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Optimizing Your Mindsets in Medicine, Step 2 - Fact vs Story

A powerful tool to use in improving your day-to-day experience is your own mind. Last week we discussed the first step of optimization - writing and reflecting on your thoughts. This week we will use that download to move on to step 2.


By default, we believe our thoughts to be true. However, physicians, like most humans, have imperfect brains. Our thoughts, the sentences in our heads that our minds automatically produce, are colored by our experiences, the beliefs we grew up with, our culture, the media we have consumed, and the influence of others in our lives. While all these inputs can grow us in unique ways, they also create an inherently flawed system open to misinterpretations, assumptions, judgments, and common cognitive errors.


Unfortunately, low-quality thoughts not entirely based on truth can lead to undue stress, mental energy drain, and actions that are not in our best interests (nor that of our colleagues, our patients, or our friends and families). I love the analogy that a mind left to default mode is like an unattended toddler running around with scissors.


Step 2 is to separate facts from the story you have about those facts - truth from thought. After unloading what’s on your mind onto paper, look for the area causing you the most distress. What is it that is most unsettling? Once you are zeroed in, we start the process. 


Pick out the facts. You can do this by circling them or rewriting those in a clean space. Now for this exercise, I will give a detailed definition of fact.

  1. It contains NO adjectives. (“hard”)
  2. It contains NO loaded words. (“dumpster fire”)
  3. It contains NO assumptions. (“They’re avoiding me.”)
  4. It contains NO judgments. (“That’s messed up.”)
  5. There’s NO room for a different interpretation or perspective. (“vaccine-hesitant”)
  6. Everyone would agree. (Not just people who think like you.)


Once you’ve carved out the facts, you’re left with your interpretation of the circumstance—the thoughts.


This seems like it should be easy. In actuality, it takes a bit of work. We become very attached to our stories and are averse to lightening our grip. “I have too much to do. Really. Everyone would agree.” Even now, as you’re reading those words, many of you are experiencing a visceral reaction in solidarity that there really IS too much.


What is too much? Is it if you can’t get the boxes checked by the end of the day? Is it if you have 10 things left to do at the end of the day? Who defines “too much”? Would everyone agree on where the line is? No. So let’s break it down to where it is a fact via the definition above by listing it out.“ I have 10 notes to write, 45 in-basket messages, a grocery list, an appointment for a tire change-over, etc.” So, we are stripping it of judgment and adjectives and ensuring everyone could objectively agree.


Thoughts containing deeply held judgments, such as “He was rude,” can be very challenging in Step 2. However, we know various things seem rude in one culture but not in another. And something that offends your partner doesn’t bother you in the least. So, we wouldn’t all agree. We know rude is an adjective. Again, list it out – what factually happened to cause you to think that way? “He interrupted me, and the volume of his voice increased. He said, ‘You have no clue.’” Put the exact words down. Now you are down to facts.


Sometimes you find yourself holding tightly to your set of interpretations as factual. When you cannot loosen your grip, think of someone who would likely look at it differently? How might they view the situation? Even if you disagree with their perspective, the exercise helps wiggle your thoughts loose a little. There are many ways to think about each situation.


This exercise step aims to give you awareness and objectivity that everything we think isn’t necessarily fact. Even recognizing something as your interpretation of the facts and labeling it a thought, lightens the intensity of the moment. 


This coming week, utilize steps 1 and 2 together each day. The whole thing can take less than 5-6 minutes. Let me know what you discover along the way. 


Next week, we will cover a framework that can be utilized in Step 3. 

Have a joy-filled week! Tonya

Download the first three key steps I recommend to increase your joy now in your life and career. Click here  



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