The worst of all possible worlds
The other day a friends was telling me a story and finished with "How could it get any worse than that?" Right away I rattled off a half a dozen gory ways it could indeed be worse. Horrified, she stopped my listing. While I was indeed trying to get a rise out of her, I also truly believe that it could be worse. It can always be worse. There are myriad ways it could be worse. Today I was talking to a patient with fibromyalgia. In the middle of her recitation of her aches and pains she said "and I know you said it will just get worse." There I halted her. I told her that while she will have exacerbations, she will also have remissions. This is a stable disease. While it tends not to get better, it also does not tend to get worse over the long run. But her self-talk had led her to believe that she would just keep getting worse. I told her "On bad days tell yourself 'it has been this bad before. I have made it through days as bad as this. Tomorrow