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When NOT to do Thought Work
Episode 1920th June 2022 • Stress-Less Physician • Sara Dill
00:00:00 00:27:16

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I 100% believe in thought work but it must be acknowledged: There are times it’s actually counterproductive. In my previous episode, titled Thought Work: The Most Important Work You Can Ever Do, I shared many of the benefits of thought work. Now, as promised, I offer you the flip side.

Before we begin, I want to reiterate that I think everybody benefits from developing the skill of metacognition. Understanding your own thought processes allows you to better relate to yourself and others, fostering more compassion and love. That said, I also firmly believe knowing when to leverage thought work and when to back off is integral to its success. In this episode, I’ll address questions which naturally arise from this position such as: When can thought work be ineffective? When can it be holding me back more than it’s helping me move forward? How do I know when it’s simply not serving me? Let’s examine the answers to those questions as we explore when NOT to do thought work.

“When you’re doing thought work… [and] you’re self-coaching… but it feels painful and you feel almost worse, then I would say you’re sort of doing it wrong… It should feel like an exploration, maybe like an opening or an ‘aha’... not like a boxing match, not like you’re attacking yourself.”  – Dr. Sara Dill

What You’ll Learn 

  • A recap of thought work and its benefits
  • 5 times when thought work doesn’t work


  • Strong emotion
  • Resistance
  • Stubbornness
  • Self-affliction
  • Rationalization

  • 4 times thought work can be unproductive

Trying to…

  • Force an agenda
  • Swap your thoughts
  • Over-investigate the why
  • ‘Fix’ yourself

Contact Info and Recommended Resources

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Connect with Sara Dill, MD, The Doctor’s Coach


I’m Dr. Sara Dill, and this is the Stress-Less Physician Podcast, episode number 19. Welcome to the Stress-Less Physician podcast. I’m your host, Dr. Sara Dill, MD. Using my unique combination of coaching and mindfulness tools, I will teach you practical ways to reduce your stress level, feel happier at work, and create a better balance between your medical career and personal life. If you are a busy practicing physician who wants to design a life and medical career that feel good to you, you are in the right place.

Hey, everyone, so good to talk to you again. How are you? Happy Monday, if this is Monday that you’re listening to this. I actually record the podcast, usually at least a week ahead of time on a Monday. And then of course, it drops on Monday morning first things, so I don’t know. I always wonder when and where people might be listening to me. So sort of fun to think about. I actually like starting my week off doing the podcast. I also really like starting the week off listening to podcasts that just helped me manage my mind and get in a good mindset for the week ahead. So I’d love to hear how you make sure that you have a good week, and whether you have any tips or strategies, send me an email, let me know.

So today, I wanted to follow up on my episode last week, which was about thought work and my belief—yes, it’s my thought—my belief that thought work is one of the most important things we can really learn how to do. And I really think that work is the most important work or skill to develop. But today, I wanted to follow up with a caveat about when I would say not to do thought work, when is a good time to not be in a hurry or not rush to do thought work.

So I just wanted to recap briefly, my definition of thought work in case you haven’t listened to my previous podcast. And so thought work as I think about it is really this process of becoming aware of what you are thinking, right? This might be subconscious thoughts, unconscious thoughts, or habitual thinking. So it’s bringing awareness, bringing your attention to what you’re thinking, and then changing or choosing what you believe or what you think on purpose. And we do this work because this is how we can more consciously create feelings on purpose, or change our feelings and create the results and our experience of the world that we want to have. And so this is also what I would call managing your mind. And again, it’s what I consider to be really the most important work or skill to develop.

Once you really understand that you can manage your mental and emotional life, both that it is possible and then understand how to do it. Everything really can shift, or that’s been my experience, at least. Because how one thinks and feels affects everything in one’s life, and shapes one’s life. But I would also say sometimes don’t do it. There are times and situations in which thought work is not what I would recommend. And basically that is when doing thought work is really not serving us. Or you could think about thought work when we’re using it against ourselves, or just doing thought work in an ineffective or somewhat unproductive way.

