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Use a SOAP Note to Analyze Your Thoughts

Dawn Baker, MD teaches us to analyze our thoughts so we can separate truths from self-limiting beliefs using this simple thought model based on the SOAP note.

May 22, 2022

You have a story in your head of what’s happening around you, but did you ever stop to consider that your story and what is ACTUALLY happening might not be the same?

“My computer’s SO SLOW! What is going on? Can you help me fix this real quick?”

“Don’t talk to me until you at least turn it off and back on again.”

(A few minutes later) “That didn’t solve the problem.”

(Audible sigh) “Try to solve your own problems.”

“But I’ve tried!”

(More sighs and maybe some swears))… etc.

 

A version of this conversation happens frequently between me and my husband, pretty much any time I have a technical issue with an electronic device. I used to get SO upset about the way he responded. Here are some of the thoughts that swirl in my head:

  • It’s HIS job to fix mechanical and electrical stuff.
  • He’s not being helpful.
  • I suck at fixing things.
  • I’ve never been handy.
  • How in the heck did I get an engineering degree and then go to medical school but I can’t fix this simple thing?
  • UGH, I’m too busy for this crap!

 

You Are Not Your Thoughts

A huge component of coaching, whether it’s leadership coaching, life coaching, health, money, relationship or otherwise coaching, is helping people to understand that their thoughts are not necessarily facts. Further, our thoughts can hold us back from learning and growing. When people are stuck and can’t figure out a way to progress, examining key thoughts and teasing out what is really true vs. what’s in their heads can be the thing that finally disrupts the inertia.

Of my thoughts listed above regarding my computer problem, NONE of them are actual truths. I’ve chosen to believe them, and not only have they caused strife in my marriage due to my own resistance and negative responses, they also hold me back from actually learning how to fix my own computer with confidence.

 

A huge component of #coaching, whether it’s leadership coaching, life coaching, health, money, relationship or otherwise, is helping people to understand that their thoughts are not necessarily facts. Share on X

 

 

Thought Models

The good news is that we absolutely have control over our thoughts and feelings. The key to escaping unhelpful thoughts and their cascade of effects is identifying them and analyzing them. There are many models for examining thoughts in the psychology and coaching world, and two of my favorites are Brooke Castillo’s and Byron Katie’s. I respect the work of both these women immensely and have utilized their thought models myself. But in my opinion, the order of Brooke’s model can be counterintuitive, and Katie’s sometimes feels limited in its applicability. I’ve used concepts from both of these to come up with my own way of teaching thought work to anyone, especially doctors.

 

The SOAP Note

In medical school, we learned to write patient progress notes using the easy to remember acronym SOAP (Subjective, Objective, Assessment, Plan). The Subjective section houses the patient’s self-described symptoms and situation. The Objective section includes the facts, numbers, and data. The Assessment is typically a summary statement of the problem based on a synthesis of the subjective and objective information. This includes one or more diagnoses, along with possible diagnoses. The Plan describes the action items to take related to the assessment.

Not only is the SOAP note used for medical patient care, it’s also described for use by psychologists in therapy sessions. Here’s how I adapted SOAP to be used in my coaching sessions, and you can use it as a journal outline for examining your own thoughts.

 

Subjective: This is the thought itself. For example, you may be behind on your charting and have the thought, “I have too much work to do.” Note that this is not necessarily a fact. From some people’s perspectives, you might be spoiled with free time; others might agree that you’re inundated with projects.

 

Objective: As with interviewing patients, it’s important to distinguish the subjective information from the objective facts. Objective translates to universally undisputed, even if it’s stripped down to bare bones. No opinions allowed. Can you see how the thought above might not be true? Maybe your idea of “too much work” is not someone else’s. You can’t even turn this into a factual statement by saying, “My work is busy right now.” Still subjective. An example of a fact related to the above thought would be, “I have a job.” Another is “I am a physician who writes notes.”

 

Can you see how the thought above might not be true? Maybe your idea of 'too much work' is not someone else’s. You can’t even turn this into a factual statement by saying, 'My work is busy right now.' Still subjective. Share on X

 

 

Assessment: What are you feeling and/or doing related to this thought? It’s tempting to list something like, “I’m feeling like I shouldn’t have this much to do.” But that is not really a feeling. For a list of feelings, check out this one, and another helpful resource is a feelings wheel. In keeping with my work example, an assessment would be, “I’m feeling overwhelmed, which is causing me to procrastinate and numb my feeling by binge-watching Netflix instead of finishing my charting.”

 

Plan: How do you want to feel instead, and what can you do to get there? For the charting example, the Plan section could be, “I want to feel confident and organized. I will delegate project A and B to liberate them from my list, and I will start a habit of working for 30 minutes before I turn on the TV.”

This approach is, at its core, very similar to the popular thought models I listed above, but different people resonate with slightly different delivery methods for essentially the same information. So with the SOAP note, I offer you another alternative way of looking at your thoughts.

What do you think? Does this model resonate with you?

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. For more information, or to submit your own opinion, please see our submission guidelines or email opmed@doximity.com. Do you have a compelling personal story you’d like to see published on SoMeDocs? Find out what we’re looking for here and submit your writing, or send us a pitch.

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. Do you have a compelling personal story you’d like to see published on SoMeDocs? Submit your own article now here.

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