How to Get Out of Catastrophizing Chronic Pain

Tord Helsingeng
4 min readMay 7, 2021
Photo by Milada Vigerova on Unsplash

One of the biggest challenges with chronic pain is what we call pain catastrophizing. Catastrophizing chronic pain has many negative consequences that can severely affect quality of life. The good news is that catastrophizing can be turned into improved coping skills.

The elements of pain catastrophizing

During pain catastrophizing, you experience the pain as a disaster, something terrible that will never end. This consists of three subconscious activities: rumination, magnification, and helplessness.

Rumination is constantly brooding about the pain. You cannot stop thinking about how severe it is; you keep wishing it would go away. With magnification, the pain takes up more space in your mind than it needs to. Magnification is subconscious, so you don’t see it as exaggeration. Helplessness regarding the pain is just what it sounds like.

If you also have unresolved psychological trauma, catastrophizing pain often leads to overactive orientation responses. Your attention is constantly drawn to the traumatic events. You can read more about important precautions for meditation in the context of post-traumatic stress in this article.

A negative spiral

When catastrophizing takes over, you often become more passive. Fear of the pain leads you to avoid anything you think might increase or prolong it, whether justified or not. And that constricts your entire life. Your body becomes less resilient. You avoid social contact and other nurturing activities, even those that might actually help you cope with the pain.

That in turn keeps you from getting positive feedback, resulting in shame, remorse, sadness, irritation, anxiety, and even depression. And that can lead to a negative spiral that maintains or even worsens the catastrophizing and its consequences.

Here is a diagram of the negative spiral that maintains catastrophizing, as well as another process that shows the way out of it.

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Tord Helsingeng

Norwegian mindfulness coach and bodyworker, specializing in chronic pain relief and stress disorders.