I still 100% believe in coaching and thought work. I think everyone benefits from learning how to think about your own thoughts, developing the skill of metacognition, that ability to think about what you’re thinking. I think everyone benefits from understanding your own thought processes, and how to relate to yourself and to others better. And ideally, how to have more compassion and love and curiosity, both for yourself and for other people.

But let’s talk about when not to do thought work. The first thing I want to talk about is not doing thought work when the emotion that you’re experiencing is really strong. And this is often where I have clients come and they tell me, like,” I was feeling really angry and I knew I was angry, and I tried to come up with a new thought.” This is usually in the middle of work or something or maybe in the middle of an argument with a partner or with children or with the patient. And they’re like, “And I just couldn’t do it. I couldn’t drop my old thought and I couldn’t get a new thought.”

So I just want you to notice if you are using thought work to try to get rid of an emotion, especially in the middle of that emotion, and especially when it’s very strong, if it’s very intense. I would say, don’t do thought work here, one, because it’s not very effective. You’ll notice that it doesn’t work. It’s very difficult to just immediately move out of that emotion. And in some ways, I almost feel like it’s a little bit disrespectful to what we are feeling. There’s nothing wrong with any emotion. I like to think about emotions or feelings as sort of indicator lights that something’s going on in our head. What if nothing’s gone wrong? What if we are actually designed and allowed to experience the full range of human emotions.

We could notice that we prefer some emotions to others. And sometimes some emotions are easier for us. But I don’t like the idea of we’re supposed to just get over it and move on. And I know, I’ve certainly done this. Especially as a coach, I would often have the thought, like, “Oh, I shouldn’t even be feeling angry, because I know I’m just having a thought that’s making me feel angry in the middle of clinic. I shouldn’t even be here.” That’s the idea, again, of arguing with reality. Because in the moment, the reality is, I am feeling strong emotion, I am feeling angry. And so just allowing that, and that is most likely not the time to do thought work. It might be the time to notice it, label it, that will give you a little bit of authority over it, and that it takes you a little bit out of the emotion once you label it, notice it, observe it. But I wouldn’t recommend doing thought work in the middle of an intense emotion, or a strong emotion.

What I would recommend doing when the emotion is strong, you could consider doing a thought download, if you’re in a place where you can do that, where you can just write down all your thoughts, basically, just get it out of your head and put it down on paper, that can be very helpful. One, it can just help settle you down. And then two, it’s a piece of paper that has some thoughts on it that you can go back and work with later. Not when you’re in the middle of anger, or grief, or rage, or some intense or strong emotion. So if you are in the middle of a strong emotion, and you can write things down, I would just write all that down. And you may or may not want to go back and work with it.

The second thing you can do when you’re experiencing a strong or intense emotion is to process the emotion. And again, can you do this? Maybe it depends where you are, what else is happening? But the way I think about processing emotions, and I have an earlier podcast on this is allowing it, naming it, exploring it, getting curious with it, noticing where you’re feeling it in your body. What does it feel like if you had to describe it to someone who never felt that emotion? How would you describe it? Often, the language is very subtle. Often in emotion, when we’re actually describing it, it doesn’t even sound like much, right? It’s like a little vibration. I feel like my shoulders are high. I feel a little tension in my chest. I might notice I’m leaning forward, whatever it might be.

So can you allow yourself just to experience the emotion? Notice if you can get into a space of curiosity, or allowing, not resisting it, sit with it, explore it. That is another thing you could do if you’re in the middle of experiencing a strong or intense emotion, rather than trying to do thought work.

And then the third thing you can do is do something else completely. If you’re very uncomfortable, or experiencing an intense emotion, it’s completely fine to do something else that feels kind or soothing. I like to take a walk or read, maybe you like to take a bath, you could talk to a friend, watch a movie, read a book, take a nap or go to bed and sleep. There’s never a rush or a need to rush to fix yourself or how you’re feeling. Sometimes just giving myself permission to just be angry, to maybe have a little mental temper tantrums, or to be upset or to be disappointed, to have hurt feelings, whatever it is, that often just giving myself permission to be a human experiencing human emotions and a human experience, settles me down as well.

