Do you often find yourself catastrophizing?
That is, do you ask yourself “What If?” questions and assume that the worst possible outcome is bound to occur?
This was the case for my patient, Hannah (note: names and details of patients have been changed for privacy reasons). Hannah had a history of “What If?” ing and catastrophizing. Recently, she was extremely worried that her son, Carter, would not be accepted into any of the colleges he applied to and would be consigned to “living in [her] basement.”
I encouraged Hannah, as I encourage all of my patients who are catastrophizing, to use the CBT strategy of asking herself these three questions:
- What is the worst-case scenario?
- What is a more realistic scenario?
- If the worst-case scenario does come to pass, what would I do to manage it?
Here are Hannah’s responses:
- Worst-case scenario: Carter is rejected from all colleges
- Realistic scenario: Carter does not get accepted to any of his top choice schools, but he gets into one or more schools
- How I would manage: If Carter is rejected from all schools, we would all be devastated at first. But I know of several kids who did a “gap year” between high school and college, which allowed them to do things that made them more competitive candidates for college. We could support Carter in finding an opportunity he’s passionate about that might help his application for the second go-round. We would not allow him to play video games in our basement all year.
Using the CBT worst-case scenario strategy helped Hannah realize that she would be able to cope effectively, even if the “worst-case” were to occur.
It’s important to note that the “worst-case scenario” technique is particularly effective for the more mundane, daily worries that many of us experience. It’s less helpful when catastrophizing about a seriously horrific outcome (for example, dying. It’s hard to think about how you’d manage that.) Good news though: there are other CBT techniques to help you with worries like that. And we’ll get to those later posts. Stay tuned!
Thoughts? Questions? Comments about CBT? Contact me here!
