Cognitive Distortions: Because Burnout Alone Wasn’t Enough

Recognising the brain’s way of making your shift harder

Everyone is having a hard time at the moment; you can see it everywhere you look. In the ambulance service alone, you don’t need to look far to find complaints from both service users and clinicians about things getting worse with little to no relief in sight.

It’s times like this that focusing on the aspects of our experience that we can control becomes even more important. When you’re sitting outside hospital for hours on end it can be helpful to recognise the ways in which your own thought patterns might be making it all seem much worse.

So here are some of the most relevant ways in which our brain lays traps for our own thinking that we can do something about.

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Personalisation

It’s easy to think that we can control events around us, especially as clinicians. The idea that we are responsible for patient outcomes is something that is important to engage with to ensure that we do the right thing for each patient. However, it can go too far.

It’s easy to fall into the trap of believing that we are fully responsible for every event and repercussion. When we have done all that we can, it is important to recognise that we only control our own actions in these situations and the reactions of both our patients and the world at large are not something we control.

If this is something that you find yourself doing, it can be useful to focus on the key points that can be taken from the serenity prayer.

May I find the serenity to accept what I cannot change, The courage to change what I can, And the wisdom to know the difference.

Unconditional acceptance of the world and the actions of others as things that you cannot control is an important tool to help yourself minimise the effects of personalisation on your stress levels.

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All-or-Nothing Thinking

Self-reflection is crucial for personal and professional growth. However, "all-or-nothing" thinking distorts this process, transforming nuanced self-assessments into harsh, unqualified judgments. Instead of acknowledging, "I could have handled that interaction better," we might think, "I always mess things up." Similarly, "My colleague could have offered more support" becomes, "They never help me." This negative self-talk erodes self-worth and creates a self-defeating cycle.

To break this pattern, monitor your language. Challenge the absolutes. Words like "always" and "never" represent extremes (100% or 0%). If you can recall even one instance that contradicts these words, the statement is inaccurate. For example, the thought "I always fail" is easily disproven by recalling past successes. Replacing "always" with "sometimes" or "often" provides a more balanced perspective. Similarly, "never" can become "rarely" or "not often."

This shift towards more realistic self-assessment reduces stress and anger. By acknowledging the grey areas, we foster self-compassion and create a healthier relationship with both ourselves and others. This allows for genuine growth and improvement, without the burden of unrealistic expectations.

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Inflexible Demands

We often impose rigid, inflexible demands on ourselves and the world, using words like "must," "should," and "have to." These demands, often self-directed but also projected onto others, create unnecessary stress. Statements such as, "I should be doing better," or "I must make this work," set unrealistic expectations. While immutable laws of physics and biology dictate certain "musts," most demands we place on ourselves, or others are not guaranteed to be met. This discrepancy causes stress. Demanding perfection from ourselves and others in an imperfect world sets us up for disappointment.

To alleviate this stress, replace rigid demands with flexible preferences. Instead of "I should be doing better," try, "I'd like to improve." Instead of "I must make this work," say, "I want to try to make this work." This shift in language acknowledges that failure is a possibility and reduces the pressure for perfection. By embracing imperfection, we can treat ourselves and others with more compassion when things don't go exactly as planned. This approach fosters self-compassion and acceptance, reducing stress and enhancing well-being. Why create demands destined for potential failure when we can set intentions with realistic expectations?

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Magnification and Minimisation

Successes and failures are just the beginning. Our brains can twist these events, making them more or less impactful than they actually are. Some minimize their achievements, dismissing them with phrases like, "It wasn't that hard," or, "I didn't do that much." This undermines confidence and robs them of deserved pride.

The more common distortion, however, is magnification. Minor mistakes become catastrophic events. Forgetting to send an email turns into a guaranteed firing. This exaggerated negativity can be debilitating.

To combat these distortions, try a simple exercise: Imagine offering advice to a loved one in the same situation. Would you tell them they're a failure for forgetting an email? Or would you offer support and perspective? This shift in perspective can foster self-compassion and help us view events with greater objectivity.

Remember, our brains are wired to protect us, but sometimes that protection comes in the form of distorted thinking. By recognizing these patterns and practicing self-compassion, we can regain a more balanced perspective and navigate life's ups and downs with greater resilience.

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Mind-Reading and Fortune Telling

Our minds, while incredibly efficient, sometimes rush to judgment, leaping to conclusions without examining the facts. This often manifests as mind-reading or fortune-telling – interpreting situations based on assumptions rather than evidence. Imagine this: A colleague doesn't acknowledge you; instantly, you assume they find you annoying. Or, you hesitate to pursue a new project, convinced it's destined to fail.

While these thoughts might hold a grain of truth, they frequently lack a solid foundation. Without evidence, we create narratives that are not only untrue but also incredibly stressful. These self-limiting beliefs distort our perception of reality, creating unnecessary anxiety.

The antidote? Consciously challenge these assumptions. Ask yourself: What concrete evidence supports this thought? And equally important, what evidence contradicts it? If there's no evidence, these thoughts are purely harmful, serving only to increase stress. If, however, evidence counters your negative assumption, you gain powerful ammunition to replace it with a more balanced and empowering perspective.

Even when some evidence supports your initial thought, evaluate the likelihood of your conclusion being accurate. We often overestimate the probability of our predictions, especially when we jump to conclusions without considering all available information. By consciously examining the evidence, you'll significantly reduce stress and improve decision-making.

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Don't Worry Twice, It's Alright

It's important to remember that these cognitive distortions are normal, and not a sign that you are in some way crazy or broken. We all engage in some of them, often a mixture of them at any one time.

The important thing is that when these distortions are frequent or extreme they can become harmful to us, especially when the situations we are in are stressful enough for us to deal with. Recognising this and taking action to reduce their impact is essential for managing stress, cultivating resilience, and staving off burnout.