So those are some things I would recommend if you’re experiencing a strong emotion. Again, taking notes, writing your thoughts down, allowing and processing your emotion or doing something else. You don’t always have to hold yourself in the middle of it, it’s totally fine to do something else that feels kind or soothing. And that might help you cope so that you can maybe do thought work right later when you’re in a better place, and the time is right. So that’s the first one when not to do thought work is when you’re experiencing a really strong or intense emotion.

The second time I would recommend not doing thought work is when you’re in the middle of resisting doing thought work. If you really don’t want to do it, but you’re telling yourself you should or you have to, or this is the answer, but you’re feeling resistance. Maybe you’re rebelling against yourself. I always do that when I tell myself I should do something, I immediately want to rebel, not do it. So when you’re resisting doing thought work, I would suggest maybe that’s not the best time to do it. You could notice, you might just want to notice the thoughts creating your feeling of resistance, you could explore those. Why am I feeling resistance? What am I telling myself about it? Why don’t I want to do it? Maybe you could look at the thoughts that you’re telling yourself that it will be better or that you’re supposed to, or this is how you’re supposed to handle things. So if you’re feeling resistance, it’s probably not going to be very productive, to do thought work.

And the third reason, or the third time when not to do thought work is sort of related to this, is when you’re really not open to it, when you’re really not open to a new perspective, a new thought, a new belief. And the way I think about this is does it feel like you have your arms crossed? Or maybe what comes to mind is like a child who’s like, “I don’t want to. No, you can’t make me,” sort of that idea. But it really feels to me sometimes when I have my arms crossed, and I’m really want to hold on to something. That’s not the time to do thought work either. I could explore, why don’t I want to give up that thought or belief or perspective? What do I think that it’s doing for me? Often, it’ll feel somewhat protective. And it might feel vulnerable or scary, or just very unsettling, to be open to an entirely new perspective. But I would never say that you have to force yourself to do it.

And this is true when you’re getting coached too. Sometimes I’ve been coached. And it feels like the person I’m working with maybe has an agenda for me, or thinks that they know the right thing. And that’s why in coaching, it’s so important to not have an agenda for my client, to know that they know what’s right for them. And my only job is to show them their thinking and help them explore the sort of repercussions of how they’re seeing whatever situation we’re talking about, and whether they want to continue to think about it in that way. And what are the emotions that that is creating? And what are they then doing or not doing, that are creating the results that they have? If I have an agenda, that’s something I need to coach myself about. And I would say the same thing, if you have an agenda for yourself, right? When you’re not open to a new perspective, as somehow you think you’re supposed to be, thought work is not going to be very productive.

And the fourth situation, when I would say don’t rush to do thought work, is when you were using thought work, when you’re using this work, when you’re using exploring your thinking and building awareness to beat yourself up. And you’ll know you’re doing this, because you will feel like you’re blaming yourself or you’re shaming yourself. Maybe you’re embarrassed about the thoughts you’re exploring or uncovering. You’re taking it very personally, and you’re making it mean a lot of negative things about yourself.

So you can ask yourself: does it feel like I’m making myself wrong? Does it feel like I’m being mean to myself? Sometimes I visualized: does it feel like I’m slapping myself? Because when you’re doing thought work in that way, when you’re self-coaching yourself, but it feels painful, and you feel almost worse, then I would say you’re sort of doing it wrong. It should feel like an exploration. Maybe like an opening or an ‘aha’, not like a boxing match, not like you’re attacking yourself. So if a lot of shame and blame is coming up. Let’s look at those thoughts that are creating the shame and blame.

Thought work is much more productive when you come from a space of curiosity and acceptance and self-acceptance. So if you’re shaming or blaming yourself, stop, and I would find someone else to work with you. Sometimes we are very tough on ourselves and we may not even recognize that you’re using thought work to sort of beat yourself up or find ways that you’re wrong. Very common. But again, I would say that it’s not the best time to do thought work, when you’re using it to beat yourself up, or blame yourself or make yourself wrong.

