Catastrophizing about pain

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teen girl stressed

​​One type of thinking that focuses on negative thoughts is called “catastrophizing”. This type of thinking is particularly common in people with chronic pain.

The Oxford English Dictionary defines a catastrophe as:

  • an event causing great and often sudden damage or suffering
  • a disaster.

Catastrophizing may include one or more of the following types of thoughts:

  • helplessness – feeling like you can’t do anything about your pain
  • magnification – thinking of your pain as the worst thing in the world
  • rumination – thinking about your pain over and over.

Examples of catastrophizing thoughts include:

  • “My pain is going to last forever.”
  • “There is nothing that I can do to make my pain any better. It is just going to get worse for the rest of my life.”
  • “If I exercise, I am probably going to get a horrible injury and then my pain will be unbearable and I won’t be able to move anymore.”

A scenario that leads to catastrophizing thoughts might look something like the situation faced by Carrie.

Carrie is a first year science student at the University of British Columbia. She studied all week for her Chemistry final exam. When she got her results, she saw that her mark was 70%. This was the lowest mark she had ever received all through school. She was a straight-A student in high school and wants to do an internship at Cal-Tech after graduation.

As she stared at her test she thought:

“I can’t believe I got this mark! I studied so hard, and none of it paid off! I’m going to fail the class and never get the internship that I want! My parents will be so disappointed in me! My life is over!”

With these thoughts, Carrie turned a fairly small negative event in her life into a catastrophe ("My life is over!").

One way to know if you are catastrophizing is to look at the facts. Ask yourself, “How likely is it that my negative thoughts will come true?”

In Carrie’s case, she is catastrophizing because it is very unlikely that any of her worries will actually happen. If she looks at the class average, she will see that marks in university courses are almost always lower than those in high school. If she considers this single exam in the context of all of the other work that she will do in university, she’ll realize that it won’t have a big impact on her likelihood of getting into Cal-Tech. If she talks to her parents, she’ll see that they are still proud of her.​

Managing catastrophizing thoughts

teen comforted by doctor

Have you ever catastrophized about something? If so, why don’t you think about what it was, how it felt and how you could have dealt with it better? We have all survived thoughts of catastrophe and we know that not all worrisome events come true.

People who catastrophize about their pain tend to take longer to recover because they avoid situations that might be painful (such as physical therapy) and are more strongly affected by their pain than people who don’t catastrophize.

These people may believe that their chronic pain is a sign of ongoing damage and may work hard to avoid situations that may make their pain worse (such as crowded hallways at school or work, completing their physiotherapy exercises). However, research tells us that, for most people, chronic pain is not a sign of ongoing damage in your body. Instead, it is the result of overexcited nerves that need to be trained by using the affected area regularly and doing exercises prescribed by a healthcare provider​.

As with other issues discussed in this session, it is important to talk to your family doctor if you find that you are catastrophizing. They might be able to refer you to a pain psychologist who can teach you helpful “talk back” techniques to challenge and overcome your catastrophic thoughts. As you learn how to do this, you will feel more confident in your ability to return to all the activities that hold meaning in your life. This is the path to recovery.

Last updated: May 2nd 2016