Challenging and changing stress-producing thinking
BMJ 2001; 322 doi: https://doi.org/10.1136/sbmj.010230b (Published 01 February 2001) Cite this as: BMJ 2001;322:010230b
- Felice E Miller, consultant psychologist1
- 1UCLA School of Medicine
A stressful situation
“Your patient had a severe adverse reaction to the medication you prescribed.” Receiving this information, you as the patient's physician are flooded with negative thoughts and feelings and a desire to escape. Through selection, training, and reinforcement, you have been conditioned to think, “I must be thoroughly competent,” “I cannot make mistakes,” and “I need to be totally responsible and in control.” This stress-producing belief system can be identified, challenged, and modified to increase well being without sacrificing integrity and work quality. I describe some cognitive-behavioural techniques that can help physicians break this cycle of negative thinking.
Negative interpretation
Figure 1 shows a physician's initial negative interpretation of the clinical …
Log in
Log in using your username and password
Log in through your institution
Subscribe from £184 *
Subscribe and get access to all BMJ articles, and much more.
* For online subscription
Access this article for 1 day for:
£50 / $60/ €56 (excludes VAT)
You can download a PDF version for your personal record.