And the last situation in which I would say I would not recommend doing thought work is when you realize that you’re using thought work to sort of stay stuck. So thought work and coaching and self-coaching is really about using these tools to develop self-awareness. So you use thought work to recognize your thoughts and your feelings, to discover why you feel the way you do, and why you have the results that you do, or why you don’t have the results that you want. So it’s a self-awareness tool, whether you’re doing a model, whether you’re doing Byron Katie’s, The Work, however, you’re exploring your thoughts.

And sometimes we don’t need to find new thoughts or new beliefs, or repeat a model over and over again. What we need to do is take some action to create the result we want. So there’s often a point where perhaps you need to take courageous kind action, rather than do more thought work. So I like the idea of once you’ve found a new thought that feels better and more believable than your old thought, I wouldn’t necessarily go back to the old thought, then your job is to sort of practice this new thought, which is going to generate some different emotions, and cause you to take different action.

So just notice if you’re using thought work, if you’d rather just keep doing more models or questioning your thoughts, rather than actually go out there and take action. And a caveat to this too, is, sometimes when we use thought work to be okay with something that we genuinely don’t want to be okay with. So it’s great to explore how we can accept and love and embrace whatever our current circumstances are now, but I would also have you notice what is keeping you from changing or showing up differently. And that might be thoughts that are generating some fear, or indecision, or confusion. Those are the thoughts you might want to look at. You don’t need to keep going back to love what is, once you realize: oh, I am accepting my current circumstances. But what I’d really like to do is ask for this, or put myself out here this way. Or maybe I want to set a boundary with someone and I’m just afraid to do it. So I might just notice that I continue to do more thought work. And that’s how sometimes we can do this work to stay stuck, because in some ways it feels safer or easier.

So those are the times when I would recommend not doing thought work. So when the emotion is really strong, when you’re resisting doing it, it’s not going to be very helpful or effective. When you’re not open to a new perspective, that sort of goes along with resisting doing thought work. But when you really don’t want to drop a thought or change your beliefs, or open to a new perspective. When you’re doing thought work to beat yourself up or make yourself wrong. And when you’re using thought work to sort of stay stuck, when you’re just continuing to run models or a question your thoughts, rather than actually then sort of putting into action what you’ve discovered already.

I also wanted to talk about what I would call unproductive or sort of ineffective thought work when we’re sort of doing it— I don’t know if I want to say wrong, but at least not productively. And it’s not harmful. None of this is harmful, actually, when you are doing thought work, and I would say don’t do it. Or if you’re doing it in these sort of unproductive or ineffective ways. It’s not harmful at all, but it just doesn’t stick. It’s not very effective. And you’ll notice that you feel like you keep doing thought work, and it’s not working. So it’s not harmful or dangerous. I think building awareness and cultivating awareness of our thinking and our habits and all of this is always helpful in my mind.

So unproductive or ineffective thought work. One of the ways I see this is when you have an agenda for yourself. Usually having an agenda to be happy—or you could insert whatever sort of goal emotion here—all of the time. So I have a lot of clients that are like, “I’m just trying to feel better, I just want to feel content, I just want to feel happy. So mistake number one here is this always sort of trying to feel a certain way, always trying to be positive all the time. And of course, this is what brings us to this work. When I first learned about the model, and that it was my thoughts about my circumstances, and not my circumstances that were creating all my negative emotion, of course, I wanted to immediately fix it and feel better.

But when you have an agenda, then we’re often not as open or curious about what’s going on. We maybe aren’t willing to explore and really consider all the different possibilities. So just notice if you have an agenda to be happy, to think that feeling one way is going to be better than feeling another way.

Another way that I see people doing unproductive or sort of ineffective thought work, is this idea of swapping thoughts, being in a hurry, not processing or feeling your emotions first, and just wanting to escape from what you’re thinking and feeling. And so again, I think this is very common, especially in the beginning, when we realize: oh, I could actually just feel better if I changed my thoughts. And again, it’s not harmful to do this, you’ll just notice that it’s not very effective.

