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When You’re About to Assume the Worst: A Guide to Catastrophizing and Fortune-Telling

Written & medically reviewed by Alice Tran, PMHNP-BC  ·  August 2026  ·  9 min read

Everyone worries sometimes. But when your mind automatically jumps to the worst possible outcome and treats it as if it is already certain, that is a thinking trap. Two common versions are:

These thoughts feel true and urgent, but a feeling is not a fact. The good news: you can learn to catch these thoughts and respond to them differently. Here is how.

Step 1: Notice and name it

When anxiety spikes, pause and label what your mind is doing: “This is catastrophizing” or “This is fortune-telling.” Simply naming the thought as a mental habit, rather than a truth, creates a little distance and takes away some of its power.

Step 2: Slow your body down first

It is hard to think clearly when your body is in alarm mode. Take a few slow breaths, with the exhale longer than the inhale. Ground yourself in the present moment: notice what you can see, hear, and feel right now. The worst-case story is about the future; your body is safe in this moment.

Step 3: Question the thought

Put the scary prediction on trial. Ask yourself:

Step 4: So what if it did happen?

Sometimes the fear loses its grip when you follow it all the way through. Ask:

Rating the situation on a scale, instead of “total disaster” versus “fine,” helps you see it lives somewhere in the middle.

Step 5: Replace it with a balanced thought

You are not forcing fake positivity. You are aiming for realistic and fair. For example:

Step 6: Watch the behaviors that feed worry

A quick tool for the moment

When you catch yourself spiraling, walk through: Notice it, then breathe, then ask “what is most likely?”, then ask “could I cope if the worst happened?”, then choose a balanced thought.

A worked example: the unanswered text from your partner

Here is what these steps look like in real life.

The trigger: You text your boyfriend and three hours go by with no reply.

The spiral (fortune-telling and catastrophizing): “Why isn’t he answering? Something’s wrong. Maybe he’s with another girl. Maybe he’s cheating on me. Maybe he’s losing interest and this relationship is falling apart.” Your chest tightens and you keep staring at your phone.

Now walk through the steps:

The result: The worry does not vanish completely, but it shrinks from “he is cheating and my relationship is over” down to “he has not replied yet, and I will find out why when he does.” That is the goal: not zero anxiety, but a fair, realistic response.

Another example: the vague message from your boss

The same steps work for almost any trigger.

The trigger: Late in the afternoon, your boss sends a short message: “Can you come see me tomorrow morning? We need to talk.” No other details.

The spiral: “I am in trouble. I am probably getting fired. If I lose this job, I will not be able to pay rent, and everything will fall apart.”

Walk through the steps:

The result: The worry shrinks from “my life is ending” to “I have a meeting tomorrow and I will handle whatever it is.”

Both worked examples apply the same evidence-based cognitive restructuring and decatastrophizing sequence: naming the automatic thought, weighing evidence for and against, generating alternative explanations, following the fear through to coping, and landing on a balanced thought. The relationship example also reinforces the behavioral point about reassurance-seeking and checking behaviors, which tend to maintain anxiety rather than relieve it.

When to get extra help

Reach out to your clinician or a mental health professional if worry is frequent, hard to control, interferes with sleep, work, or relationships, or if you ever have thoughts of harming yourself. Talk therapy, especially cognitive behavioral therapy, is highly effective for this kind of thinking, and it is a sign of strength, not weakness, to ask for support.

If you are having thoughts that life is not worth living, or thoughts of harming yourself, please reach out right now: call or text 988 (Suicide and Crisis Lifeline, 24/7), text HOME to 741741, or go to the nearest emergency room. These thoughts are a symptom that deserves immediate support, and help genuinely works.

Worry that will not switch off is worth talking about.

Alice Tran, PMHNP-BC, provides psychiatric evaluations, medication management, and supportive therapy, in person in Fairfax and via telehealth across Virginia, in English and Vietnamese. No referral needed.

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See Also

Overthinking, anxiety, and ADHD → Health anxiety → Are intrusive thoughts normal? → Why anxiety causes physical symptoms → About anxiety →

Sources

  • Szuhany KL, Simon NM. Anxiety Disorders: A Review. JAMA. 2022. View
  • Serafini G, Costanza A, Aguglia A, et al. Overall Goal of Cognitive-Behavioral Therapy in Major Psychiatric Disorders and Suicidality: A Narrative Review. The Medical Clinics of North America. 2023. View
  • Keefer L, Ballou SK, Drossman DA, et al. A Rome Working Team Report on Brain-Gut Behavior Therapies for Disorders of Gut-Brain Interaction. Gastroenterology. 2022. View
  • Jagtap S, Shamblaw AL, Rumas R, Best MW. Information seeking and health anxiety during the COVID-19 pandemic: The mediating role of catastrophic cognitions. Clinical Psychology & Psychotherapy. 2021. View
Anh Tran (Alice), PMHNP-BC, FNP-BC

Anh Tran (Alice), PMHNP-BC, FNP-BC

Dual Board-Certified Family and Psychiatric Nurse Practitioner

Alice is a dual board-certified PMHNP and FNP licensed in Virginia, trained under psychiatrist Dr. Errol Segall, MD (50+ years of experience). She treats ADHD, anxiety, depression, and more, in person in Fairfax and via telehealth across Virginia, in English and Vietnamese. Learn more →