Catastrophising

I know what you mean because I’ve even had ridiculous thoughts about the medical profession having its fair share of psychopaths, and I might be operated on by one who could decide to do something nasty to me and manage to cover it up.

Yes, it's much worse at night when you're just lying there with less activity to distract you. I go to bed early hoping to fall asleep quickly, but that often doesn't happen, and I end up going to bed too early and eventually have to get up again.

Thanks, Iain.

When it comes to planning ahead, I intend to bring things that will help me block out unpredictable noises, like noise-cancelling headphones and masking apps, in case I have to stay overnight. But (and this might sound silly) I even get stressed about the possibility of nearby patients passing wind, belching, or constantly clearing their throats, because you never know who you might end up next to in a hospital. And I know people don’t intentionally mean to be annoying, so it wouldn’t be fair for me to complain, but it puts me in a conflicting situation, and that itself can be stressful too.

But I take your point about giving yourself options to help mitigate against unpredictable consequences.

lostmyway said:

I keep imagining what could go wrong and it’s really winding me up.

The one thing that made the most difference for me was learning mindfulness so I can put things into context easily and shut down that line of negative thinking, but when the nagging thoughts won't stop then I resort to using something I learned at work.

In essence I use parts of the Project Planning methodology which deals with risk management.

What this does is teaches you to map out all the risks in a situation, decide how realistic the chances of them happening is and the impact they would have then you can decide on how to approach them. This is designed for business projects where there is a financial element to any risk and you have to be able to deal with it happening in the real world because sometime bad stuff happens

When you identify a risk you can mitigate the risk in 4 different ways:

1 - reduce. i.e take steps to make the chances of this happening lower. For example if being ill is a risk then change your lifestyle to be healthier, avoid contact with others to catch viruses etc.

2 - share. i.e. if the thing happens then have someone to share the consequences with who understand why you are doing it. For example if you were going to pick up something in you car but your car breaks down then have someone else who can do it for you..

3 - accept. i.e. accept that this thing may happen and you just have to live with it. For example if you book a garden party and it rains then you will probably have everyone indoors instead.

4 - exploit. This is a bit more sophisticated but in the garden party situation then create a mud slide, have games in the paddling pool in the rain etc. You will need to plan for lots of towels to be available for this though.

That is it in a nutshell - it can be much more detailed and comprehensive but it is a handy tool to use when you just can't shut off the catastrophising.

Yes, especially when there is a lot of uncertainty. It is worse if I wake up at night. I try to think of how many positives there are for balance but it isn't easy to switch it off.

And even if you try to take your mind off it, it lingers in the background, and when your guard is down, it can suddenly leap to the forefront as if waiting for its chance to torture you again.

II think for someone like me who doesn’t really socialize and spends hours alone on the PC, it’s worse because it almost becomes routine to feel this way in this specific place. When I’m out, it helps, because there are many more distractions to take my mind off it, although the feeling does come back when I return home.

Yes I also found resources stating that it common in autistic people. 

Yes, it's also me. Sometimes I need help getting out of the catastrophising cycle to not get insane. This is also a reason why I take meds. When I had a conflict with my colleague with BPD who mistreated me at work, I used to catastrophise that he would kill me. Later I laughed at that. Now I worry a lot, that my assessment would have to be postpone due to a flu- mine or the assessor's. And I get really nervous and anxious about it.

Ah, I see! That makes a lot of sense. Fear of the unknown AND anticipation for discomfort are at play here, given this information. It sounds like you are doing the right thing: Instead of simply dreading the inevitable you are considering possibilities to ease the potential discomfort. I don’t think it is healthy to dread the upcoming hospital stay, but workshopping ideas for ways to mitigate what bothers you is brilliant.

Again, a close friend/family member could be useful for two reasons in this case:

1) Potentially thinking of more options similar to your idea of bringing noise-cancelling headphones or asking for a quiet space to recover.
2) Potential to advocate on your behalf to get you more comfort. Ex. Your idea of asking for a quiet recovery space may be even more attainable if you have an ally that can ask for that on your behalf.

Obviously I don’t know your home life or if you even have friends that live nearby (ex. I have plenty of family nearby, but zero friends that live in my area that I can count on). However, if you do happen to have a support system, use it!

Many thanks, profdanger. The thing is, it’s not just the operation itself, but if they keep me in overnight for observation, all the old fears of unpredictable noises will come back. I do have noise-cancelling headphones, and on my cellphone, I have a couple of masking apps I can use with Bluetooth earbuds, but you can’t really wear those all the time.I keep hoping they might release me later the same day, though it’s quite possible they won’t. I guess it’s the uncertainty that’s the hardest to handle. I might ask if it’s possible to recuperate in a quiet place, which feels a bit cheeky, but there’s no harm in asking - even if it won’t be completely noise-free.

(Small note: I just realized that I have GAD (general anxiety disorder) and the guy I referenced I believe also has a similar diagnosis. Catastrophising may be more of an anxiety trait than an Autistic one. Though the two are often linked, they are separate conditions.)

Based on own experience and what I’ve heard from other Autistics, I’d say that’s likely fairly common. I recently had a client with Autism who had a surgery coming up for a failed organ and what started as a bit of anxiety over the procedure snowballed into a massive downward spiral over a week, leading him to becoming imprisoned. I know that’s a pretty extreme example, but that’s at the front of my mind right now since it literally JUST happened days ago.

My advice is tell people that you trust how you feel. Make it clear that you want your fear validated, but also accept it when they offer realistic views of how it will probably actually turn out. I think validation is important; You’re not crazy, bad things do happen. However, after getting validation for that fear it is important for you to open up to what are the realistic expectations for this operation. If you don’t, well, I’ve just seen what happens when you deny reality or ask for help too late.

All that being said, I do hope that the procedure goes well for you.