And so sometimes just cultivating more awareness until you really know, not just intellectually, but really know and see how the way you’re thinking and perceiving a situation is creating all of your emotions. Often, then you don’t even have to find another thought. Sometimes that old story just sort of disappears, like fog or mist just goes. And sometimes it might be a story that we really have to work on letting go of and finding those little bridge thoughts or ladder thoughts. So just notice if you’re in a hurry, if you’re just sort of swapping thoughts very quickly, and not giving yourself time to at least feel, allow, and process your emotion first. And again, it’s not harmful, it’s just not very effective.

And then I see this a lot, too, with clients. And I know I certainly have done it. But just notice, if you spend a lot of time wanting to know why you’re thinking something. Why maybe you have thoughts about scarcity. Or maybe why you’re a people pleaser. A lot of times clients will say, well, I need to find the deeper thought, I need to dive deeper and figure out why I am like this. And I don’t find this very helpful. The deeper thought will show up when it shows up in your brain. Often you don’t really need to go searching for it.

Sometimes I will have people ask why questions, but it’s a slightly different why. It’s not, why do I think this? But why is this a problem for me? So what might look like someone at work who has a colleague they don’t like or a boss they don’t like and they’re telling me about why their boss is a terrible boss, might say: well, why is that a problem that they do this? Not, why do you think that? Why are you the way you are? But why is it a problem? The other way of asking that is, so what? So let’s say they show up late, or let’s say they send a lot of emails, why is that a problem for you? That might get you to another layer of thoughts that might be helpful. But I would say don’t spend a lot of time investigating the why you are a certain way. I just don’t find that very helpful.

And then the last way that I sort of find thought work to be used unproductively or ineffectively is when we use thought work to try to improve ourselves and make ourselves a better version of ourselves, so that then we can feel better about ourselves, then we can like ourselves. So I think of this is sort of backwards. So if you feel like there’s something really wrong with you, or you’re embarrassed or sort of ashamed about how you’re thinking or feeling, or any of that, sort of using thought were to beat yourself up. And then you want to use thought work to change yourself, so that you can like yourself more and feel like you’re more lovable, and a better version of yourself. I think about that as sort of doing it backwards. Because then again, we’re in a hurry, we often aren’t willing to really explore our thoughts, we’re having a lot of judgment. We are not coming from the curiosity and self-compassion, and self-acceptance that makes thought work much more effective.

So again, it’s not dangerous or harmful. I would just notice if that’s something you’re doing. It’s very common. Again, a lot of us come to this work, sort of from the sense of wanting to improve ourselves so that we like ourselves more. But often, that’ll just sort of stall you out. And you’ll notice that you aren’t making as much progress. We block ourselves and we’re sort of in a hurry and we rush again, which makes that work less effective.

So that’s what I have for you today. I just wanted to offer this as a little bit more—not really a caveat, I guess, but some ideas and thoughts I have about when I wouldn’t be in a hurry to do thought work. Although, as everyone knows, anyone who knows me, knows that I love all of this work, the self-coaching, and thinking about our thinking and the ability to become aware of what we’re thinking and then change or choose what we want to believe on purpose, really can change everything. But just notice if you’re in a hurry, or you’re in a rush.

And again, if you’re using it against yourself, if you’re using it to beat yourself up, make yourself wrong, or you feel worse about yourself when you’re doing that work or afterwards, I would say reach out to a coach, send me an email, get on the phone with me or Zoom, let’s do a free session, because that’s really not the point of it. The point is to, again, cultivate more compassion, love and curiosity for yourself and others, to really learn the skills that allow you to have just a better experience of life.

So anyway, I will be starting my new group coaching program in a few weeks. So look out for an email if you are on my email list. I will give you all the details. And if you aren’t on my email list, make sure you head on over to my website at and sign up. And again, I answer all my own email. So if you have a question or a comment, or want some personal help, definitely send me an email to All right, well, have a wonderful week. Talk to you soon.

If you are a busy practicing physician ready to start feeling less stressed, enjoy work more, and learn how to create a more balanced and sustainable medical practice and life, sign up for a consult call with me at That’s It would be my privilege and pleasure to work with you.