Sunday, November 10, 2013

CYA, and Awfulising.

An aspect of modern medicine that I've found increasingly distressing, having been at the receiving end several times over the years, is the practise of many doctors to give one the worst possible scenario or outcome of whatever it may be that they are diagnosing us with. In this way do they "indicate the desire to document one's lack of culpability for foreseeable negative outcomes" or, to put it another way, "make sure that they cannot be blamed or criticized later for something."

I understand that this may be a result of increased litigation when things go wrong, and that it's most likely only fair to be honest about possibilities, but what I find disturbing, is this being done at the early stages of diagnosis, before tests such as CT scans, MRI, ultrasound, etc.

3 times in the last 3 months people I know have received an initial diagnosis which has scared them witless with the severity, only to be told after the testing is completed, that it's not nearly as bad as first thought.

So I wonder, what is gained by terrifying anyone with the possibilities of the worst possible outcome?
What good does it do to tell a person who has just suffered a spinal injury in an accident, that they may never walk again? Couldn't this wait until testing has proven the spinal damage to be that extensive and permanent?  Is it really necessary to give that information to someone whose spinal canal is still so swollen from the accident that no real long-term information can be gleaned until the swelling subsides?

What good is accomplished by telling a newly diagnosed cancer patient that they may have to have disfiguring surgery, before testing to stage the cancer tumour has begun?

My first sponsor called this "awfulising" and warned against it in all areas of life. She would interrupt me when I was engaged in a bout of awfulising, and state firmly that what might happen was beyond my control, I could do nothing whatsoever to change the outcome, why was I torturing myself with various ghastly possibilities? What did I get from doing this?

I used to quote the hoary old phrase "Expect the worst, and one might be pleasantly surprised" not knowing that by expecting the worst, I was robbing today of its pleasure, to try to arm myself against what a tomorrow might never bring.

Had I not had 29 years of membership in Al-Anon, the two months since my diagnosis with cancer would have been a very different experience. I'd have worried, fretted, agonised, stressed, and kept myself in a fever of fear and terror, continually presenting myself with hideous scenarios of what was going to happen to me in cancer treatment. Because I've had the years in 12-Step, I knew and know, enough to let that behavior go as a waste of precious time. I can push the reality out of my mind, and enjoy the moment. I can laugh helplessly with my beloved partner or another friend, I can work as a sponsor for those who seek my assistance, I can feel heartfelt and powerful gratitude for the wonders of my life today.

One sponsee used to try to have "what if" conversations with me, in which she would invent terrible outcomes for the alcoholic, and feel almost as much agony in the contemplation of those imaginations as she would have had they taken place. I finally declared that "what if" conversations were now off-limits, and I wasn't going to have one more of them with her. Her response, after a moment of silence, was an endearing giggle. This woman is newish to program, but her sense of humour is a gift and a treat. I admire her for it; by the time I came into Al-Anon, my sense of humour was long gone. I was completely unable to laugh at my own insanity. I took myself far too seriously, and wanted everyone else to do the same.

We know that we are getting somewhere in working this program when we can begin to truly laugh at the nuttiness of our old thinking. When we can stop wanting others to sit silently while we catalogue our woes, and then tell us how well we are doing in shouldering our burdens, when we can honestly take an interest in another person, rather than pretending to do so in order to have them listen to us, we are beginning to grow.

Awfulising is self-defeating, tedious, tiresome, and boring for the listener. Who wants to hear a litany of complaint or negativity? How are we sharing experience, strength and hope? That's the question of the day.


  1. Awfulising....what a great term for me to remember. If you go read my most recent blog, you will laugh. It was a bout of awfulizing at magnificent proportions. I wonder if we go to the worst case scenario because then we feel like we are heading off the trauma. It won't sneak up on us....because we have already looked head on at the worst thing that could happen. At least that is how I have always felt. I am much better than I used to be believe it or not. I love that term...thanks for sharing that.

  2. You know that whole blog just helped me! I am doing the worst case seniro in my head for the past 2 to 3 weeks. I will now be making room in my home for a cat. I know it doesn't relate to cancer and is quit trival in comparison but I have been fearing a lot of outcomes in my head because of this and still just haven't gotten one.

  3. I think it is called Catastrophizing – Giving greater weight to the worst possible outcome, however unlikely, I have been an expert over the years before Al anon, though I can still slip back into it on ocassion.

  4. I too like the term awfulising. And it sums up the idea of thinking the worst. I don't tend to be negative but think of all the ways that I can do something. Sometimes I might need a touch of reality and actually remember that I may not be able to do all the things that I would like to do.