I have been ruminating about the way in which the people I work with – families and their loved ones experiencing substance abuse, chronic pain, mental health and process disorders – live in a land of confusing messages, confabulations and catastrophes.
When a family member calls, frantic that their loved one has maxed out credit cards from shopping, gambled their money away or lied and cheated, the caller is confused by the copious, conflicting messages their loved one has given them. “Stay away!” “I need you!” “No I did not take your money, it’s your imagination, mom!” When confusing messages like these come at you, your perception of reality can become twisted, a reversal of ideas that leaves you wondering which way is up.
In this way, the person receiving the conflicting messages may catastrophize, or believe things will never get better, or that the worst possible thing could happen. “I will never have another client” or “my loved one will never speak to me again” are common narratives that play in the mind. As such, the mind will play tricks on the person, in which perception and reality bleed into each other.
Catastrophizing, a term in behavioral science used to describe the inventions in the mind when stress, emotions, and trauma play tricks on the person, is the mind jumping to the worst possible outcome. “Making a mountain out of a molehill,” as an old friend used to tell me. And unfortunately this type of mental health issue may have an adverse impact on present situations or even future goals.
“Falling prey to catastrophizing is like striking out in your mind before you even get to the plate,” writes John Grohol, a psychology expert and CEO of Psych Central, an online resource for human psychology. Grohol writes that catastrophizing takes two forms: one in the present and another future-bound.
For the present, an example could take place at work. You’re the creative executive at an upscale advertising agency and haven’t signed a new account in a month. You catastrophize by irrationally assuming it’s because you’re bad at your job and incapable of signing new accounts. The pressure builds with an executive meeting at the end of the week to review company accounts, and you decide in your mind that you’ll be fired because… well, you get the picture.
The other form of catastrophizing concerns unknown future events. Perhaps you plan to visit your family for a long holiday weekend, and since you’re new in recovery, you’re worried your family will look at you differently and ask strange questions. You fear that those who knew you in your disease will not accept you in your recovery. The catastrophizing inflates so big, you begin to create a “reality” around this line of thought, in which it ruins your whole weekend and interactions with your family.
In both cases, catastrophizing puts a dour mood on everything. “It can affect our entire outlook on life, and creates a self-fulfilling prophecy of failure, disappointment and underachievement,” says Grohol.
As an interventionist and clinician, I work with clients who describe these kinds of thoughts in great detail. It’s not uncommon to doubt and catastrophize. The truth is catastrophizing, at its core, is a defense mechanism for dealing with the uncomfortable vulnerability of living in the moment and having the courage to be seen, to live our truth. In many cases, catastrophizing bubbles up due to past traumas and hurts, constructing an invisible barrier between who we are and the world out there. If we stand at the gate, mind flooded with hows, whys and what ifs, a whirling cacophony of you’re not good enough, then we don’t step into the arena and give it our all, a lost opportunity to engage with our hearts open.
Catastrophizing isn’t the only enemy. A kissing cousin is confabulations, a psychiatric term describing a person who fills gaps in their memory with false or invented memories that they believe to be true. This type of mental disturbance can influence one’s actions and beliefs about themselves and others.
Goodtherapy.org, an online resource for finding ethical therapists, writes that “mundane confabulations can be caused by extreme emotions ranging from sadness to joy.” So when you’re certain your partner or spouse is being neglectful, take time to examine how often they actually spend time with you (rather than confabulate that it’s not enough).
“However, more serious confabulations – such as the manufacture of something that never occurred – can be caused by mental illnesses such as schizophrenia, posttraumatic stress and depression,” writes Good Therapy. For instance, people who experience depression often have a difficult time remembering positive experiences. In turn, they confabulate that only bad has happened in their life.
Despite these mental tricksters, strong mental health is closely linked to a positive outlook and daily practices that ground us in living in the moment. A good exercise to combat catastrophizing and confabulating is to complete a decisional balance worksheet. I work through these with clients to help them parse perception (influenced by emotions) from reality (grounded in basic truths). In essence, this worksheet lets the user create a list of pragmatic outcomes in the event of making a change. This helps to give my clients an honest perspective, one that takes in the full picture.
Other mental health exercises like meditating, writing down thoughts and focusing on breathing patterns help to calm nerves. For confabulating, it’s important to seize the thought in your mind, evaluate it and remind yourself of the actual events that have taken place and try not to predict the future. As I tell my clients, don’t confuse the temporary for the permanent.
Learning to see the world with truth and compassion for oneself and others triggers growth, renewal and recovery. Yes we can have a relationship! Yes recovery is possible! Yes I can speak the truth! Yes I am vulnerable! Yes I can see the part I have played in the addiction cycle! Yes I am changing my behaviors! Yes I am setting healthy boundaries! Yes I am navigating a new beginning! These are the antidotes we may empower our clients with so that confabulations, catastrophizing and confusing messages take a back seat to renewal.