The Three Gaps Behind Your Overload (And no, one of them isn't Time Management)

Most community therapists know they are overloaded. What they cannot see is why, or where it is actually coming from.

In this episode, Imogen breaks down the three gaps sitting underneath almost every sign of cognitive overload in community practice. The thinking gap, where there is no capacity left to lead your business because every lane is already full. The delivery gap, where your clinical knowledge cannot make it onto the page the way you know it should. And the leadership gap, where the inner critic is running the show and the inner mentor cannot get a word in.

These three gaps are not separate problems. They come from the same overloaded system, and no one teaches therapists how to build a practice around the cognitive capacity they actually have.

If this sounds familiar, doors are open now for Overload to Overflow. Early bird pricing closes 5 July, and the next cohort starts 13 July.

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Transcript

SPEAKER_00 0:00

Welcome to Cognitive Capacity Chat. This is the podcast for the therapist ready to think beyond the therapy room. I talk about our cognition as our foundation, not just for our clients, but for ourselves. Because the way we think, organize, and live directly shapes our clinical work, our capacity, and longevity in this profession. I'm Imogen, an OT, here to bring you practical conversations that fit into real life. This podcast is for the therapist who wants more depth, more clarity, and more life. Welcome, hello, and welcome to another episode of the Cognitive Capacity Chat. Today I really wanted to jump in three really key areas that community therapists are missing when it comes to identifying their gaps in their own work. Because I know as an occupational therapist who has worked in the community my entire career, that we are not taught how to carry the various loads that we require to. We don't get taught, we pretty much get taught to carry the clinical load. But the emotional load is sometimes touched on talking about the psychological safety. There's a lot of EAP programs, which is amazing. But we don't talk about everything else that goes on in our world and all of that piling up together as well. The mental load, like just being an adult is a lot to carry. The environmental load, what we actually have to do every day to get us to the outcome. I wanted to talk to things that you might be feeling when you are experiencing these overloads and then the gaps. So you might find early signs that your cognitive load is too high, is you're constantly saying, I just need to get to the weekend. It's just been a busy week. But there's it there it's more to it than that. You should be waking up. Sure, work is always going to have a level of complexity, but you should be waking up excited to start your work, step into what you need to do and finish the day and be present with that end time. So if your cognitive load is high, you may w wake up with unfinished tasks in your head, or as you're falling asleep, unfinished tasks pop off in your head. It's a flag that your working memory is actually just holding the information instead of processing it and putting it where it needs to go. Maybe you can't see the whole clinical picture and you're having a difficult time with really comprehensive tasks that you have to do. The easiest one for me to think of is difficulty with wheelchair scripting, and you forget to think about them going out into the community, and I don't know, their GP's office has a really small door, and you haven't actually considered that. This is an example of your executive function just being so exhausted that you're not actually able to plan and organize and totally see every functional element of the picture. The other thing that might happen is you might feel dread, urgency, avoidance, or irritability when you open your inbox or you look at your phone or you have a day off. This is the nervous system saying that you're overloaded and that your brain is almost so reactive that it's anxious when it's looking at that information, that there's so much information to process that it's overwhelming, and that you're almost lack on the response to emails or phone calls because you're so behind, that it's actually bringing up an emotional reaction, which is definitely not where we're meant to be, because managing your emails or phone calls is just part of the job. The other consideration to think about is you're feeling always busy and you're spinning the wheels, but you're not moving forward. So nothing feels completed. You're just chopping and changing between tasks, being really reactive and really not actually moving forward. So you're not doing actual productive clinical work or business development work or project-based work, leading you to feel like you are actually not moving the needle forward. The other consideration, a sign that you're overloaded in your therapy role, is your weekends become your catch-up time or maybe your evenings because you carry so much that your work time spills over into what is supposed to be your personal lifetime. And if you're an occupational therapist listening to this, occupational balance, guys, is what we're teaching our clients every single day. And when it comes to us, for some reason, occupational balance goes out the window. And additionally, you might also find that your emotional bandwidth is just so minimal that you feel snappy, flat, avoidant, foggy, overstimulated. And unfortunately, this is likely taken out on your family because you're not able to be snappy at clients, or maybe