Distorted Thoughts: Catastrophizing
In an apparent effort to prepare us for the future, our brains have an astounding ability to conjure up horrific, worst-case scenarios. Have a stomach ache? Your brain might tell you it’s an ulcer or even cancer. Spouse is ten minutes late? Your brain might tell you they crashed their car and were hurt or killed. When there are countless possible outcomes to any scenario, a catastrophizing brain will tend towards the most… catastrophic. In this third entry of my “Distorted Thoughts” series, we’ll delve a bit into this anxiety-based cognitive distortion and how to challenge it.
Most of us have probably experienced catastrophizing at some point or another. Even minimally anxious people can occasionally imagine terrible possibilities and get caught up on them. The occasional catastrophization is likely just a part of being human. If it happens frequently enough to impair your functioning or quality of life, however, it may be time to address it.
At its core, I believe that catastrophizing is your brain’s way of trying to gain knowledge where there is none. After a routine physical, for instance, you have no way of knowing right away what the results of your bloodwork may be. During that time, your brain might start to sort through the possibilities as a way of coping with the anxiety of not knowing. What if your blood test shows that you might have cancer? Or that you’ve developed diabetes? Or that you have to make a major lifestyle change? This obsessive thinking is a vain attempt to come to a conclusion and find certainty when there is insufficient information to do so. The less information we have, the more creative our brains can get when coming up with potential catastrophes
When imagining these hypothetical scenarios, you aren’t getting anywhere closer to the truth, but it does give the illusion that you are. This is a key point to remember. Anxiety almost always has a perceived payoff, as counterintuitive as that may sound. Even if anxious obsession ends up causing us more pain and suffering, there is a short-term reward. The anxiety fools us into thinking we’re taking some active role in an uncontrollable outcome.
As with all distorted thoughts, there are kernels of truth that help to fuel them. Worrying that your stomach pain is cancer is probably not rational, but it could be true. People die in car accidents often, and it could be the reason your loved one hasn’t called you. Your blood test may come back confirming that you’ve developed type 2 diabetes. It happens all the time. As terrifying as those possibilities are, though, ruminating over them does absolutely nothing but increase suffering, and it does nothing to move towards a solution. In many cases, in fact, it makes finding a solution harder. For instance, if we’re catastrophizing over our health, we may be so wrapped up in the fear that we avoid going in for a physical exam. Our worry about a terrible situation is making the terrible situation more likely. Thanks, brain.
So what do we do about this pattern of thinking? The answer, as with all distorted thoughts, is a combination of acceptance and shifting to a more reality-based thought.
Identifying a more reality-based replacement thought does not mean we engage in toxic positivity or try to fool ourselves. For instance, if we are concerned about medical tests, we don’t tell ourselves that a bad outcome is impossible, because that isn’t true either. Instead, we accept that we don’t know and that certainty isn’t achievable. For instance, instead of the thought, “I might have cancer”, try telling yourself, “I can’t know for sure what the results will be.” If you happen to know that the odds of a certain outcome are low, you can throw that in there, too. For example, “It’s unlikely to be cancer, but I can’t know for certain, and that’s OK.”
Countering your distorted thought with a reality-based one is not always sufficient. Ultimately, we have to accept our anxiety as it is currently. This doesn’t mean we indulge in the anxiety, but we simply acknowledge it and work on not trying to control it. This is one of the most useful skills acquired through regular mindfulness practice, whether it’s formal meditation or informal. Mindfulness meditation is suggested for anyone struggling with anxiety (or anyone at all, really). Acceptance is much easier said than done, and it is a skill that needs to be developed.
The most important thing to remember is that desperately seeking certainty is almost always going to increase your anxiety and keep the cycle going. Yes, it’s important to be educated about your situation, whatever it may be, but the frantic Google searching, playing out mental scenarios, and seeking reassurance from others is only resisting the unknown, which we are always at the mercy of.
As always, remember that sufficient, high-quality sleep, proper nutrition, and regular exercise will likely improve all aspects of mental health. These cognitive-behavioral and mindfulness-based approaches are helpful, but first priority is always basic self-care.