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Common Physician Thought Distortions, Mind-Reading and Personalization

Continuing our series on thought distortions, we will look at two more in the assumption category this week - mind-reading and personalization.   


Mind-reading is assuming you know what someone else is thinking. And guess what? Sadly, we aren’t actually psychic.


When getting to the PCU and finding the cardiologist shaking her head as she reads your note on a mutual patient, you may think you know what’s in her mind. If you assume she is thinking, “This team doesn’t know what they’re doing,” imagine how it will affect your day.


Mind-reading can lead to social anxiety and depression. It reinforces a negative self-image and heightens insecurities.


To move past this thinking pattern, you must be on the lookout for it. When you notice it, consider all the evidence, not just the evidence that reinforces your belief. Perform a reality check.


The evidence: mutual patient chart; cardiologist looks at the computer and shakes her head. What else do you know? You know that the troponins we were all hoping to trend down are rising. Adding that fact in, maybe she’s thinking about how she will shuffle her day around to accommodate another cath. Either way, we don’t have to know what’s going on in her mind. If you’re curious, ask. Otherwise, take it at face value and move on. 


Personalization is another assumption-based cognitive error. In fact, the mind-reading example above also includes a form of personalization for your team. When we personalize situations, we see ourselves as the cause of external events.


Maybe during your clinic day, you notice your MA being very curt with you. If you think you upset her by reminding her to get the PHQ-9s, you are exhibiting an example of personalization. 


Like many assumption-based thought distortion patterns, it can lead to insecurity, defensiveness, a sense of loneliness, worthlessness, and anxiety. It’s a significant trigger for self-blame.


When you see you’ve gone down that pathway of thought, pause and allow space for alternatives. Activate your curiosity. “I wonder what is wrong with my MA?.” There are so many things outside of our awareness. For instance, maybe her teenage son just called and said he’d wrecked the family car. What are 10 other explanations? And again, if you want to know and feel it’s appropriate, find a time to ask.


The interesting thing about thought distortions is that they often travel together—especially the assumption ones. I personally had one embarrassing moment where I filtered out some positive information, jumped to a conclusion, mind-read, and personalized a situation in one fell swoop! Thanks a lot, Lack of Sleep, New Setting, and my Well-Worn Brain Path for assumption errors. Fortunately, I recognized the assumptions and mental filter. I started to revisit the facts, add all the evidence, look at rational vs. irrational thoughts, and find a few alternative possibilities. That lessened the intensity of all the negative emotions and insecurities. I also reminded myself that I was in the perfect storm of triggers. I know that my automatic thoughts contain errors when I’m missing sleep or in new situations. I concluded that I would relook at the evidence after a good night’s sleep and return to my comfortable environment the next day. And the next day, I could laugh at how far-fetched my thoughts had been. I was so glad I hadn’t acted out of them the day before. 


Next week, we will look at the last of the 9 common thought distortions for physicians.


Until then, have a joy-filled week! Tonya

Dr. Sasha Shillcutt will be joining a private book club for those of you who follow Joy in Family Medicine Coaching.  We will discuss her new book Brave Boundaries later this month. If you’d like to be a part of it, obtain a copy of the book, and click here to register.


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