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Catastrophizing
Catastrophizing is a cognitive distortion that prompts people to jump to the worst possible conclusion, usually with very limited information or objective reason to despair. When a situation is upsetting, but not necessarily catastrophic, they still feel like they are in the midst of a crisis.
Everyone has negative thoughts. But for many people, negative thinking can spin out of control and out of proportion to the reality of a situation. A relatively modest error, disappointment, or source of embarrassment (or even the possibility of one) can sometimes become, in one’s mind, a cause for major fear or despair—in short, a catastrophe.
This pattern of thinking can itself be destructive because unnecessary and persistent worry can lead to heightened anxiety and depression. But through learning to identify and reframe initially exaggerated conclusions, along with other techniques, people with a tendency to make a proverbial mountain out of a molehill can get a better hold on their negative thoughts.
When someone makes a mistake at work, she might engage in catastrophic thinking by exaggerating how poorly the error will reflect on her and concluding that she will be fired for it—and, perhaps, that this will lead to other severe consequences, like losing her home. An airplane passenger may catastrophize by interpreting turbulence as a sign of an imminent crash. Someone who incorrectly assumes that a relationship, or her reputation with others, has been irreparably damaged because of some regrettable behavior could be described as catastrophizing.
Catastrophizing has been linked to a number of adverse experiences and behaviors, including anxiety, depression, and anger-related problems. It can be a tendency of individuals who have generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, obsessive-compulsive disorder, or other conditions—each of which is diagnosed based on a broader list of symptoms. One can also engage in catastrophic thinking without having a diagnosable disorder.
Simply noticing and identifying when this may be happening is a good place to start. You can label catastrophic thoughts (telling yourself, “I’m having the thought that I am a failure” rather than embracing the thought “I am a failure” for example), give names to thoughts that keep repeating themselves (“This is my ‘I’m a failure’ story”), and even sing them or say them in a funny voice to try to drain their power—among other active ways of responding. After identifying a catastrophic thought, it may help to replace it with a more realistic thought (such as “This is going to take more time and energy, which is frustrating” in place of “I won’t be able to get this done”). Getting sufficient sleep and engaging in physical activities may also help you stop catastrophizing.
To handle catastrophizing about the future, it may be helpful to think through the most plausible consequences of a real or anticipated mistake, accident, unexpected obstacle, or other misfortune. About the feared catastrophe, you can ask: How bad would it really be? Would it really be something you couldn’t recover from? A future problem can be “significantly unpleasant” without amounting to a disaster. With more careful reflection, the likely negative impact may well seem less severe than it does at first glance. You can also envision yourself coping with what you worry will happen, reflecting on any resources and strengths that you have made use of to this point.
Yes: If catastrophic thinking impairs daily functioning, psychotherapy, including forms of cognitive behavioral therapy (CBT), can provide concrete coping skills with the guidance of a trained therapist. A therapist with training in CBT can help an individual work through anxiety or other challenges in part by identifying and reality-testing cognitive distortions, including catastrophic thinking.
The verb “catastrophize”—along with the synonym “awfulize”—were coined by psychologist Albert Ellis, the founder of rational emotive behavior therapy (REBT). REBT, which is a form of cognitive-behavioral therapy, aims to help people identify, challenge, and replace self-defeating thoughts, of which catastrophic thoughts are one kind.
Yes, catastrophizing is among the forms of thinking that can burden children and teens, not just adults. For example, a school-age child may worry about the worst-imaginable consequences of a failure such as getting a poor grade on a test or not making a sports team.
Chronic pain involves a complex mix of physical and psychological factors. This does not mean that chronic pain isn’t real, only that the brain and body both play a role in the experience of pain. Studies show that people with chronic pain tend to report a lower quality of life if they catastrophize their pain—thinking about it as intolerable and uncontrollable—which may lead to heightened distress, pain, feelings of hopelessness, and even depression. Fortunately, there are tools available to help prevent catastrophizing from worsening the effects of chronic pain.
Catastrophizing, which is sometimes called “magnifying,” can be thought of as a second burden or injury that follows the initial one, such as a flare-up of pain. Thoughts that zoom in on pain and emphasize the worst-possible outlook for the future (“I will always feel this way,” or “I will never be able to ___”) may exacerbate stress and anxiety. For some, catastrophizing may also discourage physical activity, which can be a valuable part of the management of certain forms of chronic pain.
Therapists with training in modalities such as cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) (which involves elements of CBT and mindfulness) may help improve quality of life for someone who has chronic pain, in part by helping the person challenge any catastrophic thinking. Informal tactics such as bringing awareness to catastrophizing and reframing the thoughts can also be helpful.
Several self-report measures have been developed to assess pain catastrophizing. One of those is the Pain Catastrophizing Scale, which includes statements on which a person expresses degrees of agreement, such as “When I’m in pain… It’s terrible and I think it’s never going to get any better,” and “... I keep thinking of other painful events.” More recently developed scales include the Pain Anxiety Symptom Scale and the Fear Avoidance Components Scale.
