You may know the spiral well: It starts off as a single worry, such as how tonight’s date will go, whether you made a mistake at work or what an abnormal medical test result means. Then it takes on a life of its own. What if they don’t like me? and What if this result means something serious? become What if I never find someone? and What if I’m dying? Potential outcomes spin off into terrible futures, and next thing you know, you’re fielding some flavor of What if everything turns out terribly and nothing is ever okay?!
This emotional tailspin is what therapists call catastrophizing, a type of negative thought pattern that zeroes in on worst-case outcomes, said Joanna Arch, a clinical psychologist and professor in the psychology and neuroscience department at the University of Colorado at Boulder. “At any moment in time, there are a wide array of future possibilities and catastrophic thinking means fixating on the worst among them.”
Snapping out of that “what if” loop can feel impossible once you’re in it — in part because catastrophizing usually makes you more anxious — but it’s worth intervening. “These thoughts can spiral out of control and start to dominate our minds,” Arch said.
On top of leaving you anxious, stressed, depressed, hopeless or angry, worry has been tied to a reduced ability to feel pleasure, also known as anhedonia. Arch added that focusing on worst-case outcomes can prevent you from taking action. “When you’re in the habit of catastrophizing, everything starts to feel much harder and much less possible — it casts a negative halo over the future and zaps you of your sense of agency.”
To mitigate this impact, therapists focus on teaching chronic catastrophizers how to interrupt individual worries early, as well as addressing underlying mental health concerns more broadly.
But first, understanding why we catastrophize can set the stage for disengaging more easily.
Why we catastrophize
If fixating on the worst-case outcomes makes us feel awful, why do we do it anyway? Believe it or not, it’s your mind attempting to be helpful. One of the brain’s most important functions, Arch explained, is to keep us safe by detecting threats to our survival. “It evolved to home in on danger,” she said. The problem is, your mind can treat imagined scenarios as threats, too — which is why you may latch on to the scary what-if over more likely possibilities.
People prone to negative, repetitive thinking may also believe it serves a purpose. “They think it will prevent the bad outcome from happening or mentally prepare them if it does,” Arch said, noting that that’s rarely the case. “We don’t actually anticipate most of the bad things that happen in our lives. Or if we do, anticipation doesn’t stop them from being bad.”
Catastrophizing is often associated with anxiety disorders, obsessive-compulsive disorder, depression, post-traumatic stress disorder, traumatic brain injury, chronic pain, and other mental and physical health conditions that affect how you think and feel.
But anyone can fall into catastrophic thinking, whether they’re scrolling fear-inducing headlines or fretting about important topics such as finances, job security or personal safety. Arch noted that that has become increasingly common among her students, many of whom are concerned about the environment, the political landscape, the economy and what the future holds.
How to break the spiral
When it comes to evidence-based tools to combat catastrophizing, you have a number to choose from. Many are based in cognitive behavioral therapy, or CBT, a therapeutic intervention that targets negative thought patterns, as well as a form of it known as acceptance and commitment therapy (ACT).
Arch also recommended a newer intervention called positive affect treatment, or PAT, which is especially useful when catastrophic thinking leaves you feeling hopeless and numb. “When you flood the brain with positive experiences and anticipation of the future, it becomes much harder to dwell in catastrophizing,” she said.
Different approaches work for different people, so don’t be afraid to experiment to find what speaks to you. Arch said it’s useful to have an array of options at your disposal — some might work for certain spirals but not others, or come in handy at different times and places.
Write out the worst-case scenario
Surprisingly, giving a catastrophic thought more attention may help take away some of its power. Multiple small studies suggest that repeatedly writing out a worst-case scenario can help reduce worry. “When we get it out of our head and onto the page, it creates distance,” said Arch. And because you think faster than you write, putting pen to paper, as she recommended, can also help slow a rush of thoughts.
Aim for around 20 minutes per session and use present tense, first-person language to play out your “What if?” in as much concrete detail as possible. Say that you’re scared you’re about to be laid off and won’t find work again — what does that look like? I apply for jobs, but an offer never comes. I drain my savings as bills pile up. I fall further into debt, start missing rent payments, and have to look for a cheaper place to live. I can’t afford anywhere around me, so I consider roommates or a new city …
“Really allowing yourself to go to the absolute worst and imagining what that looks like can be very powerful for people,” Arch said. In her own research, a small pilot study of 29 adults with advanced cancer, participants who used a similar writing exercise reported reductions in fear of cancer progression and cancer-related trauma symptoms.
Get outside
“Touch grass” might sound insultingly basic compared with the size of your worries, but putting yourself in nature can yank you out of anxious thinking. Arch explained that anxiety narrows your attention as your brain zeroes in on a perceived threat. So deliberately noticing the world around you can broaden your focus and help calm the anxiety response.
“Anything that gets us outside of our own head is really helpful to breaking that cycle,” Arch said. And if you enjoy time in nature? All the better for countering feelings of numbness.
Ask ‘Why do I care?’ instead of ‘What if?’
We don’t spiral over every little anxiety — typically, it’s the stuff that matters that pulls us in. “The flip side of pain and worry is what we care about the most,” Arch said. A job flub can feel enormous when you’re passionate about what you do, and an awkward date might spell disaster if finding partnership is a top priority. It makes sense to spin out about the effects of climate change when you love the planet and young people who will inherit it.
A simple reframe can redirect your mental resources before you get sucked in. “When a worry pops up, tell yourself it’s a reminder of what’s important to you and focus on those things instead,” Arch said. That could mean responding to a catastrophic thought such as This weird stomach pain means I’m dying with My health matters a lot to me — how can I take care of my body today? “With practice, we can turn individual worries into cues to return to our values instead of cues to spiral.”
Choose — or create — something to look forward to
“One of the things that is most challenging about catastrophizing is how it doesn’t allow us to imagine a positive future or even a neutral one,” Arch said. So going out of your way to do so — from remembering concrete plans you have on the calendar to considering potential bright spots on the horizon — is a powerful way to interrupt negative thinking in the moment.
Arch suggested picking something realistic, whether it’s a dinner with a friend, a book release you can’t wait for, or a vacation you hope to take after the busy season. Then visualize it actually happening. What can you see, hear, smell or taste? What does it feel like to experience it?
This kind of positive anticipation is a component of PAT, which aims to engage the brain’s reward systems and can help restore the ability to feel pleasure.
“When we make room for other possibilities,” Arch said, “it reduces catastrophic thinking and changes our relationship to the future.”
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