Thought Work: The Most Important Work You Can Ever Do

Jun 13, 2022

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The most important work you can ever do is thought work. Why? Because it is human nature to experience emotions at every moment, and those influence our actions and reactions in life. Circumstances become thoughts, which shape feelings, which drives actions, which creates results. 

But we aren’t always fully aware of precisely what emotions we’re experiencing. There are subtleties in them, subconscious emotions, underlying emotions... so many variations and flavors. In this episode, I share about thought work, and 5 underlying principles to doing thought work, including some actionable ideas. Although it does take focus and intentionality, we can become aware of our thoughts and, therefore better influence and control our emotions. And therein lies our power. 

“Thought work and choosing what we want to believe – and thus feel on purpose – is like putting shoes on rather than needing to pave the whole world.”  – Dr. Sara Dill

What You’ll Learn

  • Defining thought work
  • Awareness and intentionality
  • 5 Underlying Principles of Thought Work
    • Observe
    • Choose
    • Locate
    • Empower
    • Pause

I encourage you to also listen to Episode 19 where I address when NOT to do thought work.

Contact Info and Recommended Resources

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


I’m Dr. Sara Dill, and this is the Stress-Less Physician Podcast, episode number 18. 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, welcome back to the podcast. I hope you had an amazing weekend. I certainly did. It was just one of those weekends that was relaxing; beautiful weather, took a walk on the beach with my puppy and sort of recharged and ready to go for the workweek. So hope you had an equally amazing weekend, wherever you are, or wherever you might be listening to this.

So today, I wanted to talk about something that I think we talk about more in life coaching or self-development circles, which is this idea of thought work. And I really wanted to talk about thought work principles, sort of a one-on-one level. I wanted to start of course, I always like to define my terms, probably comes from our science background. So what is the definition of thought work, or at least my working definition? And so thought work, at least when I use the term, encompasses a couple of things. The first thing and really the most important part of it is this process of becoming aware of what you’re thinking. It’s the thinking about what you’re thinking. It’s this meta cognition or meta thinking.

And so when you become aware of what you’re thinking, you’re often becoming aware of habitual thoughts, subconscious thoughts, previously unconscious thoughts, perhaps, and belief systems. So there’s a lot here, I think a lot of us maybe think we know what we’re thinking, but we don’t really pay much attention. And that’s on purpose, right? It takes a lot of work and effort to think about what we’re thinking, and our brain likes to be efficient. It likes to run sort of processes, and not really dig up stuff. And so you’ll often notice when you start doing this work, that it can feel sort of exhausting and tiring. And it often is, I think, it takes a lot more energy, when you’re starting to notice these things and becoming aware of them, working with them and trying to change them.

So again, the first part of my definition of thought work is becoming aware of what you were thinking. And then the second part of my thought work definition is the practice, or ability to change or choose what you believe on purpose. So thought work is becoming aware of what you’re thinking, and then changing or choosing what you believe, on purpose. And we do this in order to change our feelings or to create feelings on purpose. So a lot of what brings most of us to this work is feeling sort of lousy, feeling unhappy, feeling burned out, feeling sad, feeling guilty, maybe, about feeling unhappy. I certainly did. I felt like I had no reason, really, on paper, to feel unhappy. And then I felt sort of shame and embarrassed about that, even.

So this whole process of thought work, is what I would also call managing your mind or managing our minds. It’s what I consider, honestly, the most important work or skill to develop. And I know that sounds maybe a little bit exaggerated, a little bit dramatic. I mean, let’s get serious, our brains are always dramatic. But I really do consider thought work and managing our minds, the most important skill we can develop. Because once you truly understand that you can manage your mental and your emotional life, both that it’s possible, and then how to actually do it, everything really can shift for you. Because how you think and feel. really affects everything in your life. And how you think and feel, shapes your life, right? It’s the color, the flavor, the taste of your life. I know this isn’t really a new idea, but it can be a revolutionary one when you discover how it might be true for yourself.

So I want to just talk about in this podcast, the basic principles as I think of them, underlying thought work, and there are five of them here, in case you’d like to plan for how many I’m going to talk about. So the basic principles, the way I think about it, underlying thought work. The first one is that you are not your thoughts. Just starting to have that separation. The way I think about it, not in a spiritual way, necessarily, is that you, the you that you sort of know, are the one that’s observing your thoughts, you’re the awareness of the thoughts, you’re sort of the space in which the thoughts are happening.

