Chitra Ramaswamy 

How the hardest year of my life ended my catastrophic thinking

Worst-case scenario has always been my default setting – but complications during pregnancy and an ill mother and partner meant I had to get my anxiety under control
  
  

‘Compassion is the most powerful weapon against anxiety’ ... Chitra Ramaswamy with her daughter.
‘Compassion is the most powerful weapon against anxiety’ ... Chitra Ramaswamy with her daughter. Photograph: Murdo Macleod/The Guardian

It is March and I am Googling “meningitis” again. My partner has caught our son’s chicken pox and her symptoms are frightening me. Vice-like headache. Aversion to light. Brain fog. Also, I am pregnant and my habit of catastrophising has sprouted horns, and, pumped up on hormones, my heart is working twice as hard as usual. Nausea is now approaching something more … cataclysmic. My phone starts autocorrecting “morning” to “meningitis”. I become convinced that my partner has developed brain swelling, a rare complication of chicken pox. From here, it is a short step to picturing her dying and me giving birth alone, letting the worst case scenario in like an old friend.

The thing is, this time I am right. Sort of. She does have meningitis. The GP takes one look at her and sends her up to the infectious diseases ward in a taxi. I feel a tiny bit triumphant in the way only catastrophisers can. See? I told you. The worst has happened! But I’m also wrong: a tiny wad of catastrophe may have been fired at us, but my partner does not die and I do not give birth alone. She recovers. The baby is born. We are lucky again.

Time and again during the hardest year of my life (to date, the catastrophiser in me would like to qualify), my habit of fearing that the worst will happen got, well, worse. I don’t know when it began, so peculiarly subtle is the feeling that the most likely outcome is the really bad one. But this year some of my most calamitous predictions came true, at least in part. The realisation that I needed to do something about it came when my partner, who is a psychotherapist, arrived home with a book. “I saw this and thought of you,” she said. It was called Why Does Everything Always Go Wrong?. I laughed a bit too hard. The truth is, there was a lot to catastrophise about this year, on a global, national and personal level.

Just before the meningitis episode I discovered that the baby I was carrying was high risk for Down’s syndrome. While we awaited more results, my pregnancy was reduced to a series of statistics – one-in-58 chance of Down’s, one-in-100 risk of miscarriage with amniocentesis – and I grappled with the fact that someone has to be the “one”. In fact, I already knew what it was to be the one, because my son is autistic and, actually, we are all coping brilliantly; being the one is not a catastrophe once you are living it.

But catastrophising does not give a damn about hard evidence and I remained terrified. A fortnight later, the results came in: the chance of the baby having Down’s was vastly reduced, to one in 10,000. It occurred to me that catastrophising is more than just a destructive habit: sometimes it is a reasonable response to what is happening, a kind of mental preparation.

In April, my mother, who is incurably ill with breast cancer, got pneumonia and ended up in A&E. She asked to see my sister and I, so I rushed to London from Edinburgh, five months pregnant, with a daughter (and dread) somersaulting in my belly. I feared the distress would make me lose the baby and I thought my mother was going to die. Catastrophisers have a habit of thinking a person is dead if they are half an hour late, so a situation like this suits our sense of drama perfectly. My mother recovered. We continued to live with the deep uncertainty that comes with scans every three months and the neverending wait for results. Each time, I prepared myself for the worst. Maybe this is not a habit to be broken, but a coping mechanism.

By June, I had to make a major decision that provided an opportunity to see whether I could nix the catastrophising: how to have my baby. My son, who is four, was born by emergency C-section and so I was offered an elective caesarean. I saw a consultant who ran through the risks I faced if I attempted a natural birth without constant foetal monitoring and a cannula in my hand. I decided to laugh – or, at least, get off my head on laughing gas – in the face of potential catastrophe and attempted a natural birth on my own terms. I hired a doula to support me in hospital and – here is a first – hoped for the best.

In August, my daughter was born 45 minutes after I arrived in hospital. It was a short, fierce and mind-blowing natural labour. It was not perfect – I had an episiotomy and there was a minor Strep B scare that meant we ended up in A&E twice in the first week after her birth – but it was one of the best days of my life (to date, the optimist in me would like to qualify).

How am I trying to break my habit of catastrophising? Not by deep breathing, yoga, therapy, drugs or imagining all the catastrophes I fear floating away down a river. Talking and thinking have helped in the daily maintenance of perspective, which is catastrophising’s greatest enemy. Has this year been about the worst happening (and I write this a week after my beloved dog has had four tumours removed from her powerful, young body) or about a series of narrow escapes? Is it about bad luck or survival? After all, my partner recovered. The baby is perfect. My mother is still here. The dog is walking off the lead again. We are lucky.

Catastrophising is dependent on you never being in the moment: it constantly shoves you up against an unknowable, uncontrollable future. Once you go there, you are lost. Parenting, so often a source of anxiety, has been the best antidote to this. The hard graft and small, pure joys of looking after a baby and a little boy with autism anchor me to the present. The baby keeps me healthy, makes me feel lucky and gives me a constant dose of perspective. She is also exhausting: I am too tired and busy to catastrophise with as much fervour as the habit demands.

Then there is my brilliantly singular, loving and brave son. Before he was diagnosed with autism (that happened this year, too) I feared this moment: how will we manage? What will we do about school? How will he develop? Is everything going to be OK? The mystery and idiosyncrasy of autism can be frustrating, but it is also a visceral reminder that none of us knows what lies ahead and that compassion is the most powerful weapon against anxiety. So, here I am, living and thriving in the future over which I once catastrophised. And you know what? It is not so scary after all.

 

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