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Take These Steps to Avoid Catastrophizing

Getting stuck in a negative spiral of thought can be paralyzing instead of freeing you up to identify more effective solutions

By Gary M. Stern

My friend Rory is in his mid-sixties, plays tennis, works out at the gym, watches what he eats and is generally healthy. But one day on the tennis court, he felt pain in his ankle, which he hoped would go away on its own. The next day he felt a twinge in his back that concerned him and that hampered his play. And then he felt a mild throbbing somewhere in his brain.

His girlfriend said to him, "Rory, you have to see a doctor and get everything checked out."

A man worried about his ailments looking out of a window. Next Avenue
Catastrophizing about current ailments intensifies emotional distress, increases anxiety and depression and leads people to neglect their general health.  |  Credit: Getty

Rory finally agreed.  But inside, he was thinking, "that's it, I'm a goner. The pain in my brain could be a tumor. What if I die soon?" He started catastrophizing and thinking the worst. And for many people, that negative thinking, which imagines the worst possible outcomes, comes naturally and often is an exaggerated response to a certain fear. 

Most people who have a chronic disorder often consider that it's going to get worse or stagnate, but often fail to consider taking proactive steps to alleviate or remedy the pain.

Experts say that being mindful of thinking the worst and looking for solutions, rather than dwelling on the negatives, can lead to much better outcomes.

Many people catastrophize because "if they say the worst, they won't be tempting the gods," explained Ellen J. Langer, a professor of psychology at Harvard University, whose latest book is "The Mindful Body: Thinking Our Way to Chronic Health."   

But thinking negatively often exacerbates an already conflictual situation. "If you think the worst, you're going to be stressed and that's the biggest killer," Langer said. "It makes any condition worse."

Anticipating the Worst Can Be Stressful

Langer has observed that most people who are stressed are often locked into seeing the issue from one fixed perspective. They often seek out data that confirms their hypothesis and avoid any new information that contradicts that set perspective. Getting stuck in a negative spiral of thought paralyzes them rather than frees them up to identify more effective solutions.

Based on the research for her book, Langer recommended an alternative to catastrophizing and instead focusing on "attention to symptom variability" or stated plainly, being "mindful and noticing changes." Most people who have a chronic disorder often consider that it's going to get worse or stagnate, but they often fail to consider taking proactive steps to alleviate or remedy the pain.

If you are more open to taking in new information, three things will happen: you'll notice you're not in equal pain all the time; sometimes you feel better; and being more open and mindful enables you to search for new solutions that lead to better results and avoid the "woe is me, the sky is falling, the worst is about to happen" syndrome.

"They're hyper-focusing on the symptoms and neglecting the larger picture."

In fact, Becca Levy, a professor of epidemiology at Yale University and a Next Avenue Influencer in Aging, in her book, "Breaking the Age Code: How Your Age Beliefs Determine How Long and Well You Live," cited a 2014 study of 100 adults, average age 81, who were trained in positive thinking and showed improvement in their physical functionality.

The problem with some older adults, explained Bonnie Floyd, a clinical health psychologist who focuses on geriatric residents in South Wales, New York, is they "jump to conclusions based on insufficient information. The problem may not be as severe as they anticipated."

When people catastrophize about their current ailments, she said, it "intensifies their emotional distress, increases anxiety and depression and leads them to neglect their general health — they don't go for health screenings and can ignore nutrition and exercise. They're hyper-focusing on the symptoms and neglecting the larger picture."

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Floyd urges her patients to focus on their remaining abilities and strengths, and what they can do, not what they've lost over the years. She suggests keeping a gratitude journal, where they list the many things they're grateful for, accentuating the positive. She also encourages them to get adequate medical care, go for medical evaluations, screenings and follow-ups, and ascertain their prognosis and what they can do to get healthy.

"Think about how 'I'm still here. I have some aches and pains but I'm still here walking and talking and living.'"

Floyd recalled one patient, going in for knee replacement surgery, who thought the worst and felt that the pain would be her downfall. Instead, the surgery was successful, and Floyd encouraged her to dwell on what she could do, how she could still go for a walk and gain strength to increase her activity, not to focus on what she had lost.

'A Self-Fulfilling Prophecy'

The problem with people who catastrophize about any of their ailments is "it becomes a self-fulfilling prophecy," explained Nancy K. Schlossberg, a Sarasota, Florida psychologist and author of "Too Young to Be Old" and also "Revitalizing Retirement." People who think negatively about being "over the hill" and tell themselves "I'm going to die" believe it and it worsens the situation, she suggested.

Schlossberg recommended that people dealing with several ailments "reframe" their mental outlook. Instead, "think about how 'I'm still here. I have some aches and pains but I'm still here walking and talking and living.'"

Rather than getting involved in a negative doomsday spiral, Schlossberg recommended a multi-pronged approach:

1. What can I do to change my situation and decrease my pain? Calling a doctor or starting physical therapy are some positive steps to take.

2. Accentuate all the positives. I'm older, but I can still play tennis and go to the fitness center.

3. Focus on de-stressing, whether it entails meditating, going swimming or jogging in the park.

4. Consider meeting with a therapist because talking with someone who has helped many people in comparable situations can lead to better outcomes.

Just realizing there's something you can do to alleviate pain and change the situation lifts the spirits and encourages resiliency, and that enables people to bounce back from adversities, Schlossberg said.

Floyd noted that there's a moral to the story for people who accentuate the worst and have a hard time letting go of those feelings. "Sometimes people cling to the worst care scenario but it doesn't happen that way. Sometimes our fears are much worse than reality."

Gary M. Stern is a New York-based freelance writer who has written for the New York Times, Wall Street Journal, Fortune.com, CNN/Money and Reuters.  He collaborated on Minority Rules: Turn Your Ethnicity into a Competitive Edge (Harper Collins), a how-to guide for minorities and women to climb the corporate ladder. His latest book collaboration From Scrappy to Self-Made, written with Yonas Hagos, about his life as an Ethiopian immigrant coming to the United States, knowing two words, yes and no, opening one Dunkin’ Donuts 30 miles west of Chicago, and turning it into owning 47 restaurant franchises including 21 Smoothie Kings, 16 Dunkin’s and 6 Arby’s is just out from McGraw Hill.
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