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Thoughts and Intentions

Friday, March 16, 2018

CIPC faculty member, Professor Christine Runyan, writes a regular column on clinician wellness for the Family Medicine Residency newsletter.  We will be sharing some of her writings in this blog as they touch on many issues affecting professionals in integrated primary care.

Imaginative graphic with head and molecules radiating from it

Watch your thoughts as these become intentions.

Watch your intentions as these become actions.

Watch your actions as these become habits.

Watch your habits as these become your character.

Watch your character as this becomes your destiny.

This month, I am going back to the basics and writing about the primacy of our thoughts and beliefs. As physicians, you all know about the placebo effect (an inactive substance or intervention improves a patient's condition simply because the person has the expectation that it will be helpful) as well as the corresponding nocebo effect (expecting an intervention to cause harm or pain does). Numerous studies have demonstrated changes in biological markers, such as endorphin activation, and functional MRI studies have equally confirmed the placebo effect, which is rooted in belief. As a true believer (pun intended) in mind body medicine this is not a hard sell for me. This is partly why your words as a physician are so powerful to patients … and why your words to yourself are even more powerful.

 None of us have control over the 50,000+ thoughts we have in a day. In addition to thinking about stimuli from the outside world, we are also processing information from the inside – from the mind itself. Which, by the way, tends to be vastly more ‘negative’ than ‘positive’ and more self-critical than self-congratulatory. With so much noise, the mind strives for efficiency and to simplify, privileging expected data and ignoring novel or unexpected information. If you are expecting to be frustrated at work, you will find and notice that which frustrates you. If you are expecting a patient to be difficult, you will experience him/her as difficult. If you are expecting a critical evaluation, you will be oblivious to the positive feedback being given. The placebo effect teaches us that what we believe has tremendous power. So choosing which thoughts to believe and which to be curious about and which to dismiss takes attention and conscious effort. Once we are aware, however, we can gain control over a tendency to passively accept thoughts as truth and begin to shift our reactions to our thoughts.  REALLY we can! It starts with awareness. Awareness is cultivated by paying attention to what you are thinking and believing. Just notice. Start there.  You will be amazed what you find.