Cut Out Catastrophizing

Catastrophizing is a common thought pattern in which you think about a situation as being a catastrophe or imagine the worst possible outcome of an action or situation. When catastrophizing, a person jumps to the worst possible outcome with limited information or without objective evidence to support that conclusion.

Catastrophizing is associated with anxiety and depression and can arise when living with chronic health conditions such as chronic pain. In relation to chronic pain, catastrophizing involves a cognitive and emotional response to pain consisting of magnification of pain sensations, rumination about pain and related concerns, and feelings of helplessness about one’s ability to manage pain.

When catastrophizing, you may exaggerate how bad a situation is or think in all-or-nothing terms. For example, you might think, "I can't do anything I need to do because I'm anxious," “I will never be able to be active again,” or “This pain will ruin my life forever.”

Pain catastrophizing is associated with increased pain intensity, pain-related disability, and psychological distress, and is a key factor in the experience of persistent pain. Decreasing pain catastrophizing can positively change a person’s experience of pain and lower pain intensity.

Catastrophizing can seem helpful and protective. You may tell yourself that if you think about the worst possible outcome, you can prepare for it or at least not be surprised if it happens. We believe catastrophizing will save us from distress. Unfortunately, it doesn’t. If something bad happens, you will likely feel upset regardless of whether you thought about it ahead of time or tried to prepare for it, and catastrophizing will lead to more distress along the way.

Why? Because thinking about worst-case scenarios is distressing and stressful and can lead to unhelpful rumination or perseveration on catastrophic thoughts. With catastrophic thinking, like other unhelpful thought patterns, we don’t typically think about a possible worst-case scenario for a few minutes and then move on. Instead, we think about possible catastrophes over and over again.

And, the outcome you are fearing will likely never come to pass. The worst-case scenario is typically not the most likely. Thinking about the worst case understandably causes a strong emotional reaction and increases anxiety, which in turn can skew your assessment of how likely that outcome is. Also, when you are catastrophizing, you are focused on your thoughts and stuck in your head instead of being tuned into the present moment and what is happening right now. This can lead to less enjoyment, less appreciation for what is going well in your life or what you are grateful for, and a sense of missing out on life.

How to Stop Catastrophizing

1. Start by writing out your thoughts. Writing out specific thoughts helps you build awareness of them so you can practice noticing and catching them in the moment. It also helps you to see your thoughts more objectively.

2. Practice asking yourself questions to challenge your thoughts. For example:

• What is the best possible outcome, the worst possible outcome, and the most likely outcome?
• Am I 100 percent certain that this outcome will happen?
• Are there any alternative outcomes that I am not considering?
• If a bad outcome were to happen, how can I cope?

3. Write out, and repeat to yourself, alternative and more helpful thoughts. For example, if your initial catastrophic thought about chronic pain is “I will never be able to be active again,” your alternative thought could be “I may have to modify some activities, and I can still move my body.”

4. Connect to your body. If you are caught in your thoughts, it can be helpful to pause and practice connecting to your body to decrease the focus on your thoughts. This may mean taking a few breaths and noticing the feeling of air moving in and out of your body, stretching, or pushing your feet into the ground and noticing the physical sensation of being rooted in the moment.

Catastrophizing Essential Reads

Catastrophizing: Why We Proclaim Our Worst Fears

3 Tips to Keep Your Catastrophic Thoughts at Bay

5. Shift your attention to a values-based action. When you notice that you are caught in catastrophizing, practice deliberately placing your attention on a values-based activity. This may look like refocusing on a work task, talking with a loved one and actively listening to them as they speak, or taking a walk outside. You will likely be pulled back into catastrophizing and that is OK. Each time you notice you are hooked by these thoughts, you can practice shifting your attention from catastrophizing to your values and the present moment.