intensity that rigid thinking brings, and through mindfulness and emotion regulation, DBT allows you to stay steady even when thoughts lean toward the extreme. DBT is best known for its use in borderline personality disorder therapy, but has also been adapted for depression, PTSD, eating disorders, and substance use.13 

Acceptance and Commitment Therapy 

ACT takes a different treatment route and, rather than questioning whether your thoughts are right or wrong, it focuses on changing your relationship with them.14 In this approach, you learn to accept uncomfortable thoughts and feelings as temporary experiences rather than fixed truths. This helps build what psychologists call “psychological flexibility,” the ability to notice harsh, black and white judgments without letting them control how you act.

For example, an ACT therapist might help you recognize a thought like I’m a failure and see it simply as a passing mental event instead of an identity. This way of thinking could reduce the emotional power those thoughts hold. 

Further, ACT has been shown to be effective for conditions in which inflexible thinking is common, such as OCD.15

Mission Connection: Supporting Change and Lasting Recovery

Persistent dichotomous thoughts can make life feel like it’s constantly swinging between extremes, and when this pattern starts interfering with your life, it’s time to reach out for help.

Mission Connection has extensive experience with identifying and treating the conditions most commonly linked with dichotomous thinking, including: 

  • BPD
  • Anxiety
  • Depression
  • Eating disorders
  • Narcissism, and more. 

We use therapies like CBT and DBT to build emotional flexibility and help you recognize the thoughts that keep you stuck in extremes. As you learn to challenge these patterns, steadier ways of thinking begin to take shape.

For those who could benefit from a change of scenery, our residential mental health treatment programs are located across the US, allowing you to focus fully on recovery. If staying home suits your lifestyle, our outpatient options make it easier to get consistent support without disrupting your routine.

Whichever path you take, the high standard of treatment remains consistent, so you can focus on changing rigid beliefs and finding a more balanced mindset.

Reach out to Mission Connection today to start moving toward greater clarity and emotional steadiness.

Woman smiling after receiving treatment for black and white thinking in adults

References

  1. Stanborough, R. (2020, January 14). How Black and White Thinking Hurts You (and What You Can Do to Change It). Healthline. https://www.healthline.com/health/mental-health/black-and-white-thinking
  2. Murphy, T. F. (2023, October 20). Beyond Black & White: Understanding Dichotomous Thinking. Psychology Fanatic. https://psychologyfanatic.com/dichotomous-thinking/
  3. Salters, K. (2024, March 11). The Link Between Dichotomous Thinking and Borderline Personality. Verywell Mind. https://www.verywellmind.com/dichotomous-thinking-425292
  4. Chapman, J., Jamil, R. T., & Fleisher, C. (2024, April 20). Borderline personality disorder. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430883/
  5. National Institute of Mental Health. (2019). Borderline personality disorder. Nih.gov; National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/borderline-personality-disorder
  6. Sanivarapu, S. (2015). Black & white thinking: A cognitive distortion. Indian Journal of Psychiatry, 57(1), 94. https://doi.org/10.4103/0019-5545.148535
  7. Byrne, S. M., Allen, K. L., Dove, E. R., Watt, F. J., & Nathan, P. R. (2008). The reliability and validity of the dichotomous thinking in eating disorders scale. Eating Behaviors, 9(2), 154–162. https://doi.org/10.1016/j.eatbeh.2007.07.002
  8. Vallejo, M. (2023, August 18). Breaking Down OCD Myths: Dispelling Misconceptions and Stigma. International OCD Foundation. https://iocdf.org/blog/2023/08/18/breaking-down-ocd-myths-dispelling-misconceptions-and-stigma/
  9. Egan, S. J., Piek, J. P., Dyck, M. J., & Rees, C. S. (2007). The role of dichotomous thinking and rigidity in perfectionism. Behaviour Research and Therapy, 45(8), 1813–1822. https://doi.org/10.1016/j.brat.2007.02.002
  10. Jones, S. (2023, January 2). Understanding and Overcoming All-or-Nothing Thinking. Psychology Today. Www.psychologytoday.com. https://www.psychologytoday.com/us/blog/all-about-cognitive-and-behavior-therapy/202210/understanding-and-overcoming-all-or-nothing
  11. Chęć, M., Konieczny, K., Michałowska, S., & Rachubińska, K. (2025). Exploring the Dimensions of Perfectionism in Adolescence: A Multi-Method Study on Mental Health and CBT-Based Psychoeducation. Brain Sciences, 15(1), 91–91. https://doi.org/10.3390/brainsci15010091
  12. Curtiss, J. E., Levine, D. S., Ander, I., & Baker, A. W. (2021). Cognitive-behavioral treatments for anxiety and stress-related disorders. Focus, 19(2), 184–189. https://doi.org/10.1176/appi.focus.20200045
  13. Corliss, J. (2024, January 22). Dialectical behavior therapy: What is it and who can it help? Harvard Health. https://www.health.harvard.edu/blog/dialectical-behavior-therapy-what-is-it-and-who-can-it-help-202401223009
  14. P, A. S., & S, G. (2025). Acceptance and commitment therapy and psychological well-being: A narrative review. Cureus, 17(1). https://doi.org/10.7759/cureus.77705
  15. Philip, J., & Cherian, V. (2020). Acceptance and Commitment Therapy in the Treatment of Obsessive-Compulsive Disorder: a Systematic Review. Journal of Obsessive-Compulsive and Related Disorders, 28, 100603. https://doi.org/10.1016/j.jocrd.2020.100603
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