Caring for yourself during your intern years

By Clinical Professor Leanne Rowe AM

Switching off on time off

Our time off work is very precious. It can be difficult to slow the brain after a long intense day. In an overstimulated brain, our negative mental filter can go into overdrive as we rehash the day’s events, often thinking about what we forgot to do or what we must do tomorrow.

Unless we are seeking solutions, it is usually a fruitless exercise to let our minds dwell on the same dysfunctional thoughts over and over again.

Here are some examples of common negative thinking patterns:

Black and white thinking supposes that things are either awful or perfect. For example, we may focus on one career as a goal, discounting all other options and predisposing ourselves to feeling like a failure if our ‘only’ choice happens to not eventuate. It can be more helpful to think about shades of grey and to try to become aware of the feelings and thoughts in between the extremes.

Common negative over-generalisations are thoughts such as ‘Things always go wrong’, ‘Everyone at work is against me’, ‘No-one understands how I feel’. The evidence for these unhelpful thoughts needs to be challenged. It may help to simply be a little kinder to ourselves: ‘I had a bad day, but tomorrow will be better’, ‘Work has been stressful for everyone recently but I’ll try not to take things so personally’, or ‘Talking about how I feel to like-minded colleagues will help me feel better’.

Mind-reading involves making assumptions about what someone else thinks of us or believes about us. The evidence for such assumptions needs to be questioned, for example, ‘How do I know this?’, ‘How can I be sure?’, ‘Could my colleague have something else on their mind?’

Making mountains out of molehills is a catastrophic way of thinking. For example ‘It will be awful/terrible/horrible’, ‘I can’t stand it anymore’. A more helpful approach may be to ask how these statements make us feel and to try to come up with another way of thinking like: ‘Yes, it will be difficult, but I have got through such things before and I will try to do my best’.

Challenging Negative Thinking

Here are some helpful questions for challenging negative thinking:

  • What is the evidence for this way of thinking about the problem?
  • Is there another explanation for what I am feeling or what is happening?
  • What is the worst that could happen in this situation?
  • What is the best that could happen out of this?
  • What is the most realistic way things could work out?
  • What would I advise a colleague if he or she were facing the same situation?

Challenging negative thinking can be more difficult if we have unconscious unrealistic belief systems. Common unhelpful beliefs include:

  • I need other people’s approval to make me happy.
  • I should always have complete control over my feelings.
  • It is weak to feel anxious or sad.
  • I should never make mistakes and I should always be right.

If our beliefs and thought processes are unhelpful, we can practise prefacing our self-talk with words like, ‘I will try’, ‘I would prefer ’, rather than ‘I should’, ‘I always’ and ‘I must’.

To make it easier to unwind, we can try to build mindfulness into our day, when we are waiting on the telephone, in a queue, taking an elevator or walking from consulting room to waiting room, and at many other times when our minds are usually set to ‘automatic’.

Simple things like trying to slow our breathing and pulse at appropriate times throughout the day, eating nutritious food slowly when possible, exercising opportunistically (for example using stairs not elevators), help us keep our stress levels in check during work hours and help us switch off after work.

If we wake at night, we can try to practise meditation or deep relaxation exercises.

How do you switch off on your time off?

Clinical Professor Leanne Rowe AM is a GP and past Chair of the RACGP. Her book ‘Every Doctor: Healthier Doctors=Healthier Patients’, co-authored with Professor Michael Kidd AM, is about thriving in medicine as well as addressing the tough issues in medicine.

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