The Dangers of Catastrophizing in Client Communications

Through my own journey with chronic pain, I am acutely aware of the impact language can have on your health. More specifically, I recognize the role catastrophizing plays in magnifying pain and that simple word substitutions can facilitate healing. It has also triggered a recognition that the language I use with clients may also negatively contribute to their anxiety.

Catastrophizing involves exaggerating the severity of a situation and jumping to the worst possible conclusion. As noted in the recent Psychology Today article, “Catastrophizing”:

Everyone has negative thoughts. But for many people, negative thinking can spin out of control and be disproportionate to the reality of the situation. A relatively modest error, disappointment, or source of embarrassment (or even the possibility of one) can sometimes become, in one’s mind, a cause for major fear or despair – in short, a catastrophe.[i]

In the context of chronic pain, a sufferer may tell themselves that the pain will never improve, it will only get worse and the pain will result in losing their job and family. The sufferer may use phrases to describe their pain such as ‘sharp knife’, ‘stabbing’, ‘searing’ or in my case ‘being beaten with a bat’. Numerous studies have found that this way of thinking or catastrophizing increases the severity of pain. Substituting these words with more neutral adjectives such as ‘sensation’, ‘tingly’ or ‘pulsing’ has a profoundly positive effect on pain levels.[ii]

In addition to chronic pain, several conditions such as anxiety, depression and fatigue may be also exacerbated and be more prevalent in those who catastrophize. [iii] What does this mean when your bread and butter is based on pessimism and identifying worst-case scenarios as it is in the legal profession?

There are many in the profession who embrace our tendency to catastrophize and see it as indispensable to a successful practice. As noted by one practitioner:

It’s probably why I’m a not-too-bad lawyer. I worry – all the time.

….

Catastrophizing, often seen as pessimism in everyday life, is indispensable in legal practice. It’s a form of strategic foresight that protects clients. Lawyers should lean into this character flaw but also keep it in track – try to stop worrying before going to bed.[iv]

As noted by Richard J. Landau, an experienced lawyer and clinical psychologist specializing in cognitive behavioral therapy:

Attorneys need to accurately predict outcomes and envision worst-case scenarios. Catastrophizing is their stock in trade. In this unforgiving environment, optimism can be a liability.[v]

However, Landau also warns of the danger of this thinking, particularly when it seeps into our personal lives. He offers cognitive behavioral therapy as a means for lawyers to recognize pessimism and catastrophizing as useful tools for their practice but also “a means to an end with limited applicability to healthy functioning in day-to-day life”.

While leaving these analytical tools at the office as Landau suggests is good advice, it only addresses one issue – the health of the lawyer themselves. What about our clients? Is our catastrophic thinking bleeding into our client communications and causing unnecessary harm?

Research conducted in the medical profession found that a physician’s use of language and choice of words can influence how anxious patients are after a consultation.[vi] Like lawyers, doctors often meet their patients/clients at their worst moment and need to deliver difficult news. Researchers have identified ‘never words’ that doctors should avoid to reduce harm to their patients.[vii] These ‘never words’ include:

There’s nothing else we can do.

They will not get any better.

Withdrawing care.

‘Fight’ or ‘battle’.

I don’t know why you waited so long to come in.

Instead, research suggests alternative word choices can decrease patent anxiety. For example:

• ‘They will not get any better’ replaced with ‘I’m worried they won’t get better’. The doctor is replacing a negative prediction with an expression of concern.
• ‘Fight’ and ‘battle’ replaced with “We will face this difficult disease together’. This alternative language focuses on the team supporting the patient rather than implying that the patient can overcome the illness with sheer will and may let loved ones down by not fighting hard enough.

For help drafting client communications with less catastrophic language, following the principles of trauma-formed lawyering is a good start. While not specially providing guidance on avoiding catastrophizing, trauma-informed lawyering allows us to be more conscious of the impact of our words on our client’s well-being.

The Guide to Trauma-Formed Legal Writing[viii] developed by the British Columbia Law Institute provides practical guidance on creating legal documents that “are sensitive to the experiences of those affected by trauma.” Best practices for a trauma-informed approach to legal writing include:

• Avoid assumptions, biases, and myths
• Use clear and accessible language
• Be aware of triggers
• Be empathic and respectful
• Offer support and seek feedback

The guide does not provide clear ‘never words’ as outlined above, but the section on avoiding deficit-based language and euphemisms under the heading ‘Be empathic and respectful’ provides some useful word substitutions.[ix]

Overall, there is a balance that needs to be struck between utilizing our catastrophizing skillset and delivering options or possible outcomes to clients in a way that allows them to make informed decisions without causing unnecessary anxiety. We must catastrophize to a point but find a way to minimize unnecessary catastrophic language. This is an area I will continue to explore and aim to provide further guidance in my upcoming posts.

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[i] Lybi Ma, “Catastrophizing” online:<Psychology Today> https://www.psychologytoday.com/ca/basics/catastrophizing.

[ii] Laura Petrini and Lars Arendt-Nielsen, “Understanding Pain Catastrophizing: Putting Pieces Together”, 11 Front. Psychol., 2020 online <frontiers> https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2020.603420/full.

[iii] Sian Ferguson and Olivia Walters, “Catastrophizing: What You need to Know to Stop Worrying” online <healthline> https://www.healthline.com/health/anxiety/catastrophizing#causes.

[iv] Deanne M. Koll, “Final Thought Catastrophizing” online <Wisconsin Lawyer> <https://www.wisbar.org/NewsPublications/WisconsinLawyer/Pages/Article.aspx?Volume=98&Issue=6&ArticleID=31080.

[v] Richard J. Landau, “Does “Thinking Like a Lawyer” Play a Role in the Legal Profession’s Mental Health Crisis?” 40 Michigan Bar Journal (October 2018) online <Michigan Bar Journal> https://www.michbar.org/file/barjournal/article/documents/pdf4article3495.pdf.

[vi] “Physician’s positive language use reduces anxiety among patients with unexplained symptoms” online <Radboud University> https://www.ru.nl/en/research/research-news/physicians-positive-language-use-reduces-anxiety-among-patients-with-unexplained-symptoms.

[vii] Leslie Henton, “Do No Harm: Researchers Help Doctors identify Words They Should Never Say to Patients”, online <Texas A&M Mays Business School> https://news.mays.tamu.edu/news/2024/11/do-no-harm-researchers-help-doctors-identify-words-they-should-never-say-to-patients/.

[viii] British Columbia Law Institute, “Guide to Trauma-Informed Writing” online https://www.bcli.org/wp-content/uploads/TILWG-Final.pdf.

[ix] Ibid at 42.