Controlling your Catastrophizer

Controlling your Catastrophizer
Suffering equals pain x resistance
A few years ago, a good friend, let’s call her Leia, started on a journey of pain and suffering. It didn’t go away. She went from physiotherapists to doctors, back to physios and back to her general practitioner. Over 2 months, she struggled to find a diagnosis. Then she started losing weight, had unexplained joint pain in joints from her knee to her baby finger and then her sacro-illiac joint. Over this time, I saw her battle with insomnia, depression and fear. She didn’t know what was happening, and I didn’t realize how much it was impacting her until this one conversation I can clearly still remember.

Me: “So, what do you think it is?”

Leia: “I’m not sure…I’m just worried”

Me: “worried about what?”

Leia: “…I think it might be something really serious.”

Me: “serious as in…?”

Leia: “I’m worried it’s something like cancer.”

Fears around your pain
Life threatening diseases. These are the kinds of fears that go through your head when you’re experiencing ongoing pain without an answer. Your limbic system is activated – fear responses are produced when the amygdala and hypothalamus in the brain are activated. That’s normal but often does not help us. It’s scary. It’s not necessarily based in local physiology either. She might think she has cancer, but there aren’t any physiological signs. In this case, she had already been seen by her G.P., her physio and consulted a family of medical professionals. We didn’t think she had cancer, she didn’t have the textbook signs of it. But as someone who is confused, scared, worried and in pain, your mind takes you everywhere. And it can be terrifying.

Your mind rushes headlong to the worst possible outcome, and you think about it over and over and over again. You feel helpless because nothing you do has helped. You might even play back in your mind when it first started, trying desperately to find an answer and maybe even blaming yourself or your loved ones. This is your resistance to your pain. This resistance increases your pain experience.

How your fears impact your pain
And believe it or not, these kinds of thoughts make your pain worse. Your thoughts impact how you feel. It may not be what has happened to you that causes you to become anxious, but rather what you tell yourself about what has happened and what is to come. These thoughts often happen automatically. You get tangled up in these thoughts. We actually believe our thoughts. Instead of recognizing back pain, you think you might have.

Your body-mind responds to this. It thinks it is under serious threat and it ramps up your self-protection system of flight or fight. This is the source of emotions such as anger, fear and anxiety. This kind of response can be extremely helpful in real life-threatening situations, but not that helpful in situations where there is a perceived threat, but no real, life-threatening threat. The anxiety fuels negative thinking, such as “I think I’m going to die”, and this, in turn, fuels more anxiety and stress. We know that pain ‘catastrophizing’, as it is called in the scientific literature, has been found to intensify the experience of pain and depression and that stress can negatively impact our health.

What can you do about it?

It can be really tough to emerge from the fog of difficult thoughts and see clearly, but the main thing to remember here is that we are so much more than our thoughts or our emotions.

Notice your thoughts and emotions
Thoughts and emotions come and go like the tides in the ocean. A storm may come, and create waves of uncertainty and despair, but even so, the deep, crystal-clear blue sea is still there. In other words, noticing our thoughts and feelings can help us to navigate this storm so that we can find the space to reveal what’s truly happening. It’s not about ignoring our thoughts and emotions or just staying positive. It’s being able to notice our thoughts, name the emotion that’s coming up, such as “that’s fear”, and coming back to the moment. These negative emotions are often the resistance that is increasing your suffering during your pain experience. Therefore, no matter who you are, or your health status, when painful thoughts come and go, you don’t have to believe them or ride the storm of fear that these emotions can take you on.

See a Healthcare provider
Share you concerns with your healthcare provider. Your G.P or physiotherapist will be able to take action to find out what is going on. This can be very reassuring and help to set the mind at rest. Remember, all your concerns are valid and pain is a subjective experience. It’s as painful as you say it is. Most importantly, a physiotherapist who specializes in pain understands bodily processes, and knows how integrated your mind, feelings and thoughts are in your experience.

Resistance to your pain increases your suffering. To get around this, start to notice your thoughts and emotions. Seek advice from someone who specializes in pain, they can do a world of good.