When we’re anxious, we tend to catastrophize. The term “catastrophizing” was coined in the 1950s by Albert Ellis, one of the pioneers of modern cognitive-behavioural therapy (CBT). Ellis had been influenced by the linguistic concept of verbing or verbification, which refers to the act of turning a noun, such as catastrophe, into a verb, such as to catastrophize. By replacing the noun with a verb, we are encouraged to think of ourselves as engaged in an activity, and take more responsibility for the way we view things. Nothing in nature is a catastrophe. Humans choose to interpret certain events as catastrophic. Realizing when and how you’re catastrophizing is the first step to change.
Decatastrophizing is the name of a specific strategy used in cognitive therapy, of which there are several variations. Sometimes the term decatastrophizing is used more loosely simply to refer to the idea of countering catastrophic thinking. For example, catastrophizing is typically characterized by What if? thinking. “What if this happens? What if that happens? How will I cope?” Therapists often refer to the idea of replacing What if? thinking with So what? thinking. “So what if it does happen? It’s not the end of the world.” This technique of So what? thinking can be viewed as the simplest form of decatastrophizing.
In this article, I’ll look more closely at the nature of catastrophic thinking, before describing in detail how different versions of the decatastrophizing technique are used in cognitive therapy, and how they can be used for self-help. I’ll also be drawing some analogies with Stoic philosophy along the way.
What is Catastrophic Thinking?
You may, perhaps as a child, have heard the tale of Chicken Little or Henny Penny. She was walking through the farmyard one day when something landed on her head — and it hurt! She flew into a state of high anxiety, and began to worry that the end of the world was nigh. Running around the farmyard, squawking “The sky is falling!”, she spread panic among the other animals. Eventually, a wise owl, the voice of reason, explained to everyone that it was merely a harmless acorn dropping from an oak tree that had hit Chicken Little on the head. With her catastrophic thinking dispelled, she returned to pecking corn peacefully in the yard. The moral is that once our anxiety is triggered we are all prone to take small threats and amplify them into ones that are much more severe and catastrophic.
When we become anxious, our brain enters a different state, which cognitive psychologists call the “threat mode”. This is associated with a number of psychological and physiological changes, such as the fight-or-flight response, but also certain cognitive and attentional biases. We tend to pay more attention to potential signs of danger in our environment and to overlook signs of safety. One of the main problems with the threat mode comes from the way it causes us to engage in biased “threat appraisals”.
These appraisals can be broken down into three main elements:
Overestimating the probability of threat
Overestimating the severity of threat
Underestimating our ability to cope
In plain English, we tend to tell ourselves: Something awful is about to happen and I won’t be able to deal with it! Negative automatic thoughts of this kind are common in all forms of anxiety. When we dwell on these thoughts and ruminate about them, we experience a longer, and more voluntary, sequence of anxious thoughts known simply as worry.
Worrying tends to focus our attention exclusively on the worst-case scenario. Our thinking becomes extreme. We also tend to exhibit highly selective thinking, by ignoring evidence of safety, and what psychologists call “rescue factors”, such as resources available that might help us cope. We may jump to conclusions prematurely about what is bound to happen, which therapists sometimes call “fortune telling”. These are some of the most basic “cognitive distortions” or thinking errors found in anxiety and particularly in worried thinking.
Simply being more aware of catastrophizing as an activity, labelling it as a form of bias, or a thinking error, and taking more responsibility for doing it, can help us to break free from its grip. Often, near the start of therapy, clients will say “I noticed myself doing that ‘catastrophizing’ thing again but I was able to stop once I realized what was happening.” Often simple insights like this can be surprisingly powerful. Once we notice how we are deceiving ourselves, we are no longer deceived. The instant you truly realize that you are making an error in your thinking, you cease to make the error. As a result, you may have an Aha! moment and see through the illusion created by catastrophic thinking, almost as if you’re awakening from a trance.
Decatastrophizing in Cognitive Therapy
Beck and his colleagues have described their method of decatastrophizing in a number of different ways. It’s based on the premise that the situations we fear are, in reality, seldom as bad was we imagine when feeling anxious. It therefore requires facing your fears by confronting the idea or image of the worst-case scenario.
Normally people avoid really exposing their mind to their biggest fears in this way. You have to be prepared to endure what may be quite a challenging and uncomfortable experience. However, although your anxiety may increase at first, it will typically reduce during the exercise. By repeating this several times, perhaps once a day for five days or a week, you may find that the anxiety has been extinguished or at least reduced to a normal or negligible level.
The emphasis in this procedure is for the patient to see whether he can learn to accept and tolerate the experience he fears. The therapist stresses that the feared outcome is unlikely and that the patient still has some choice over how the situation turns out. — Beck et al., Anxiety Disorders and Phobias: A Cognitive Perspective (2005)
Don’t do this exercise alone if you suffer from a psychiatric condition, or if you experience panic attacks. In those cases, you’re probably better doing it under the supervision of a qualified mental health professional, simply because facing their worst fears can, despite the long-term benefits, be overwhelming in the short-term for some individuals, particularly those suffering from anxiety disorders.