you just don't have as much tolerance for your comprehensive clients, is because you've got so you're carrying so much every day that you are just not actually achieving any relief from all your thinking that you're doing. You are just holding it in your brain. So why you are feeling this way is because your load is too high. So there's so many different reasons that this could be. It could be because you don't have very many systems with your adulting load. So the invisible thinking just required to get through the days. You don't have a plan for dinner, you're often feeling like you're missing personal activities like the gym. Your life admin waits until it becomes urgent. You delay simple personal tasks because it feels like it occupies too much of your headspace. There's so many different reasons, but those are a few examples. Commonly, clinical load can really be impacted where you're overwhelmed, like forgetting details from sessions, being so stretched that you can't make a decision, or maybe you're so worried that you're not able to actually remember pieces of information because your brain is so full. Another real common one is you sit and procrastinate when you're writing your reports instead of actually just doing them. I would also say procrastination from a point of using AI instead of doing it yourself. Now, I am all for AI for enhancing things or getting clear and concise. But when we're really overwhelmed and overloaded from a clinical lens, when you are producing a report primarily through AI, which you do have to stand in court and be proud of that, you don't have the brain capacity to then critically analyze what the AI is spitting out. You do not have the capacity to actually say, hey, if I was reading this as a planner or a support coordinator or a carer, would I actually understand what I'm saying? Or is it just words on paper? So that is a consideration as well when we think about overloaded therapists. Maybe you are emotionally overloaded, maybe you're everything emotionally overloaded means that you are carrying that emotional energy that you get from your clients all the way home, and you feel so full even though on paper your workload is manageable. Or maybe you just become really sensitive to pressure or feedback. And then there's environmental load as well, which the systems or lack of systems you work within and the load they add. So, for example, if your inbox if was really full and overloaded, that could be an example of being environmentally overloaded because there's no system in place to manage your emails. You might also find that you are really thrown by anything that's beyond your control, such as NDIS or if a report comes back. And so I wanted to talk to you today the three key gaps that actually cause this overload and why it's so essential to actually action these and tackle these head on so that you can actually start feeling like you have the capacity that we really need as community therapists because we hold so much. So the first gap is the thinking gap. So this is true for all of those areas of load that I just spoke to that most of the time when we are overloaded, we have no capacity left for the higher level thinking because the lanes are already so full that we can't actually action anything else. And this is so costly to clinicians and business owners because you consistently need to critically analyze your business, how you're getting referrals, how you're marketing things, how your cash flow is looking, what you need to change internally for an improved system structure for your team, for yourself. How are you going to expand and move beyond just one funding body, particularly if that one funding body is a fixed price? And how are you going to actually do that personal project or actually clock off if you are not able to access that higher level thinking? And that higher level thinking isn't going to be able to be achieved until you are able to optimize your cognition from attention, info processing, memory and recall, and then stepping into being able to do those executive functioning tasks of emotional regulation, decision making, inhibition, being able to critically analyze and piece together multi-diff multiple different pieces of information and then consider each part. And a lot of you are relying on AI to do that decision-making capacity, which is concerning. And yes, AI is really great, but if you don't have that critical analysis piece in the back of your mind of what is actually true for my business, what holds down my values, and how can I actually deliver a profitable service, then that is a really big gap. Additionally, if we can't think, if we can't get over the line to just write a report, a comprehensive report, then we're going to have no billable hours. Additionally, if you are just leaning into AI more and more as you write your reports, then you are going to find that coordinators or NDIES are going to start declining more and more because you are not actually writing for the person. You are writing for an AI who cannot be clear on their outcomes. Additionally, I know a lot of people just stare at their computer screen and might get distracted with social media and not actually take action. And then the ongoing cycle of that is actually just adding more to your cognitive load. So if we don't have higher level thinking capacity, this is a huge gap with being able to create profitable business. Additionally, another gap is when what you know clinically versus what you can actually produce when your capacity is maxed. So potentially not being able to actually write that report or being able to be present with that client