Decatastrophizing worksheet

Catastrophizing means believing the worst possible outcome will happen, even when it is very unlikely. A psychologist at Cleveland Clinic suggests coming up with alternatives to your worst-case scenario, so you have a middle ground to stand on.

The NHS lists always expecting the worst outcome from any situation as one kind of unhelpful thought. To check a thought like that, it suggests asking how likely the outcome you are worried about is, whether there is good evidence for it, and whether there are other possible outcomes.

The worksheet gives each outcome its own box. The worst case stays on the page; you are not asked to talk yourself out of it. It just stops being the only outcome you have written down.

1. Write the worry in one line, as a question if that is how it sounds in your head: “What if…?”
2. Write the worst case in full: what happens, and what happens after that.
3. Write the best case: the other end of the range, not what you expect.
4. Write what is most likely, in words. Think of how things like this have gone before.
5. Write how you would cope if the worst did happen: what you would do first, and who you would call.
6. Pick one small thing to do today, or decide to leave it until tomorrow.

For example: “What if I mess up the presentation?” Worst: I freeze and my manager doubts me. Best: it goes well and starts a good discussion. Most likely: I am nervous for the first minute, then get through it. If the worst happened: I would send the slides by email and talk it through with my manager the next day. Today: run through the first two slides out loud once.

Health anxiety is when worrying that you are ill, or will become ill, takes up so much time that it starts to take over your life. It can include checking your body for signs of illness and asking people for reassurance that you are not ill. The NHS suggests seeing a GP if worries about your health stop you leading a normal life, or if self-help is not working.

If your worst case is about a symptom or an illness, this sheet is not the right kind of help: see “When to get help” below. The same goes for unwanted thoughts that keep pushing you to check or ask for reassurance.