Takeaway
With the constant barrage of negative news, our brains can get caught in unhelpful thought patterns. We can share tools with patients to instill more adaptive ways of thinking.
Lifelong Learning in Clinical Excellence | September 8, 2025 | 2 min read
By Neda Gould, PhD, Johns Hopkins Medicine
In one of the beautifully written Winnie-the-Pooh stories, Pooh and Piglet have the following exchange:
“Supposing a tree fell down, Pooh, when we were underneath it?”
“Supposing it didn’t,” said Pooh after careful thought.
Piglet was comforted by this.
—A.A. Milne
It’s interesting how, given the same situation, some people (and bears and piglets) can focus on the positive while others can come up with a myriad of catastrophes. In psychology, the latter is often called catastrophic thinking. The constant barrage of negative news and uncertainty in the world has, understandably, made this type of thinking more common. While it can be evolutionarily adaptive to be aware of potential threats, constantly thinking of worst-case scenarios can be exhausting. Sharing the following tips with patients (and with ourselves) can help contain these maladaptive thought patterns:
1. Label the thoughts.
The simple tool of noting when we are caught up in these thought patterns allows us to step away from them. You may say to yourself “Hello, catastrophic thought. I was expecting you!”
2. Challenge the thoughts.
As a next step, you can begin to challenge these thoughts. As Pooh so wisely states, consider if there are alternatives to the catastrophic situation. Ask yourself if there is a more balanced outcome. List a couple of these alternatives.
3. Use “Worry Time”
Block off a period (or two) of 10 to 20 minutes a day to write down all your worries (and possible solutions if there are any). For the remainder of the day, redirect your mind to the activities you’re engaged in. In this way you can compartmentalize the worry to some degree.
4. Note what is in your control and what is not.
When your mind focuses on what you can’t control, come back to what you can do.
5. Practice mindfulness.
Mindfulness can be a very useful strategy to return to the present moment when the mind begins to get caught up in negative thought cycles. Take a few deep breaths and notice your senses to ground yourself back into this moment.
If the catastrophic thinking persists despite regular practice of these strategies and interferes with quality of life, consider Cognitive-Behavioral Therapy (CBT). This is a relatively short-term, goal focused treatment approach that focuses more intently on changing unhelpful thought patterns and building effective coping strategies.
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This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.