So just this idea that I don’t have to equal my thoughts, just because I’m thinking something doesn’t necessarily mean anything about me. And that can be a huge relief, when a lot of the time we make ourselves wrong, or we make ourselves bad, or we make ourselves something negative for the thoughts that our mind is thinking. I was going to say, for the thoughts that we are thinking. But again, I would even question that. Thoughts often arise.

And I don’t always agree with the idea that we’re always choosing our thoughts. I think that until we become aware of them, and until we are aware that we’re not actually our thoughts, that thoughts are happening in our mind, and we’re observing them, that it is then that we can start to take more responsibility for how we work with our thoughts, for if we want to continue to believe them, whether we want to continue to react to them. And that’s where our power lies, I think. Not in the specific choosing of every single thought we have. A lot of the science suggests that we have 60,000 thoughts a day. So again, a lot of these are running on autopilot. They’re running based on cultural origin, maybe family of origin stuff, who knows what you read in the newspaper, or a magazine or saw on Facebook or Twitter, so many sources for some of the thoughts that pop up in our head.

So again, the first principle is you are not your thoughts. You are the observer or the awareness of the thoughts. The second principle underlying thought work, is that you can learn how to change or choose what you believe on purpose. So just because you think something doesn’t make it true, just because you think something doesn’t make it useful. Maybe technically, it is true. We can always play around with ways that could be true or not true. But is it even useful? Is it a thought that is serving you or creating a result that you want to continue to experience in your life? I would also say another part of this principle of learning how to change or choose what you believe on purpose is this idea that I would suggest that our thoughts are not just caused by the outside world, or events. There’s always the filter of our perceptions, and mind, and how we interpret these outside events. Everything comes in through our senses, our eyes, our ears, what we smell, what we taste, what we touch, all of that, and then we interpret it.

And so there’s never just this sort of cause-effect where something happens, and then it makes me feel a certain way. That’s certainly how a lot of us were raised. And that’s how a lot of us still speak about it and think about it. But the best news I can give you is that between that sort of event and reaction, there’s a lot of thinking that’s happening. And that’s where our ability to act and choose and control what we want to believe on purpose. That’s where all of that power lies.

And another point about this second principle that we can learn how to change or choose what we believe on purpose, is that a lot of the thoughts that upset us are actually typically distortions or misperceptions, they’re flawed or they’re in error in some way. Most of our thoughts probably don’t really land or cause much of a reaction at all. But the ones that upset us really do bear some investigation, some curious, gentle, you know, shining a flashlight on them, and some questioning of them because they’re typically not really true or not really helpful, or both.

Number three, for the basic principles underlying thought work, is again this idea—I would say test it for yourself—but this idea that your feelings are caused by your thoughts about what happens in the world, not by the world itself, not by any external circumstances. So you feel the way you think. What if your feelings are just signals, to check out how you’re thinking about something that’s happening? This does not mean that you have to be happy about everything, that you want to be happy about everything, or that the way you feel is in any way wrong. It’s just good to know that you have some authority here, right? That our feelings aren’t just caused by things we have no control over. The circumstances in the world, things that happen outside of us. Sometimes even things that happen inside of us, maybe illness or pain or anything like that. Our feelings are caused by our thoughts about what is happening.

And number four, how you feel, the emotions you are feeling, the feelings you’re having, are going to determine how you act and the results you have in your life from those actions. So again, this is where all your control lies. It’s where your choices lie. It’s where your personal power resides. So there’s the quote that’s often attributed to Viktor Frankl, unclear whether he really said this or wrote this, but I do love it. And this is why I love this work, this thought work. And that quote, is “Between stimulus and response, there is a space in that space is our power to choose our response. In our response lies our growth and our freedom.” So between that stimulus and response, between circumstances in the world, and how we feel, and then how we act about them, there’s a space. In that space is our power.

So the first step, of course, is always just having some awareness. What am I thinking? What am I feeling? What is the stimulus? What am I responding? Am I reacting? Am I just sort of on autopilot? So, this is really not a new idea, this idea of whether you know this is the model, right? The model that I was taught at the Life Coach School of circumstances or events in the world, causing our thoughts, which then create our feelings, which then drive our actions, which create the results that we have in our life, or whether you think of it as the think, feel, act, have cycle, right? This idea that our thoughts create an emotional response, and our emotional response drives our actions or inactions, and that creates what we create in the world. Is not a new idea. It’s also part of cognitive behavioral therapy, and a lot of different psychological literature, as well, but it’s incredibly useful.

