How to Avoid Pain Catastrophizing

How to Avoid Pain Catastrophizing

The Source of Pain Catastrophizing and How to Overcome It

The term “catastrophizing” refers to a specific sort of pain reaction, one that is closely related to anxiety and its effects on the psyche. It involves dwelling on the worst-case scenario or fixating on a terrible outcome to a potentially threatening situation (a catastrophe), which leaves you feeling vulnerable and afraid.

Catastrophizing pain tends to exaggerate physical sensations in the body, leading many people to describe the pain as intolerable. As long as there is pain, there is a good chance of panic, so the tendency to catastrophize can have a serious and continuous effect if you live with a chronic pain disorder like fibromyalgia.

Causes of Pain Catastrophizing in Fibromyalgia

Since pain and descriptions of pain are generally subjective, it can be difficult to pin down a cause, the severity, and the best way to overcome pain intolerance. The first step is to find out where the urge to catastrophize pain stems from, and when you may be at risk:

  • Depression and anxiety. These emotional conditions, common in fibromyalgia, inspire negative thoughts that can quickly spiral out of control. Since catastrophizing is an expression of severe anxiety, it almost certainly will occur in sufferers that already struggle with some anxiety or depressive issues.
  • Personality. People who struggle with neuroticism — a tendency to remain in a negative emotional state for long periods of time — may be prone to catastrophizing, as will people who tend to worry a lot and lack confidence in problem-solving skills. Studies have also shown that a person’s personal beliefs about pain can affect the extent of their reaction to it, too.
  • Situational triggers. While some people may be naturally disposed to catastrophizing pain, certain situations can also contribute to this extreme reaction. Social situations, environmental cues or circumstances that cause more pain can lead to catastrophizing, even in people who are not prone to anxious responses.

The Challenges Catastrophizing Pain Poses to Treatment and Control

The emotional and psychological processes behind catastrophizing pain can complicate fibromyalgia treatment, since stress accounts for so much physical discomfort among patients. If you can’t shake the stressful worry, fear or negative thoughts, traditional approaches to pain relief could become even less effective.


Although pharmaceuticals might be able to provide some relief, treatment for pain catastrophizing should address more than the physical causes. Since the disorder also rests on personality and situational triggers, cognitive behavior therapy might be a better approach to treatment:

  • Sharing coping strategies in group sessions can be indispensable to catastrophizing pain treatment. Learning how to control your feelings in a supportive environment can give you a boost in confidence and the reassurance you need to suppress damaging negative emotions.
  • Exposure therapy, or exposing the patient to the threat or task they fear most, can be a difficult yet very helpful process. Repeatedly viewing visual representations of the fearful activity can eventually reduce your pain catastrophizing as your mind adjusts. The goal is to diminish or eliminate your fear of the activity or consequence so you can more easily avoid severe emotional distress in your daily life.

Fibromyalgia is still one of the most mysterious chronic pain disorders, but recent studies have uncovered some important connections between the brain, the body and painful sensations. The psychological element of the disease can be difficult to treat, but if you can learn to improve your emotional reactions and control your behavior, your mind can be one of your most effective allies in your battle against chronic pain.

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by Angela Finlay on July 28, 2014
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