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Years ago I was finishing my final year of training for my doctorate in clinical psychology. A few months into my internship, I started having spells of dizziness, chest tightness, and headaches. Although I initially attributed it to stress, I gradually became convinced that something of a cardiac or neurological nature was at play.
Even after multiple tests came back negative, I struggled to let go of the thought that my physical symptoms weren’t due to a life-threatening physical condition. Only after months and even years, did I come to accept that what I had experienced was partly related to issues of lifestyle (limited exercise, poor diet) and stress management, most especially my catastrophizing. As a psychologist in training, it was humbling to realize just how much “believing the worst” could really impact me.
Decades later, like many others, I still feel the pull of this worst kind of worry. There are times where a small twinge or discomfort immediately leads to worries of something going really wrong; other times, it is a minor social or emotional circumstance that leads me to ultimate ruin.
A seminal study
In 1995, a seminal study was published in the journal SPINE that showed the power of psychosocial variables on people disabled by back pain. One psychological factor -- the degree of catastrophizing -- was almost seven times more predictive than any clinical or historical variable in predicting disability.
Catastrophizing is a type of cognitive distortion, or irrational pattern of thinking. We all engage in cognitive distortions at times, but the more that they occur, the more we are at risk for many negative physical and psychological outcomes.
When we catastrophize, we tend to only see the worst possible outcome in a situation. In the case of acute back pain, a person might catastrophize around the intensity, frequency, and/or duration of the pain; for example, they might come to believe that it will never improve, resulting in long-term discomfort and an inability to return to normal activity, or even disable them altogether.
We are finally coming to realize just how powerful our minds are when it comes to not just our physical experiences, but our entire existence. Many experiences of pain and discomfort do have a physical cause, but very often, when we believe that something must be wrong, it is our perspective and attitudes that are most responsible for our discomfort.
As time, curiosity, and experience are often the best teachers, I have learned there a few keys critical in reducing the likelihood and impact of catastrophizing.
First, what we "consume" matters.
it is imperative that we understand that the more media/technology and conversations we consume “of the worst kind” (i.e., all the bad things going on, and opinions about them), the more likely we are to catastrophize. If you surround yourself with drama, horror, and heartache, you are priming yourself to believe that a catastrophe is always “around the corner.”
Second, our internal voice is controllable.
While we may have a "gut feeling" that evokes a sense of catastrophizing, our internal response back is always controllable. It might sound something like, “Well, it is possible that I have a horrible disease, but until I have further information it is not going to help me to over-think it.” Another example might be, “Don’t forget – I have had this worry many times, and it has not come true.” The key here is that your internal voice must be realistic and positive in combatting the feelings and thoughts that might be neither.
Finally, keep perspective.
When all else fails, remind yourself that if you're catastrophizing, it means you are conscious and alive enough to be worrying this way in the first place. Dead people don’t have the opportunity to worry. Which means that the opportunity to live, and even live well, is still possible for all of us. While this might sound trite or Pollyannaish to some, I can say from personal experience that this perspective, along with a prayer to the One who gave me life in the first place, has been a godsend of a real kind.
Every now and then, our catastrophizing is a timely alert to mobilize immediately. But almost always, it is a reminder to pay attention, use the internal voice that God gave us, and to give thanks for what we have, and can worry about at all.
