Managing Catastrophic Thinking in PTSD

Managing Catastrophic Thinking in PTSD PTSD Coping Print Managing Catastrophic Thinking in PTSD By Matthew Tull, PhD twitter Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. Learn about our editorial policy Matthew Tull, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on June 24, 2019 Post-Traumatic Stress Disorder Overview Symptoms & Diagnosis Causes & Risk Factors Treatment Living With In Children Marc Dufresne / Getty Images People with posttraumatic stress disorder (PTSD) often experience cognitive distortions such as catastrophic thinkingâ€"a tendency to expect the worst to happen without considering other possibilities. Cognitive distortions are extreme, exaggerated thoughts that dont match up with the reality of a situation. For example, a woman with  PTSD who was traumatized by rape may have the catastrophic thought that if she goes out on a date, she will be assaulted again. Although that could occur, its much more likely that the date will not feature anything upsettingâ€"it could even go well. But people who struggle with catastrophic thinking typically dont even consider that anything but the worst could happen. Understandably, focusing on the worst-case scenario leads to a good deal of anxiety and stressâ€"and in this case, could cause the woman to refuse the date. How Catastrophic Thinking Develops Living through a traumatic event destroys positive beliefs that people typically have about the world, such as that theyre safe from deliberate harm or, after someone elses traumatic event, that This cant ever happen to me. So it makes sense that someone with PTSD might fall into catastrophic thinking after exposure to a traumatic event: The trauma is viewed as proof that the worst actually can happenâ€"and seen as a sign that only traumatic events will happen from now on. No other possible outcomes are even considered. As time goes on, catastrophic thinking develops into a day-to-day coping strategy designed to help ensure that the person will never be placed in a dangerous situation again. But having catastrophic thoughts over and over can be paralyzing, leading to extreme anxiety, avoidance, and isolation. This may have the effect of undermining the coping strategy. How? By bringing back the persons sense of being constantly in danger and not safe anywhere. How to Manage The first step in managing catastrophic thoughts is knowing when you have them. Self-monitoring can be an excellent way of increasing awareness of your thoughts and the effects they have on your mood and actions. Next, take steps to move your thinking away from extremes. Allow yourself to consider other options. When catastrophic thinking starts, it may be helpful to ask yourself these questions: What evidence do I have that this thought is realistic?What evidence do I have that it isnt?Have there been times when Ive had this thought and it didnt come true?Do I have this kind of thought when Im feeling okay, or when I feel sad, angry, or anxious?What would I tell someone else who was having this thought?Is it possible that Im having this thought just out of habit?What might be a different, more realistic thought in this situation? Asking yourself these types of questions can help you break the habit of catastrophic thinking by learning to be more flexible in considering your options. Youll know youre succeeding when you feel that 1) youre not as anxious as you were before or 2) your anxiety isnt getting any worse. It may also help if you practice mindfulness about your thoughts, which can help weaken their power over your mood. Its easy: When you notice that youre having a catastrophic thought, simply view it as just a thought, nothing elseâ€"just something your mind does when youre feeling a certain way or are faced with a certain situation. Just a habit. You may decide to go out and test how well youre managing your catastrophic thinking. Similar to exposure therapy, the idea is to slowly approach the situations that brought up catastrophic thoughts in the past and see what happens now. If you dont have such thoughts, or they arent as strong and threatening as before, youll know youre making progress. Manage Symptoms With the 9 Best Online Therapy Programs Getting Treatment If you have many catastrophic thoughts, you may find it helpful to discuss them with a cognitive behavioral therapist. Cognitive-behavior therapy places a strong emphasis on the thoughts people have and how those thoughts influence their emotions and behaviors.