Many people with PTSD experience frequent cognitive distortions, such as catastrophic thinking. Cognitive distortions refer to unpleasant thoughts that are extreme, exaggerated, and/or not consistent with what is actually going on in the real world. As a result, cognitive distortions can have a negative influence on our mood and eventually lead to unhealthy behaviors. Catastrophic thinking in particular refers to a tendency to expect the worst to happen without considering other alternative outcomes that are more likely to happen.
For example, someone with PTSD may have the thought that if she goes out on a date, she will be assaulted again. Although this outcome could occur, it's extremely unlikely. There are many other, more less extreme outcomes that would more likely occur. For instance, the date may go very well or the date may be boring and unpleasant. But when someone struggles with catastrophic thoughts, she generally don't consider or connect with these other possibilities. Instead, her mind conjures up the worst-case scenario, understandably leading to considerable anxiety and distress. This anxiety and distress would then have the high likelihood of causing someone to not go out on the date.
How Do Catastrophic Thoughts Develop?
It would make sense that someone would develop catastrophic thoughts following exposure to a traumatic event. After someone experiences a traumatic event, he receives verification that the worst can actually happen. A traumatic event destroys assumptions that we often make about the world, such as that the world is a safe place, or "it won't ever happen to us."
After a traumatic event, our body and mind try to ensure that we will never be placed in a dangerous situation again, and it tries to prepare us for future traumatic events. One way it might do this is by bringing up catastrophic thoughts. Unfortunately, these catastrophic thoughts don't present all other possible options — they only present the worst possible case. As a result, these thoughts can be paralyzing, leading to extreme anxiety, avoidance, and isolation. They may make a person feel as though he is constantly in danger and nothing is safe.
Managing Catastrophic Thoughts
Catastrophic thoughts can be debilitating. Fortunately, there are steps you can take to address catastrophic thoughts.
The first step in addressing unhealthy thoughts is knowing when you have them. Self-monitoring can be an excellent way of increasing awareness of your thoughts, and how they impact your mood and behaviors.
Next, you want to take steps to move your thinking away from extremes, and to consider other options. So it can be helpful to ask yourself some of the following questions:
- What evidence do I have for this thought?
- What evidence do I have against this thought?
- Are there times when this thought hasn't been true?
- Do I have this kind of thought when I'm feeling OK as opposed to feeling sad, angry, or anxious?
- What would I tell someone else who was having this kind of thought?
- Is it possible that I'm having this thought just out of habit?
- What might be an alternative, more realistic explanation?
Asking yourself these types of questions can help break the habit of catastrophic thinking and help you be more flexible in your thinking. In the end, this could reduce your anxiety, or prevent your anxiety from getting worse.
In addition, it may also be helpful to practice mindfulness of your thoughts. That is, when you notice that you are having a catastrophic thought, simply view the thought as just a thought, and nothing else. It's just something your mind does when you're feeling a certain way, or are faced with a certain situation. It's a habit and not an indication of truth. Taking a step back from your thoughts can help diminish their power over your mood.
Finally, you may want to go out and actually test your thoughts. Similar to exposure therapy, you would want to slowly approach the situations that you fear. Doing so can dis-confirm your catastrophic thoughts, reducing the extent to which they seem true. You can learn more about how to break down avoidance behaviors and counter catastrophic thoughts through this step-by-step approach.
Addressing Catastrophic Thoughts Through Treatment
If you find that you're having frequent catastrophic thoughts, you may find it helpful to address those thoughts with a cognitive-behavioral therapist. Cognitive-behavior therapy places a big emphasis on the thoughts we have and how those thoughts influence our emotions and behaviors. There are several websites that can help you find cognitive behavioral treatment providers in your area.
Beck, J.S. (1995). Cognitive Therapy. New York, NY: Guilford Press.