And again, it can be a revolutionary one, when you test it and discover how it might be true for yourself. So if you don’t believe me, if you think that sometimes there’s just things that happen in the world that make you feel a certain way, you could just test that out, you could notice, does every single person in the world feel the same way about this? Probably not. That is just the little crack into this idea that you can start to explore some more.

And then the fifth sort of principle underlying thought work, and this is something I’ve talked about before, is that often you can get some immediate relief, even before you change anything, just by starting to pause and becoming aware. Stepping into the present moment, awareness of your thoughts, your feelings, your sensations, can give you this immediate sense of relief. Because once you step into awareness and become the narrator, or the observer of your experience, you’re already out of the experience a little bit, you’re sort of out of the thoughts and the feelings where you have a little distance from them, you have space, you have that space that Viktor Frankl talked about, between stimulus and response, or stimulus and reaction.

So if you notice or feel like you’re in a storm of thoughts and feelings, check in with your senses. Your body is always in the present moment. I love that. I don’t know where I heard that from, but I love it. Notice something you see or hear. What do you smell? Can you touch something? Maybe even just touch your fingertips together. Or can you taste something? It will give you a little space from your thoughts and feelings, give you a little breather. It will give yourself just a moment to start to notice and pay attention. And then you can start to do more of this work.

So this whole thought work, the principles of thought work, you are not your thoughts, you really can learn how to change or choose what you believe on purpose. Your feelings are caused by your thoughts about what happens in the world, not by the world, or any external circumstance. You feel the way you think. How you feel will determine how you act and the results you have in your life. And this is where all your control and power and choices lie. And that pausing and being aware, stepping into the present moment awareness of your thoughts and feelings, sensations of what’s happening in the world, both internally and externally, can give you some immediate relief, even before you change anything, gives you a little space.

This whole process is what I would also call “managing your mind”. And as I said at the beginning, it really is what I consider the most important work or skill to develop in your life. Because once you truly understand, not just intellectually, but you really have experienced, that you can manage your mental and emotional life, that you can shift it, that it’s possible, and you know how to do it, everything else can shift for you. Because how you think and feel, affects everything in your life. It shapes everything in our lives. It’s the flavor of our life.

And so again, it’s not a new idea that humans operate in this think, feel, act have cycle or pattern. It just sort of explains how we perceive and process and take action. But it really can be almost revolutionary, when you discover its truth for yourself. I remember when I first learned and really understood that I was not my thoughts, and I didn’t have to believe them. That just because they thought something didn’t make it true. And that I could question it, and I could wiggle it loose, and I could sort of detach from it, or develcro from it. And these thoughts that once caused me so much suffering became sort of neutral, or maybe sort of funny, or maybe just nothing, and they just sort of disappeared, they melted away.

So I would just ask, have you discovered that you don’t need the world to change for you to have a better, happier, different experience in the world. I love the idea that we’re just one thought away from a completely different experience of our life. I like this idea, too, that thought work and choosing what we want to believe, and thus feel on purpose, is like putting shoes on rather than needing to pave the whole world. We don’t have to keep stepping on our toes, and paving the world, we can just put shoes. It doesn’t mean we don’t want to pave the world in some places, it doesn’t mean that we don’t want to improve the world or change the world. But we can do it from a place where we don’t need to do it, to immediately get our own relief, to have a better, happier experience in the world. This is why I think that managing our mental and emotional health is the best investment we can make in ourselves.

I have never regretted any of the work that I have done to learn this work, to go to coach training, to go to retreats, to pay my own coach, which I still do. I mean, I really think it’s the best investment I’ve ever made. Because, again, our thoughts and feelings are responsible for everything in our lives. They not only create our daily experience of the world and our life, but our thoughts and feelings can both create and solve our problems. If the way to solve a problem is to identify, what is it? Is it a thought? Is it a feeling? Is it something I’m doing or not doing? Is that a result I have that I want to keep having or I don’t want? We can solve any problem.

I know I sort of sound like an over enthusiastic acolyte of this but I really am, and it has changed my life for the better. And I would just encourage you to reach out if you need help with any of this. And I want to say that next week, I want to talk about when not to do thought work. I know I just went on and on about all the virtues of it and how amazing it is. And I do think it is amazing. I know that it is, but there are times when I would say I would not recommend doing that work. And I want to give some equal airtime to that. So next week, when not to do thought work, some important caveats.

And again, my new coaching group is starting soon, if you’re listening to this when the podcast drops in June, can’t wait. If you’re interested in that at all, please give me an email at [email protected]. I reply to every email and I read them all. So, hope you have an amazing, wonderful rest of your week. And I will talk to you next week about when not to do thought work. Stay tuned.

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.

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