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Catastrophizing - Big Word, Big Stress

Last updated: December 2022

Catastrophizing. Oh boy, that’s a big word. A big, scary, word. Of course, as blood cancer patients we should probably be used to scary words, “cancer” being the big daddy of them all. But it never quite goes away – that feeling of dread and weightiness that comes with words like “cancer” and “catastrophizing.” Well, that quasi-onomatopoeic (talk about big words) effect is dead on in this case because catastrophizing is not only a scary word, but the real world effects can be scary as well.

Thinking the worst is going to happen

Blood cancer is like living with a very quiet, very annoying, sometimes terrifying roommate who doesn’t always make trouble but when they do, oh boy, watch the heck out! The problem is, you can’t evict them because they technically never leave you even if they disappear for years.

You just never know when they are going to show up and suddenly that special turkey pot pie your mom made that you put in the fridge and clearly marked with your name simply… disappears! Later on, blood-cancer walks in and says they ate an amazing pot pie for lunch and asks if they can have the recipe for “Dan’s Turkey Pot Pie.”  Uhh, metaphorically.

So of course, we always think the worst is going to happen – it literally already did when they told us we had cancer!

In fact, after a few years of blood-cancer, I feel like you’d be silly if you didn’t consider the worst possible scenario in every case.

Round and round and never ending

Well, folks, that’s catastrophizing, and it can have a fairly significant outcome on your mental state, which, in turn, can affect your physical state (as stress often does), and round and round we go on the carousel of stress and pain with no end in sight. It’s not one of those fun merry-go-rounds either, where you can grab a brass ring and win prizes, unless the prize is chemotherapy, and no one wants that. I’d rather have the plastic spider ring.

No, this is a scary and poorly lighted carousel with rusty screws and jagged edges and nary a seat belt in sight. Plus, the calliope plays death metal at volumes that would make Ozzy Osbourne ask for earplugs. Yeah, it’s a disaster and something you want to avoid at all costs. Again, metaphorically. We are really going bonkers with the analogies today.

Minimizing catastrophizing

So, the goal is to lessen the catastrophizing and the stress it causes which can directly affect your cancer outcome. How do we do that? Well, I have two methods I’d like to share but before I do, let me put in the required disclaimer. I, in no way, consider myself a Zen master or some sort of relaxation guru, but I have been using these techniques I’ve honed over years for a long time now, and those I’ve shared them with seem to generally approve of the results. Just want to make sure we all know where we are coming from so that no one sues me for metaphorical misrepresentation of a carousel.

Playing the "what if" game

The first technique I have developed to help combat catastrophizing is what I call the “what if,” game. Say you have a PET scan or blood test coming up, and we all know how scanxiety is. Cancer, especially the blood kind, relies on numbers and scans to tell us how it’s going. Because tests are likely going to cause some stress, there’s a fair to good chance that you’re going to assume the results will be bad. To combat this, take a few minutes and ask yourself “What if?”

  • “What if my numbers are bad or the scan shows activity?” Ok, well, before I freak out I’ll see what the doctor thinks, and we’ll make a plan to move forward.
  • “What if my chemo makes me have brain fog during the appointment and I can’t remember things?” You know what, I’ll make a little cheat sheet I can take with me just in case.
  • “What if I feel like crap and I miss the appointment entirely?” Well, that won’t be great, but it won’t be the end of the world either. I can possibly reschedule or maybe even skip it till next time.

You see what I’m doing? Imagining some of the things that could happen and making a plan for that scenario. The scariest thing you can face is the unknown, so by putting a name to the fear and planning, it somehow becomes less frightening.

Staying practical

The second thing you can do is make sure you’re not taking on something that is impractical for your illness. In short – don’t set yourself up to fail.

Let’s face the facts here folks, if you have cancer and especially if you are currently in active chemo, you aren’t going to be able to do the things you used to.

If your child’s birthday is coming up and you want to plan the whole thing like you usually do, well, you’re going to have to be realistic. If you try to do it it’s going to cause stress, which is going to affect your illness, which, in turn, is going to lead to thoughts of doom and gloom and all the things that could go wrong. You are, quite literally, walking yourself into the pitfall of setting yourself up for the perfect conditions to catastrophize. Just…. don’t.

These are the two main rules I follow and after years of practice, it usually works. Mind you, it’s not going to happen overnight, you’ll need to get better at it just like anything else new, but it will help. Along with reminding yourself that most things aren’t the end of the world, and that if the worst does happen and you die you won’t care because you’ll be dead (silly but true), you can combat catastrophizing the stress triggers that come with it. Talk soon.

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