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 we did,
i.e. Heather looked it up for me. 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 behaves in some other
way that we get suspicious about, is having an affair, drinking
again, or committing some other violation of their contracts
with us or with themselves. Essentially catastrophizing is
making 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.
Most recently 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 get killed and it was
going to bankrupt the United States government. Who knew that
the shooting war could be all but over in a mere three weeks?
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,
I think that 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 the country was recently 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 vindicated,
exonerated and 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 catastrophes,
our traumatic childhood experiences.
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?
John C Flanagan, LCSW
818 NW 17th Avenue, Suite 7
Portland, OR 97209-2327
503-228-7574
www.johncflanaganlcsw.com
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