When Those Old Thought Patterns Return (And How to Break Free)

Last week, I found myself in a hospital gown, being wheeled into emergency surgery. An IUD had perforated my uterus, and suddenly my carefully planned week was replaced with pain medication and follow-up appointments.

But here's what surprised me most about the whole experience: it wasn't the physical pain that caught me off guard. It was how quickly those old, familiar thought patterns came rushing back:

"This isn't fair."

"I'm losing income because I don't have sick leave."

"Why is this happening to ME?"

There I was - someone who coaches physicians through exactly these kinds of mental patterns - suddenly swimming in victim mode thinking. The exact kind of thinking I haven't lived in for years.

The Default Thoughts We All Have

If you're nodding along, I'm guessing you have your own version of these default thoughts. Maybe yours sound like:

• The voice that whispers you're never doing enough, even after a 12-hour shift
• The guilt that creeps in when you say no to anything (from committee work to your child's bake sale)
• The perfectionism that has you redoing what others have completed because it's not quite right
• The belief that you don't deserve to rest unless you're physically collapsing

What I realized (and shared in this week's podcast) is that those default thought patterns never truly disappear. They're like old grooves in a vinyl record - the needle can slip back into them during times of stress, fatigue, or when we're triggered by familiar situations.

Why Changing Circumstances Isn't Enough

Many of us fantasize about escaping these patterns by changing our external circumstances. If only we could:

• Work in a different practice
• Have a different boss
• Reduce our hours
• Leave medicine entirely

Here's the uncomfortable truth I've discovered both personally and through coaching hundreds of physicians: If you keep the same thoughts but change your circumstances, you'll have the same emotional experience - just in a different place.

That's why physicians who leave medicine without addressing these patterns often end up just as burned out in their new careers. They're still operating from the same mental programming, just with a different backdrop.

How to Break Free (Without Self-Judgment)

The old me would have spiraled for weeks in that victim mindset after my surgery. The current me noticed it within days, recognized "Hey, this isn't who I am anymore," and guided myself back to healthier thinking - with kindness, not self-judgment.

That shift didn't happen by accident. It came through intentional practice of these three steps:

1. Notice Without Judgment

When those old thought patterns appear, simply acknowledge them: "There are those thoughts again. I notice my brain is telling me I should feel angry/powerless/overwhelmed here."

Sometimes we notice the thoughts directly, but often we catch the emotions first - that familiar feeling of being drained, resentful, or stuck can be your first clue. For me, it was recognizing that drained, overwhelmed feeling that harkened back to previous burnout periods.

2. Recognize the Discrepancy

This is where the magic happens! Take a moment to notice the gap between your default thinking and who you are now. "This doesn't feel like me anymore. This isn't how I typically think these days."

When I caught myself in victim mode thinking, I could recognize: "The person I am today doesn't live here anymore. I've developed so much more agency and choice in how I respond to challenges."

This recognition helps us see how far we've come and prevents us from believing we've lost all our progress.

3. Be Kind As You Let Go

Instead of, "I can't believe I'm thinking this way again! What's wrong with me?" try "Yes, these are thoughts I've had before. This is an old pattern. We don't do that anymore, and it's completely normal these thoughts showed up during a stressful time."

Kindness works better than judgment every time. We've all internalized that critical voice from medical training - what I sometimes call our "inner attending." But that voice doesn't help us change; it keeps us stuck.

The Journey Forward

We're all on a journey. The place you are now is further along than where you were last year, five years ago, or ten years ago. When we intentionally work on our thought patterns, we're building the foundation for the next version of ourselves.

Those people you admire who seem to have it all figured out? They've faced challenges too - they've just made different decisions about how to navigate them.

Here's what one physician I worked with shared about her experience:

"I was drowning in resentment and working 70+ hours a week when I started working with Megan. Six months later, I've reduced my clinical time by 20%, finished my charts by 6pm most days, and most importantly - I no longer feel like medicine is slowly killing me. The ROI on this investment has been immeasurable."

This transformation isn't about never experiencing negative thoughts again. It's about developing the tools to notice them, recognize they don't define you, and guide yourself back with compassion instead of criticism.

Ready to Break Free?

If you're tired of those default thought patterns running your life and career, I'd love to help. I'm opening up three spots for 1:1 coaching starting in April.

Not ready for 1:1 work but still want support? My group program Unbound is opening for enrollment in June.

Either way, remember this: those default thoughts don't have to control your life. With practice and support, you can create new patterns that serve the life and career you actually want.

Want to hear more about breaking free from default thinking? Listen to the full podcast episode here. And if you're interested in working together, reach out through the contact form below or email me directly at [email protected].