because you're too full in your brain. You can't actually deliver the emotional space for the client who's crying in front of you, or for the client who's outburst at the funding body because they've said no for the third time for a really basic piece of equipment, for the frustration of the carer, for the grief of the carer who is having to get carers in because their husband is losing their independence, but the husband doesn't want care in. And so when we don't deliver on things, when we don't actually get the task done, when we don't actually have the space for our clients to from an emotional lens, from a practical lens, from a functional lens, every single thing, we are going to find that this is going to eat into our clinical integrity and our trust and rapport with clients. And I know that as Allied Health Practitioners, a lot of referrals come through word of mouth. People need to know and trust you. And you need to deliver an excellent service to enable you to actually get those referrals and make marketing and referral management easy. But when you stop delivering on your amazing clinical service that you know you can do because you are so cognitively overloaded, you are going to lose that business structure where you just get word of mouth referrals and they trickle in as required for your referrals, particularly if you're a sole trader or a small business. The third gap that is really important is the leadership gap and being unable to internally lead yourself. And what I mean by this is if you're overloaded, it's likely that your inner critic is the loudest. So it's likely you're saying to yourself, I should have done more, I should have, I should work for longer, that report was no good, that session was no good, I stuffed up that email. And your inner critic is really loud to the work that you're producing. And potentially it's right, because potentially you are just leaning way too heavily on alternative sources such as AI to deliver the service that you're supposed to be delivering. And when our inner critic is really loud, it means our inner mentor is not as loud. And so without internal leadership, without that inner mentor saying, You got this, it is very difficult to externally lead a business or a team. So if you are overloaded and you have a really high inner critic, and that is going to completely deplete your ability to make a decision from a business lens, from an area of growth, and it actually will cause you to have this slow snowball effect of not being able to lead yourself, not being able to lead support coordinators, for example, is someone we often do lead to encourage the best for our clients. We're not going to be able to lead from a point of if someone starts to critique our work, which does happen a little bit, that we just get emotionally snappy and want to disengage with the service rather than identifying their actual concerns about the letter or the report that we've done it. And so you've probably heard that all these gaps intertwine. So you've got the leadership gap, the delivery gap, and the thinking gap. They're all related with the cognitive capacity that you currently have. And it's all because the same system is overloaded. You don't have various brains, but you do only have one self and one business that you're working towards growth. And I just believe so strongly that community therapists are so integral in our world. We need allied health out in the world. But if we can't manage how we service, how we have systems on our practice, the infrastructure to actually hold what we need to do, we are not going to be able to deliver on those amazing clinical skills that you have and that you should be delivering. And if this is true for you, then I would love for you to think about one small thing. I like to call them potholes because you drive over them every single day and they're really annoying and you think you can't fix them because it will close a lane down, but really it just closes it for the day and then it's repaired. I would love for you to think about that one small thing that you can repair that will help you carry less going in tomorrow. Maybe it is having discipline to book out 30 minutes at the end of your day and have your session finish at 4:30 rather than 5. Maybe it is using Heidi AI for your notes and just voice dumping whilst you are on your in the line to school pickup. It is a small action that can help reduce your cognitive load. But what I also know to be true, it's really hard to carry all of this by yourself, to work out the key areas that are impacting to you as a clinician and moving through it and leading yourself and your business through it whilst also trying to tackle it. And so that's exactly what I want to do in Overload to Overflow. The doors are open and we have early bird pricing until the 5th of July 2026. So that's only four days away if you're listening to this podcast as soon as it's dropped. And the cohort starts on the 13th of July. So in two weeks' time, you could be feeling like you have a plan to tackle all of these things, all of these overload, because I am there with you and we are walking through the overload together. We are going through the systems that you need to implement, the solutions that we need to create to help your inner mentor be louder, to help you actually have that occupational balance piece and have personal life. So you're not emotionally reactive. Whatever it is for you, we will optimize your cognitive capacity. If this is interested for you, just DM me overload and I will send you through the Discovery Call link. The website is also linked below, and I think that's about it.