Catastrophising: Nuance is needed

The last two posts I’ve written here and here have explored differing perspectives and current debate about the term catastrophising – and I hope I’ve been clear that I don’t dispute the usefulness of (or the accumulated data about) a construct that is associated with poor outcomes across so many pain experiences. I just don’t find the term and its definition lands well with people living with pain, and the way it’s discussed amongst some clinicians is problematic. This post is my take on a nuanced approach. The term catastrophising is defined as ‘an exaggerated negative mental set’ (Sullivan et al., 2001). Exaggerated, according to Oxford Languages dictionary, means ‘regarded or represented as larger, better, or worse than in reality.’ This means someone, somewhere needs to define ‘reality’. The argument presented by Crombez et al., (2024) is based on the complete lack of external referent for how someone should experience their pain. Pain is, as we all accept, a subjective experience. We have no external referent for how pain ought to be experienced: its intensity, qualities and meaning are individual. What we do have are inferences about ‘how bad’ pain is based on what we observe in another person, and our interpretation of what we might be like in the same situation. In other words, we use social cues, compare these with our social norms, and make a judgement. Given we know that wom...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Uncategorized catastrophising catastrophizing Chronic pain Health pain management Research Source Type: blogs