A topic that I did not mention by name, but which is very important and which can decrease the quality of life of an OCD patient considerably, is the so-called catastrophic thinking (German: Katastrophisierungszwang).
I would not call it a wrong interpretation of reality (which description might be applicable to magical thinking, and thought-action fusion – see earlier posts with the search function as a guide); rather, it is a distorted view on reality, one that defies the impact of many earlier experiences the patient had, and may remember very well.
Simply stated, catastrophic thinking is the conviction that things will go wrong, and seriously so. The patient, seen as the center of feeling, thinking, and behaviour, on many occasions is absolutely certain that a line of action he/she may undertake will have bad, or even disastrous consequences. I myself know quite a lot of examples of this phenomenon. When I, as a young student, had loaded a laboratory centrifuge with test tubes that were filled with some type of sugar solution and other stuff, I was extremely diligent to make sure that the weights of the tubes were the same (opposite tubes should never be unequal in weight, otherwise the centrifuge, on high rotation speed, would be seriously damaged). Certain experiments required very long rotation times, e.g. overnight they had to stay on. After loading and turning the apparatus on, I went home pretty at ease. But when going to sleep, fears began creeping up on me, and I could not suppress the thoughts and fears about having made a mistake, so that I would find ‘damage and ruin’ the next day, i.e.: be responsible for, and guilty of trouble, for the staff and the students working at that lab. Often, sleeplessness would be the result. And there was no way in the world that the rational memory of having done it all very, very thoughtfully, could overrule my intense fears.
That, my readers, is catastrophic thinking.
In practice it can apply to every aspect of human life. Someone driving a car may have to turn around every few miles or so, to inspect whether he/she has wounded, or even killed, an animal or a child with the car. A young mother may be over-, overanxious that she did not care enough for her child, and thus force herself to run up the stairs many times on a single evening, to see whether everything is all right – and the sad thing is that overanxiousness of the mother can cause psychological problems in her offspring later in life.
The ultimate and saddest consequence of catastrophic thinking is that the patient won’t undertake any action of importance any more. He/she may become ‘grounded’, a recluse, someone whose goals are limited to the bare necessities of life: food, drink, and a roof above the head. The daily job may be lost, as may social relationships.