This week’s topic in my Critical and Creative Thinking class is stress and stress-relieving exercises. I get a kick out of the table of thought distortions brought on by stress from Challenging and changing stress-producing thinking by Felice E Miller published in the Western Journal of Medicine, 2001 January; 174 (1): 49–50.

“Catastrophizing” also reminds me of old woman in the film Underground that continually says “It’s a catastrophe!” (or “katastrofa” because it’s Serbo-Croatian/BCE)—which my girlfriend and I like to repeat ad naseum.

Table 1

Common thought distortions and how to challenge them

_ Distortion _
_ Challenge _
Magnification or minimization
Overemphasizing or underemphasizing one aspect of the situation: “I didn’t check out with the patient if he understood the reason for the medication”; overlooking other factors that may be important
Using black and white thinking: “My colleagues are going to think I am incompetent”; are there shades of gray?
Taking the situation personally and ignoring the total picture: “It’s my fault”; what would I say to a colleague in the same position?
Stress-producing language
Using words such as should, have to, must, need rather than would like, want: “I should never make a mistake”
Pessimistic thinking
Thinking of the situation as permanent, pervasive, and personal: “I’m never going to have the respect of my colleagues” or “I’m not suited to this profession”; rather than temporary, specific, and related to factors beside myself 3
Is this unfortunate incident a catastrophe: “I’m going to be sued”; if the bad outcome happened, what would/would not be the consequences, and could I handle them?

West J Med. 2001 January; 174(1): 49–50.