ways of coping with upsetting thoughts and memories

People with posttraumatic stress disorder (PTSD) often experience cognitive distortions such as catastrophic thinking–a tendency to expect the worst to happen without considering other possibilities.

Cognitive distortions are extreme, exaggerated thoughts that don’t match up with the reality of a situation.

For example, a woman with PTSD who was traumatized by rape may have the catastrophic thought that if she goes out on a date, she will be assaulted again.

Although that could occur, it’s much more likely that the date will not feature anything upsetting–it could even go well. But people who struggle with catastrophic thinking typically don’t even consider that anything but the worst could happen. Understandably, focusing on the worst-case scenario leads to a good deal of anxiety and stress–and in this case, could cause the woman to refuse the date.

Living through a traumatic event destroys positive beliefs that people typically have about the world, such as that they’re safe from deliberate harm or, after someone else’s traumatic event, that “This can’t ever happen to me.” So it makes sense that someone with PTSD might fall into catastrophic thinking after exposure to a traumatic event: The trauma is viewed as proof that the worst actually can happen–and seen as a sign that only traumatic events will happen from now on.

No other possible outcomes are even considered.

As time goes on, catastrophic thinking develops into a day-to-day coping strategy designed to help ensure that the person will never be placed in a dangerous situation again. But having catastrophic thoughts over and over can be paralyzing, leading to extreme anxiety, avoidance, and isolation.

This may have the effect of undermining the coping strategy. How? By bringing back the person’s sense of being constantly in danger and not safe anywhere.