Catastrophizing cognitive distortion: Worksheet and examples
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The catastrophizing cognitive distortion keeps clients stuck in patterns of unhelpful thinking and behavior.
This guide to the catastrophizing cognitive distortion gives therapists an overview of catastrophizing in psychology, along with catastrophizing examples that may arise in different scenarios.
You can also download a free CBT catastrophizing worksheet that you can save to your electronic health record (EHR) and share with clients.
What is catastrophizing?
In cognitive behavioral therapy (CBT), catastrophizing is a type of distorted thinking.
These thought distortions create a negative bias in how we interpret our experiences. When someone has a catastrophic thought distortion, they expect and worry about the worst possible outcomes.
Over time, catastrophic thinking can contribute to mental health problems like anxiety and depression. The catastrophizing cognitive distortion can even exacerbate pain and feelings of hopelessness about pain.
People who catastrophize may exhibit the following characteristics:
Future-oriented
Catastrophic thinkers spend time worrying about a situation that takes them away from engaging in the present moment, reducing opportunities for enjoyment.
Exaggeration of consequences
People who catastrophize often think of situations in the worst terms, blowing things out of proportion. They might anticipate future events as “a complete disaster” with no evidence supporting that statement.
Dismissive of other outcomes
By focusing on the worst possible scenario, catastrophic thinkers dismiss the possibility of other positive or neutral outcomes and overlook other plausible explanations.
Preoccupation
People who experience the catastrophizing cognitive distortion will become preoccupied with worst-possible scenarios, which can exacerbate stress, anxiety, panic, and depression.
Predictor of pain
Catastrophizing is associated with adverse pain-related outcomes and contributes to pain-related distress, and is also a predictor of pain intensity and disability.
People who catastrophize do so for several reasons. Individuals with a trauma history may have a heightened sense of danger, making them more likely to perceive a situation as threatening because it may remind them of their past experiences.
Individuals who grew up in a household with high standards may be more prone to perfectionism, thinking anything less than perfect will be disastrous.
Whatever the reason, observing the catastrophizing cognitive distortion in clients indicates a need to strengthen the client’s coping skills, which will allow them to better manage uncertainty and navigate difficult situations and challenges.
Catastrophizing examples
The catastrophizing cognitive distortion manifests in various contexts and situations.
Some catastrophizing examples include:
Relationship catastrophizing examples
- “They didn’t respond to my message immediately, but I know they read it. I must have done something to upset them.”
- “My friend didn’t invite me to their work party as their plus one like they did last year. They must not want to be friends with me anymore.”
- “My partner isn’t as attentive as they used to be. They must want to get a divorce.”
- “They canceled dinner plans. They must want to break up.”
Work catastrophizing examples
- “If I mess up this project, I’ll get fired.”
- “I forgot to email my colleague back. They will think I’m unreliable and don’t care about my job.”
- “I can’t believe I made a mistake on that report. The entire team must think I’m stupid and should quit.”
- “I wasn’t invited to that meeting, so my boss must be planning to replace me.”
Health-related catastrophizing examples
- “I’ve had this stomachache for two months now. It must be cancer.”
- “My heart rate went up when I got up from my chair. I’m going to have a heart attack.”
- “If I slip in the snow, I’ll break a bone.”
Life-related catastrophizing examples
- “I see clouds in the sky. It will end up raining all day and ruin our vacation.”
- “I can’t find my wallet. I will be late for my appointment, and I bet I’ll have to wait three months for another one.”
- “If I don’t pass this exam, I won’t get this job and will have to give up my dreams of working as a …”
Using the catastrophizing cognitive distortion worksheet
The catastrophizing cognitive distortion worksheet is a versatile therapeutic tool that can be used in several ways:
- In-session psychoeducation:
- Use during therapy sessions to teach clients about thought distortions
- Help clients identify their catastrophic thinking patterns
- Demonstrate the relationship between thoughts and well-being
- Client self-monitoring:
- Clients can take the worksheet home for self-reflection
- Serves as a reminder of catastrophizing examples
- Helps track thought patterns between sessions
- Assessment and history-taking:
- Assists in understanding the client's background
- Helps identify potential causes of catastrophic thinking
- Guides treatment planning and intervention strategies
The catastrophizing cognitive distortion worksheet can help clients recognize their thought distortions and develop more balanced thinking patterns while providing therapists with valuable clinical insights.
Sources
- Cox, A. R. (2021). "It's all in your head": Managing catastrophizing before it becomes a catastrophe.
- Pike, A. C., Serfaty, J. R., & Robinson, O. J. (2021). The development and psychometric properties of a self-report Catastrophizing Questionnaire.
- Simic K, Savic B, Knezevic N.N. (2024). Pain Catastrophizing: How Far Have We Come.
- Sokol, L., & Fox, M. G. (2020). The Comprehensive Clinician’s Guide to Cognitive Behavioral Therapy. PESI.
- Stanos, S. P., Tyburski, M. D., & Harden, R. N. (2021). Chronic pain.
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