January 9, 2023

How to Reframe Your Past and Change Your Future as a Pre-Med

Why is it that some pre-meds can deal with bad grades while others seem doomed to repeat the mistakes of the past? A lot of it has to do with the tactic of re-framing -the ability to tame self-doubt and re-tell the stories of your past to better affect the present.

I want to start with a story.

My daughter - a precocious five-year-old - and I were traveling, and she had an allergic reaction to something - the pollen, the environment, not sure exactly what. Though it was late when we arrived, our hosts fortunately had a Benadryl, a small pink pill that would probably cure her itchiness and allow her to go to sleep. The only challenge was getting her to swallow this pill.

She couldn’t do it. Nothing I did - from giving her a glass of water to gentle encouragement to explaining why she should take the pill - made her able to swallow the pill. I ended up crushing it up into some milk, which she swallowed reluctantly.

My daughter now believes - four years later - that swallowing pills is “impossible for her” so she will just opt for the liquid version of medications the rest of her life. Her evidence is that it’s easy for her dad, but when she tries to do it, she just can’t. So, is it true? Is it really impossible that she will ever be able to swallow pills?

Presumably, you see the error in her thinking: she’s exhibiting “all-or-nothing thinking” where she’s taking this one example and jumping to a conclusion that isn’t supported. And it’s my job as her father to help her with this conclusion, but she’s unfortunately inherited an unhelpful trait from me: stubbornness.

How would you try to get my daughter to reframe her past experience to support a proper conclusion? One way to do this is a Reality Testing worksheet:

Reality Testing Worksheet

  1. Describe the situation clearly: One time, my daughter had trouble swallowing a Benadryl.

But there's a lot of extenuating circumstances! When you point out all of them, the conclusions that we can draw become much more limited in scope.

  1. Identify any irrational beliefs based on the experience: “I will never be able to swallow pills.”
  2. Look for evidence for or against

Evidence for: One time swallowing the pill was hard.

Evidence against: It was after a long day of exhausting travel and she was quite tired. She was only five years old. She was quite itchy and distraught. She had never had to swallow a pill before.

So is that irrational belief justified? No.

  1. Reframe that irrational belief: “I have had trouble in the past with swallowing pills, but I just need more practice.”

Okay, what does this have to do with doing well in your classes and preparing yourself for the future?

If your thoughts are anything like mine, you relentlessly abuse yourself for past mistakes. And usually these thoughts are a) unhelpful, and b) not true.

Now, I’m not saying, “think happy thoughts” and your life will be good. Indeed, I would argue that you can’t really control your thoughts at all. In my experience with meditation, I’ve observed that thoughts seem to just occur out of the blue. I’m no more in control of whether they occur than I am in control of your thoughts. What we can do is test our thoughts against reality to see what the evidence is for or against these thoughts and to be able to rebut the voice in our head better when those thoughts inevitably come back.

Also, re-framing is quite rational. You can’t control what happened in the past, and figuring out what’s true about what happened contains quite a bit of subjectivity. Now, if my daughter’s conclusion had been, “My dad’s trying to poison me with this stupid pink pill,” then I think we can say that’s (probably) false.

But we can choose what lessons we take from the past and the stories we tell ourselves in the present, and that’s not just logical; it’s the way you build resilience for overcoming future adverse events.

Let’s look at an experience that many students face: you got a bad grade in a class. Wait, let’s make it more nuanced:

You got a C+ in freshman biology.

I’ve seen an experience like this change the career plans of really smart people. They get a bad grade, they say, “well, I’ll never get into med school now,” and they switch their major. Or they look at everyone in the class and say, “everyone else is mastering this, so there must be something wrong with me.”

So, is it true? Is something wrong with you? Will you never get in? Should you switch your major based on this one bad grade?

Situation: I got a suboptimal grade in one class.

Possible conclusion: I should switch my major.

Evidence for: Others got a better grade than I did. Classes are going to get harder from here.

Evidence against: I’m just a freshman. I didn’t fail. I will only get better at studying from here.

Reframe: “I should work harder and become a more efficient studier so that I improve in future classes.”

Look at how much more helpful that re-frame is. If one person is saying, “I must suck at this,” and another is saying, “I need to improve my performance,” I’m betting on the latter to be more successful in the future.

So, I have an assignment for you: find a mistake that you’ve made in the past. Or maybe it’s just a situation you wish had gone differently. Whatever it is, pick something that you think about frequently that you kick yourself for.

Clearly describe what happened. Just stick to the facts.

Let’s get out each conclusion that you’ve been thinking to yourself about this experience. What are the thoughts you’ve been having? What have you been telling yourself?

Now, let’s look for evidence for and against these conclusions. Write down the extenuating circumstances.

And finally, re-frame. What’s a more helpful story you can tell yourself about your past?

A final word here:

You’re not looking for excuses for past mistakes. The point isn’t to avoid learning anything from the past. The point is to make sure that what you’re taking away from the past is accurate (you need to convince yourself of this, especially if you’re stubborn like me), and then to re-frame the story you tell into something more helpful!

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