Catastrophizing

by John C. Flanagan LCSW

Awhile back I went to the dermatologist because I was having a strange rash that was not responding to treatment. After examining it she said that I might have “Bullous Pemphigoid”. I’m guessing that most people have never heard of it. I never had. After the doc left the room I asked the nurse how to spell it. She said, “Now don’t go looking it up on the internet!” Yes, of-course, that is exactly what I did. Well, Bullous Pemphigoid is an autoimmune disease that is sometimes (rarely) fatal. I remember talking to my friend, John, and telling him about it and crying. I was dying…. Well, no, I wasn’t dying. I was Catastrophizing. It turns out that I’m allergic to Sudafed and was having a “focused drug reaction”, which I also never heard of. It’s really quite interesting, but that’s another story.

Catastrophizing can take many forms. It can be reading too much into what or how a doctor tells us about an illness. It can be assuming that our spouse or partner, because he or she gets home later than expected or otherwise behaves oddly, is having an affair. Essentially catastrophizing is making extreme assumptions about what’s going on based on very limited or circumstantial evidence. It is assuming a more dire conclusion than we have adequate evidence to support. And it is having an emotional reaction proportional to that dire conclusion. In 2001, I found myself catastrophizing about the war in Iraq. I thought that our government had grossly miscalculated and that the war was going to go on for years, just like Viet Nam. A lot more people were going to die and it was going to bankrupt the country. Unfortunately sometimes catastrophes do come true.

A distinction needs to be made between a crisis and a catastrophe. A crisis is when something bad happens that needs to be dealt with in an expeditious manner. A catastrophe is when something extremely bad happens and there is very little one can do about it. Mostly one just has to suffer through it. It’s a bigger bad thing that has less that can be done about it. Catastrophizing is essentially turning a crisis into a catastrophe. In the example at the top of the page, the rash was a “concern”. The doctor’s inability to diagnose it was a crisis. And my sense that I was going to die from it was catastrophizing. In this example, there was no actual catastrophe. However, it is still catastrophizing any time we think a crisis is a catastrophe, even if it later becomes a catastrophe.

So why do we catastrophize? I think that people catastrophize for a variety of different reasons at various times. In part we catastrophize because our society teaches us to do it. For example during the “war on terror” the country was put on red alert because of a suspected terrorist attack using biological or chemical weapons. We were advised to buy duct tape and sheets of plastic with which to seal up our houses. It sounded like a catastrophe but it wasn’t, especially for the duct tape and plastic sheeting industries. So maybe we catastrophize because it is what we are used to, especially if we grew up in a dysfunctional family. Our whole lives have been or seemed to us to be catastrophes. Maybe it is because that is what we dread. Our childhood was a catastrophe. But we have diligently striven to make our adult lives placid and uncomplicated. We have done all sorts of things to give ourselves a sense of control. And now something hints of spinning out of control and it panics us. Our house of cards, for if we are honest with ourselves, that is what it feels to us like we have built, is about to collapse.

Or maybe we have been waiting our whole lives for a “real” catastrophe to happen to us so that we can feel justified. We suffer. We have suffered all of our lives. But we have never felt entirely certain that we had ample reason to suffer. Now here comes this catastrophe. We are finally validated in our suffering. I am reminded of clients that I have known who were strangely relieved to have some horrible illness or other disaster befall them. Another reason for this kind of reaction, for reaction it is, might be that these events make us feel like those around us finally recognize our suffering. The world around us finally sees that our pain is legitimate. Or maybe the catastrophe seems to legitimatize our eccentric and inappropriate behaviors, our reactivity, which stem from our original catastrophe, our traumatic childhood.

Sometimes our tendency to catastrophize about certain things can be a useful tool to teach us about ourselves. Just like any other symptom, its character may stem from our original trauma and therefore may shed light on what that trauma was and how it impacted us. For example, maybe a person tends to catastrophize about illness because it was only when he or she was ill that attention was given. Or contrariwise, maybe he or she was shamed for illnesses and therefore only feels like a very serious one is legitimate.

What can we do to catastrophize less? My mind tends to respond to this question by turning to several of our old standbys. We need to turn to the tools in our tool chest and apply them liberally. We have learned that whenever we notice ourselves being reactive, we need to question our reactivity. We need to journal, meditate, visualize and say affirmations. We need to look at the situation through the eyes of a third party, either in our imagination or literally through our relationships. We need to follow our intuitions and insights.
It is helpful to keep reminding ourselves of the need for adequate information before trying to reach any conclusions. I love the story that Carl Sagan told in the Cosmos series about the early astronomers. They were looking at the planet Venus and saw that it was covered with clouds. They concluded that it must be a tropical rain forest type atmosphere much like when dinosaurs roamed the earth. Sagan says, “Observation, we can’t see a thing. Conclusion, dinosaurs.” It is always helpful to get more data.

Desired Outcome: Become able to catastrophize less often, less severely and for shorter periods of time.

Discussion Starters: What instances can I remember when I have catastrophized? Under what circumstances do I tend to catastrophize? How does the pattern of my catastrophizing relate to my history? What tools do I have or can I develop to help me catastrophize less? What ways do I have or can I develop to help me detach from this kind of extreme thinking?

For a downloadable version of this article, click here: Catastrophizing

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