Catastrophic Thinking or “Catastrophizing”

ctThe treatment of chronic pain is often quite complex.  It usually affects a patient’s mental health and treating this aspect of pain can be as or more important than medications or interventions.  Chronic pain patients are often depressed and anxious.  Sometimes this turns into obsessing about their pain, magnifying it and feeling helpless about it.   Having this magnified and negative world-view about our personal events is called catastrophizing.  This belief system can be reinforced by socioeconomic, psychological or health issues.  Doing this routinely can be harmful to one’s psyche, overall health and can lead to increased and chronic pain.

The Merriam Webster Dictionary defines a catastrophe as the following:

  1. the final event of the dramatic action, especially of a tragedy
  2.  a momentous, tragic event ranging from extreme misfortune to utter overthrow or ruin
  3.  a :  a violent and sudden change in a feature of the earth b :  a violent usually destructive, natural event (as a supernova)
  4. utter failure

There is a simple formula that is used to determine if patients have fallen into this way of thinking, which is:  Obsession with one’s pain or a focused mindset on pain + magnification (turning pain into something greater than it is) + a sense of helplessness = catastrophizing

Research psychiatrists at Harvard and Massachusetts General Hospital found that pain at rest, pain during activity, and disability were significantly predictable in these patients with catastrophic thinking.   Catastrophic thinking was strongly associated with pain intensity and disability for patients recovering from musculoskeletal trauma, There is strong evidence that people suffering from pain, who also catastrophize, risk developing chronic pain syndrome.

Researchers noted a profound response in these patients when they were given Cognitive Behavioral Therapy (CBT) to treat their catastrophic thinking.  In as little as 2-4 CBT sessions, pain was significantly reduced.  The researchers feel that if CBT is used much sooner with catastrophic thinkers, they can be kept from developing chronic pain syndromes.  CBT is also quite effective for all patients with chronic pain, whether they catastrophize or not.

Using Cognitive Behavioral Therapy, we try to redirect focus or modify thinking of those in pain to realize that they do have power over their pain and to recognize the strong influence that their thoughts can have on their pain experience.  When given education and resources to become aware of their catastrophic thinking, most patients can begin a mental journey toward pain relief.

If you suffer from pain and feel you need to break out of your patterns of ineffectual thinking, help is available to you.  Taking this pro-active step could make a world of difference in your level of pain and quality of life.