For the majority of people, with less severe anxiety, though, facing the worst-case scenario will feel uncomfortable at first, as you’d expect, but it quickly becomes quite manageable. You could compare it to getting into a swimming pool filled with cold water, which may feel very bracing, like a shock to your system, but after a few minutes your body will get used to the temperature, until the water starts to feel quite normal and comfortable.
It’s therefore important to rate your level of anxiety before, during, and after each decatastrophizing exercise. Most people use a simple SUD (subjective units of discomfort) scale, from 0-10, although some people prefer to use a percentage. Measuring changes in your emotions actually makes them more likely to happen, and it also helps you to track your progress.
While avoidance may seem easy, and tempting, the more we try to suppress thoughts, especially those rooted in fear, the more persistent they become. Consider this example: try not to think about a polar bear for the next minute. The more we try to avoid thinking about anything, especially our fears, the more likely the thought is to keep recurring in the future. What if thinking about the worst could make it more likely to happen? That’s a common concern. However, clinicians have consistently found it disproven by experience. The mind doesn't manifest negative events simply by imagining them. Facing our fears, in the right way, usually makes them less powerful not more powerful.
Decatastrophizing Imagery
Some people prepare themselves to do decatastrophizing by writing a catastrophizing script, describing in detail all of their worries about the worst-case scenario, which they fear. This can help you to visualize things but it’s not essential. The main step is simply to close your eyes and picture the worst-case scenario as if it’s happening right now. This is a form of what therapists call “imaginal exposure therapy”, which requires exposing your mind for a prolonged period to images that trigger anxiety. We know that doing this, very reliably, tends to lead to an initial increase in anxiety, followed by a reduction. Decatastrophizing differs from conventional imaginal exposure, however, because it also involves changing the way you think about the perceived threat, by challenging your catastrophic thinking.
As we’ve seen, simply realizing that you’re engaged in catastrophizing and labelling it as such is often enough to change how people feel. As we’ve seen, catastrophic thinking usually entails overestimating the probability of the threat. So Beck recommends that, if appropriate, you should focus your attention on the low probability of the worst-case scenario happening, while you mentally picture it. Consider the evidence for its likelihood, such as the fact that you have worried about many things in the past, and what percentage of them have happened as predicted.
Decatastrophizing involves the identification of the “worst-case scenario” associated with an anxious concern, the evaluation of the likelihood of this scenario, and then the construction of a more likely moderate distressing outcome. Problem solving is used to develop a plan for dealing with the more probable negative outcome. — Clark and Beck, Cognitive Therapy of Anxiety Disorders (2010)
I would say that, generally, however, I find it somewhat more helpful to focus on the other aspects of threat appraisal: the severity of the threat and your coping ability. This is where imagining the threat becomes more interesting. Picture the worst-case scenario in as much detail as possible, looking at it from different perspectives, patiently, maybe for 5-10 minutes, or longer. Explore the image by asking yourself questions such as: “What’s the worst that could realistically happen in this situation?”, “What’s so bad about that?”, “How might it affect your life?”, etc. By developing a more moderate and realistic appraisal of the threat’s severity, you will usually also arrive at a more likely perception of the outcome.
Ask yourself, therefore, whether your thinking about the severity of the situation is realistic or if it might contain any exaggeration or other thinking errors. Are things really as bad as you initially assumed? Knowing that the threat mode tends to narrow your attention onto signs of danger, causing selective thinking, try to reverse that by now paying more attention to any signs of safety or rescue factors. Look for evidence that things might not be as catastrophic as you at first imagined. Are there resources available or people who could help you survive?
Coping and Moving Forward
Even if the worst-case scenario happened, are there ways in which you could cope? What help or support is available in the situation? What resources could you use to get through it okay? What would you do if you were behaving more confidently or assertively in that situation? How might someone else cope with this problem?
When people worry, for some reason, their mind typically fixates on the worst moment in a sequence of events, the point at which their anxiety reaches its peak. In most cases, though, if you simply asked yourself what would probably happen next, and moved forward in time a little, you would eventually experience a sense of relief, and the image would feel less overwhelming. So deliberately get yourself past that stuck point. Ask yourself “what would most-likely happen next?, and after that?, and after that?”, and so on.
You can combine this with another technique called time projection, which involves asking yourself how you would feel about the feared event a week from now, a month from now, a year, a decade, and far away in the distant future. It might seem, at first, like an odd thing to ask but if you know that you would feel less upset about this event in the future, why shouldn’t you just choose to feel that way right now? (It can be useful just to contemplate that question for a while.)
After you’ve finished picturing the worst-case scenario and examining it patiently in your mind, asking yourself whether it’s really as bad as you initially felt, you may want to review the exercise by writing what’s sometimes called a decatastrophizing script. (If you earlier wrote a catastrophizing script, this would be the opposite, in a sense.) Write down a new description of the worst-case scenario, using completely objective language. Suspend any value judgements or emotive terminology. Just stick to the facts. Focus more than normal on any potential signs of safety or rescue factors, and conclude by describing in some detail how you would cope with the stress and problem-solve the external situation. Describing the worst-case scenario in this way should make it feel much less intimidating. When you then repeat the decatastrophizing imagery, you’ll find it much easier from now on to imagine events more realistically and without catastrophizing.
