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  • Writer's pictureSarah Covey

Ask a Therapist: On Catastrophization

Q: I find my thoughts go straight to the worst case scenario and I don’t know how to manage that tendency better.  Can you help?

A: It sounds like you have what I call the “what if” voice taking up residence in your headspace.  This is the voice that operates out of anticipatory anxiety at its worst and out of risk management at its b

est.  It is the voice that questions every decision and every interpretation of an event that has a tendency to envision the worst possible outcome as the first consideration.

People who struggle with the common cognitive distortion of catastrophization tend to worry a lot about what

will go wrong instead of considering what will go right.  The truth is, it is important to consider potential dangers and risks when making our plans and decisions; however, for some personalities this pattern of thinking is debilitating if it remains the only framework for consideration and the default processing mode.

People who catastrophize are telling themselves the story – automatically – that the worst outcome is the predictable one. They project a narrative into the imagined future that goes directly to catastrophe and fail to also include the other, equally possible, imagined future stories that encompass more positive outcomes.

Naturally, if you are always worried about the worst case scenario or waiting for the other sho

e to drop you will be living in a heightened state of anxiety which is unhelpful for day-to-day functioning. Your system responds as if the worst thing is already happening and you have to navigate the stress of the catastrophe in real time. Of course, this catastrophe is only psychological.  It hasn’t actually come to be.


combat the mental patterns that form through catastrophization, you need to tell yourself ALL the possible stories about how things could play out to soften and temper the hyper-focus on the worst version of events.  Tell yourself the best case scenario and imaginatively play out all the other potentially different stories that could fall between those two extremes.  Expanding your thinking to include other scenarios will allow you to release the grip of that negative bias.

Also, when you do think about the worst case scenario, you can imagine the “what if” thought through to an “even if” to remind yourself of your resilience even if adversity comes.  Sometimes we have and will navigate very hard things but you have survived all your hard days so far! Even if that worst case scenario unfolds you can find a way to be supported through the struggle or the grief and you will be okay.

When catastrophization and worry are taking over your headspace, you are borrowing trouble and impacting your wellness today.  If you are struggling with these types of thinking patterns, it can be very helpful to speak to a therapist who can guide you through some tools to protect your wellbeing in each present moment so that the anticipatory anxiety doesn’t steal your current joy.

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