In my clinical work, I have found that many patients and their families have certain “automatic” faulty cognitive patterns and reaction patterns. The main reason why I call them “automatic” is that these cognitive patterns and reaction patterns are the conditioned reflexes that are almost unchanged when they face external things. Moreover, these cognitive and reactive patterns have a very negative impact on the patient’s illness as well as treatment and recovery. The following are some of the phenomena that I have observed that reflect these types of cognitive and reaction patterns. The first phenomenon is the tendency of patients and their families to be overly concerned with current problems or to overestimate the consequences of current problems, to make pessimistic predictions, and to assume that the current state of affairs is indicative of the future state of affairs, or even to assume that this will always be the case, especially when the patient’s condition deteriorates or when the patient’s outcome is poor. For example, in some female patients, the overall trend of the disease is towards stabilization and recovery after the acute phase of treatment has ended and the patient has moved on to the consolidation phase. However, during the premenstrual period (i.e., about a week before menstruation to a few days after the onset of menstruation), the patient’s condition may fluctuate to a certain extent or even show signs of deterioration. At this point, many patients’ relatives and even the patients themselves will be very worried and ask us whether the patient’s condition will become more and more serious and whether the disease will never be cured. This kind of worry and speculation precisely reflects the pessimistic cognitive pattern of patients and their relatives, who ignore or even forget that the patient’s condition had achieved a good therapeutic effect for a long period of time. At the same time, they also habitually reacted with anxious behaviors such as increasing or decreasing the dose of medication, or changing hospitals or doctors. Such behavioral responses reflect a tendency to negate the efficacy of the previous treatment because of the current difficulties. Such response patterns not only lead to further deterioration of the condition as a result of poor choices made at the time, but also contribute to the development or reinforcement of the patient’s psychological deficits of restlessness and distrust of others. It is this pessimistic cognitive pattern and corresponding response pattern that leads to the patient’s subsequent descent into pessimism over the current insignificant ups and downs of life. I call this cognitive and reactive pattern “treating the present as forever”, where a bad day means a bad forever, and a bad day means a bad day will never get better. Very similar to the above phenomenon, some patients and their families often interpret some occasional problems as inevitable results, and for this reason, they are anxious or even worried, and then make wrong choices according to their own misunderstanding. For example, some patients who have acute stomach cramps after taking medication for a long period of time, that is, they think it is the medication that causes them to have “stomach cold” and pain, and then insist that the doctor reduce or stop the medication for them. The patient’s logic is: I have never had such stomach cramps before when I was not taking medication, and the current stomach cramps are entirely caused by the medication, and concludes that there is a causal relationship between the two. Another patient may interpret the dizziness of waking up in the morning as the result of having played a sport the day before that he had not played before, and may even refuse to play any kind of sport from then on. He understands that there must be a causal relationship between the fact that it never happened to me before when I did not play sports and the fact that it happens today after I played sports yesterday. In fact, one of the fatal flaws of this logic is that it treats a living human being in a state of constant change as a vehicle moving at a constant speed on a flat track or as a machine running at a constant speed or even as a piece of unchanging stone. The second fatal flaw in this logic is that it treats things in the world that are intricately related, especially an extremely complex living being such as a human being, as if they were only directly connected from point to point. In fact, this mode of perception and reaction is “chance as necessity,” believing that if there is a connection in a time series, there must be a causal connection, even if it is only once in a while. The third phenomenon, which is similar to the second situation of “taking chance as necessity”, is that they are also prone to interpret phenomena that are generally regarded as coincidences as phenomena that are connected by some inner regularity, and even form the inference that there is a causal relationship between them. For example, when a doctor makes an almost insignificant adjustment in the dosage or usage of a patient’s therapeutic drug, the patient happens to experience some kind of change on the same day or the next day that had not occurred before, such as a slight increase or decrease in the duration of sleep at night. Patients and their families often assume that this phenomenon is a direct response to the medication adjustment, making a causal connection between two unrelated events. Sometimes, after a natural and slight fluctuation in the condition of a patient undergoing systemic treatment, the patient or his/her family members believe that the fluctuation must be due to some external cause or trigger, and identify events that were originally unrelated but slightly earlier than the fluctuation of the patient’s condition in chronological order as the corresponding causes or triggers: e.g., he/she ate a piece of deep-fried chicken nuggets from the fast-food restaurant or drank a bowl of American ginseng soup in the morning, etc. I define this phenomenon as the “cause and effect” phenomenon. I define this phenomenon as “treating coincidence as a rule”. In fact, “treating coincidence as a rule” is based on background anxiety and an over-concern with clues of changes, which leads to pessimistic cognition and over-interpretation. Finally, there is the phenomenon, very common among patients and their families, of attaching great importance to trivial events, especially those of an unfavorable or harmful nature, and worrying too much about these events triggering the worst part of the chain of events, instead of overlooking the abundance of information about the event that predicts a relatively optimistic outcome. They don’t even consider the probability of a good or bad outcome at all, and always assume that the risk of a bad outcome is greatest when the probability is so small as to be “what if”, and take excessive precautions in worrying about it. This phenomenon also reflects their anxious and pessimistic cognition and expectation in the style of “not seeing Mt. Tai through a blindfold”, i.e., the tendency to overestimate the risk of “making a big deal out of a small matter”. For example, if a female patient of childbearing age becomes pregnant unexpectedly more than four months after stopping the medication, which is still a little short of the six-month period set by the patient’s family, the patient’s family will not hesitate to force the patient to take measures to terminate the pregnancy. They do not even consider how long the medication can be stopped to avoid the adverse effects of the medication on the fetus, let alone the essential difference between four months and six months, but just stubbornly adhere to the rigid standards they have heard about. In response to some of these erroneous perceptions and reaction patterns that often occur in patients and their families, I have advised them by making up a paraphrase: don’t treat the present as forever, don’t treat chance as inevitable, don’t treat coincidence as a rule, and don’t treat trivialities as a big day. Whether it will serve as a wake-up call for them is obviously still an open question. But I hope that people who tend to cope with matters in an anxious and depressive cognitive mode will remind themselves to change those habitual cognitive and reaction patterns, and eventually establish an optimistic and positive attitude and cognitive mode of life.