Some people also like to follow this by asking themselves what the best-case scenario would be. The most-likely case will usually be somewhere between the worst-case and the best-case scenario. Whenever you notice that you are worrying, catastrophizing, and focusing on the worst-case scenario, you can now deliberately shift your attention onto the most-likely scenario. In my view, though, if you adopt this strategy of shifting focus onto the most-likely scenario prematurely you risk turning it into a form of subtle (cognitive) avoidance. It’s better to wait until you’ve practised decatastrophizing in the image enough times for your anxiety to have reduced significantly.
Stoic Decatastrophizing
There are many ideas in the Stoic literature that could be linked to the concept of decatastrophizing.
Premeditation of Adversity
The Stoics advise us to go further than Beck, by imagining any misfortune that could conceivably happen, one at a time, as if it is happening now. The primary aim of Stoic premeditation appears to have been, in a word, to rehearse a philosophical attitude toward misfortune. However, the Stoics also seem to have understood the phenomenon of emotional habituation, i.e., that anxiety abates naturally through prolonged, repeated, exposure, such as imagining various misfortunes or worst-case scenarios for long enough. By targeting a range of adverse situations pre-emptively, Stoic premeditation appears designed to create general emotional resilience, and to function preventatively rather than therapeutically.
The Dichotomy of Control
This is the opening sentence of Epictetus’ Handbook and the topic of the first book of the Discourses so it appears to be given a fundamental position in his approach to Stoicism. During premeditation or decatastrophizing, you can simply ask yourself which aspects of the situation are up to you and which are not. Another way of doing this is to ask yourself how much control you have over the outcome of the situation, roughly, from 0-100%. Assuming it’s not at either extreme, you can first ask yourself why you didn’t rate it 0% and then why you didn’t rate it 100%. This technique definitely seems helpful to people who are engaged in decatastrophizing. Dividing things into two columns seems to make it easier to parse difficult situations. All you have to do next is focus on accepting the aspects that you don’t control and taking more responsibility for the aspects that you do control.
Cognitive Distancing
The most well-known saying from Stoicism is the fifth passage of Epictetus’ Handbook, which reads “People are not disturbed by events but by their opinions about them.” Bearing this in mind while you’re examining the image during decatastrophizing can help you to gain what Beck called “cognitive distance”, by separating your thoughts from the situation to which they refer. Nowadays, we’d tend to view this as a form of mindfulness and acceptance practice in CBT and, indeed, you can approach decatastrophizing as an opportunity to exercise mindfulness while rehearsing the mental imagery. That alone will tend to reduce your anxiety as well as improving your ability to think through coping strategies.
Stoic Functional Analysis
We could list many other Stoic techniques but the one I sometimes find most helpful, for want of a better name, I call Stoic “functional analysis.” In behaviour therapy, functional analysis is a process whereby we understand the purpose of a behaviour by identifying its antecedents and consequences. (For which we use the acronym ABC: antecedents, behaviour, consequences.) Most habits are triggered by certain antecedents and maintained, often in subtle ways, by its consequences, in the form of external punishments or rewards. For the Stoics this takes a slightly different form because their philosophy assumes that we should be more motivated by whether something helps or harms our own character. The way they would remind themselves of that perspective was by repeating the paradoxical saying that our own fear does us more harm than the things of which we are afraid.
Here are some variations of that you can try doing during decatastrophizing imagery:
“What does you more harm, the situation you worry about or your worry itself?”
“What does you more harm, the worst-case scenario or your catastrophizing?”
“What does you more harm, the trigger event or your emotional response?”
These are all questions designed to shift your focus away from perceived threats and back on to your way of thinking and responding to the situation. You will find that by asking these questions, with mindfulness and self-awareness, you are able to gain further cognitive distance in the situation.
Conclusion
If you understand the concept of catastrophizing and can spot yourself doing it, you will already be able to gain cognitive distance, and by facing your fears in imagination, patiently, and repeatedly, you can learn to turn a perceived catastrophe into a more tolerable experience, from which you can potentially learn. To recap, apart from just getting used to the feared situation, decatastrophizing also works by encouraging us to view the worst-case scenario more rationally and realistically, in a balanced way.
We begin to re-evaluate our appraisal of the probability of the threat, by becoming more aware of evidence suggesting the worst-case is quite unlikely
We begin to re-evaluate our appraisal of how severe the worst-case would be — is it really the end of the world?
We become more aware of the whole situation, including signs of safety and rescue factors, which we’d previously overlooked, such as opportunities for help and other resources
We begin to problem-solve and identify practical solutions, which we can rehearse in our mind’s eye until we feel more confident about coping
We move past fixation on the worst moment and begin to imagine what would happen next, viewing events from a broader chronological context
Remember, as Seneca once said, "We suffer more often in imagination than in reality", because there are far more things in life that are capable of frightening us than there are which can actually destroy us.