Disputing Catastrophic Thoughts

Learning Objectives

  • Understand the nature and impact of catastrophic thoughts in the context of cognitive behavioral therapy.
  • Learn how to recognize and dispute catastrophic thoughts.
  • Discover methods to defuse, manage, and counteract catastrophic thoughts.

Catastrophic thoughts provide an especially vivid example of the subjectivity of the “real world.” Consider the following real example:

A guy works as a cab driver. He is driving his cab down the city streets of a small town. As he approaches a stoplight, he imagines the engine dying. Then, he imagines coasting to a stop at the light. Then, he imagines turning the key and…nothing, just nothing…the engine is completely dead. Traffic begins to back up. People are upset. Someone calls the police. A police officer arrives and asks for his license and tells him to pop the hood. Seeing nothing obviously wrong, the officer becomes frustrated, writes the guy a ticket, and calls a tow truck. Now the guy has no cab to drive and a traffic ticket to pay. Moreover, he has no idea how he’s going to visit his parents, make it to the grocery store, or anywhere else he needs to go. If he can’t drive the cab, he can’t work, he can’t pay his rent, and if he can’t pay his rent, then he will end up evicted and homeless…

In the example above, the client experienced this sequence of catastrophic thoughts at every stoplight. In a fraction of a second, the entire fantasy would unfold, escalating his anxiety to panic proportions. I asked him whether his cab had ever died at a stoplight. No, his cab had never died at a stoplight, not once in forty years of driving. But his cab did occasionally make some weird noises, and to the client, these noises conjured the whole sequence of catastrophic outcomes, all possible, but also highly improbable. I asked whether he’d had any vicious encounters with police. No, the police had only been helpful to him.

Buying a new cab was not an option, so the client decided to fix his thoughts instead. We agreed that even if the engine really did die at a stoplight, the purpose of a police officer is to help stranded motorists, not punish them. Your engine dying is not a criminal act. If required, the tow truck delivers your car to the mechanic, where it can be fixed. Would it be inconvenient? Yes, certainly. Would it be worth a panic attack? No. Hundreds of cars are dying in traffic all across the world right now. The police know what to do…it’s just part of their job, and not even the most stressful part, not like chasing bandits on foot through dark alleys. So if and when your engine dies, the police will be happy to help you, if it comes to that.

As shown by the example, clients with catastrophic anxiety tend to 1) overestimate the probability that something terrible with happen, and 2) overestimate the severity when it does. In the example above, the client was doing both. When not in the grips of these catastrophic thoughts, the patient knew her conclusion was completely irrational.

Making an Inventory of Catastrophic Thoughts

Because entire sequences of catastrophic thoughts occur in milliseconds, they often happen below the level of conscious awareness. Such thoughts become a habit, and the accompanying feelings of dread may seem to come from out of nowhere. The first step in combating this habit is to bring awareness to it.

Dispute Catastrophic Thoughts Rationally

The next step is to dispute the catastrophic thoughts rationally. While you can’t predict the future with absolute certainty, you can usually estimate the odds. For example, you could ask, “What are the actual odds that the engine will die?” or “If the engine does die, what are the actual odds that I’ll lose my house?” or “If I lose my house, what are the actual odds that I’ll end up homeless?”

Defusing Chains of Catastrophic Thoughts

You can defuse the chain of catastrophic thoughts by creating a deliberate gap, by pausing, and by focusing your mind on the moment instead of allowing it to race ahead.

Exposure to Catastrophic Thoughts

The final step is to willingly expose yourself to the thoughts, and to the sensations of panic they induce, again and again, until you become desensitized. You could repeat to yourself, “Even if the worst should happen, even if the engine does die, I can handle it.”


Reading Comprehension Questions

1. What is a common characteristic of individuals who engage in catastrophic thinking?

  • A. They tend to underestimate the severity of potential outcomes.
  • B. They usually predict outcomes with high accuracy.
  • C. They often overestimate the probability and severity of negative outcomes.
  • D. They frequently underestimate the probability of negative outcomes.

2. What are the steps to combat catastrophic thinking as outlined in the document?

  • A. Buying a new car, changing jobs, moving to a new city
  • B. Bringing awareness to it, disputing the thoughts rationally, defusing the chain of thoughts, and exposure to the thoughts
  • C. Ignoring the thoughts, distracting oneself with other activities, sleeping more
  • D. Taking deep breaths, meditating, practicing yoga

3. What is the purpose of exposure to catastrophic thoughts as a part of the process?

  • A. To increase the frequency of these thoughts.
  • B. To become desensitized to these thoughts and the sensations of panic they induce.
  • C. To validate the catastrophic thinking.
  • D. To give up and accept the catastrophic thinking as a part of life.

4. What does the cab driver example illustrate about catastrophic thoughts?

  • A. That it’s possible for an engine to die at a stoplight.
  • B. That people with catastrophic thoughts can overestimate the likelihood and severity of negative outcomes.
  • C. That cab drivers are more likely to have catastrophic thoughts.
  • D. That the police are not helpful in these situations.

5. What is the goal of disputing catastrophic thoughts rationally?

  • A. To ignore the thoughts completely.
  • B. To suppress the feelings associated with these thoughts.
  • C. To accurately assess the odds of the feared outcome actually happening.
  • D. To convince oneself that the feared outcome will happen.

Answers

1. C. They often overestimate the probability and severity of negative outcomes.

2. B. Bringing awareness to it, disputing the thoughts rationally, defusing the chain of thoughts, and exposure to the thoughts

3. B. To become desensitized to these thoughts and the sensations of panic they induce.

4. B. That people with catastrophic thoughts can overestimate the likelihood and severity of negative outcomes.

5. C. To accurately assess the odds of the feared outcome actually happening.