Internal Head Noise: The Cognitive Load Nobody Audits

In this episode, I am talking about head noise. Systems and apps are the tangible side of cognitive load, but negative self-talk is the load nobody audits. Those repeating thoughts are cars on your highway, and they are taking up lanes you need for clinical reasoning.

I unpack why we default to outcome-based wins, and why that is a problem when outcomes sit with fluctuating funding bodies, inconsistent decision makers, and clients who are human. I take you through the reframe I use with my own team and coaching clients: measuring skills and strengths instead of outcomes. They are concrete, evidence-based, and within your control.

I also cover why this reframe matters for clinic owners, including how strengths-based language keeps your marketing AHPRA-compliant when outcome claims cannot.

In this episode:

• Why negative self-talk is a cognitive load problem, not a mindset problem
• The wins trap: how outcome-focused celebration keeps you waiting months to feel competent
• The wheelchair reframe: four wins that happened before approval ever arrived
• How to make your inner mentor louder than your inner critic
• Strengths-based marketing that stays on the right side of AHPRA

Your challenge this week: DM me on Instagram @imogen_occupationaltherapist or email imogen@onot.com.au with one skill or strength you displayed this week that you are proud of.

If this resonated, Overload to Overflow is where I help you own the strengths you have and build the ones you need. It is a complete overhaul of how your brain operates so you have capacity for work, for life, and for you. The waitlist is open at imogenot.com.au

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Transcript

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 thank you so much for coming in again for episode 15 of the Cognitive Capacity Chat, which is super exciting. I absolutely love getting my thoughts out into the world and truly appreciate you being here. Today, I wanted to talk about cognitive load in the sense of head noise. So I think it's really easy and really transactional to say, you know, you need systems and processes like an app or a to-do list or a filing system, an organization system that works well for you and how you operate. But that is really tangible to understand and easy for me to speak to 'cause I think it's, it's tangible. It's like a mathematics calculation, A plus B equals C. But something that's less tangible is the self-talk head noise and how that negative self-talk can truly impact how we operate as allied health professionals, and then therefore impact our cognitive load. Because we know that anxiety in particular is reoccurring, repeating thoughts that manifest into the worst possible outcome or, you know, a considerably bad outcome. And so these reoccurring thoughts in our mind is going to create more cars in our highway and therefore less capacity to actually be able to do something else or send different cars up there. And I think it's very often, and I see it all the time, all, all, all the time, that we always are focusing on our wins I think every different place that I was employed, every different coaching container that I do, "Let's celebrate your wins. What's your weekly wins? Tell me about your wins." And it is so common for people to place their wins down as outcomes, that we got the AT report finished, or it was approved by the funding body, or I was able to set up the wheelchair, or I was able to deliver the meal plan, or I was able to do the swallowing assessments. I was able to create a relationship with the family members and have an outcome based on that. But so, so much of our wins are specifically focused on that outcome, and I think this is common as a society. We like to focus on the outcomes rather than the process. What's that, that common quote? "Focus on the journey rather than the destination." But really what I wanted to speak to was how integral it is to focus on our skills and strengths rather than our outcomes when it comes to cognitive capacity Focusing on your skills and strengths is going to help you collate evidence that what you are already doing, regardless of the outcome, is positive, impactful, and is getting you places. And we have a few clinical restrictions when it comes to AHPRA and advertising, and I believe that focusing on your skills and strengths, if you have staff members, if you have yourself, focusing on those versus outcomes is also gonna direct your marketing and advertising really, really well. And we also have an inconsistent funding body. For me, I've experienced the NDIS being very fluctuating and very dependent on the person you get on the other end, and similarly with other funding bodies like TAC and WorkSafe, you're always writing to someone different, and someone else is picking up the paper. And as much as you align with their required laws or criteria of the funding, decisions fluctuate. Humans fluctuate, and there's so many variables outside of your clinical reasoning, out of your outcomes that you hope to achieve, that can impact that decision. So I wanna take you through what I mean when I say skills and strengths versus outcomes. I wanna reframe that a typical one, one that comes up a lot in my world, is when a wheelchair is approved. So a lot of people celebrate the fact that the wheelchair is approved, and don't get me wrong, that should still be celebrated, absolutely. But the whole journey from... journey, not the destination, whole journey can be celebrated before we get to the wheelchair script. You can celebrate the skill of MAT evaluation and your interpretation of the results to enable you to get the right positioning outcome that you were seeking that no other wheelchair solution was able to resolve prior to. You can celebrate your strength of client communication and collaboration to get a piece of equipment that the client is fully on side with after having a history of abandonment. You can celebrate the strength of your report writing after you sent it to your supervisor and you got minimal feedback back because you finally did symptoms, functional impact, and what the intervention is going to improve from the barrier pers- perspective And then the ongoing wait, you can talk to the strength or skill of setting up a compensatory strategy for your client so they're not calling you all the time regarding, the AT outcome. And you can see how many strengths we've, and skills that we've started to highlight and how that, A, happens live in the moment. You'll be able to draw something every single day for your skills and strengths wins, versus waiting months and months and months for an AT outcome. Your skills and strengths are concrete, they're evidence-based, and they're within your control. All things that we as health professionals should be jumping onto, because that is exactly what we do when we practice our practice. We have to be clinically evident. We have to actually have clinical integrity, and we don't just base it off outcomes. And I wanna speak here that our clients are humans as well. So when we think about outcomes based, you know, oh, I had engagement with that client, which other therapists really struggled with and they weren't able to form a relationship with That outcome has so many variables attached to it. Maybe they changed their meds, maybe they were more open to engaging with your therapy. Maybe you're more, I don't know, look like their mom. I don't know. Could be any reason But when you focus on your skill of being able to be really personable, adjust to their needs, approach in a calm, grounded way, you can start creating that evidence that you, you are able to engage with clients that are difficult to engage with. And as for marketing, we can start saying, instead of saying, "Hey, we engage with clients that are tricky to engage with," that's the outcome. You can say, "Our therapists have the skill to sit and be grounded and regulated and adapt to your clients' needs." See how those two different ones separate from AHPRA and enable us to actually speak from a lens of marketing, because we're more so speaking about strengths and skills rather than outcomes, which you aren't able to do. I would also like a disclaimer here that this is not... I'm not a professional marketing person. This is just what I've learnt, and this is my personal opinion, that focusing on strengths of your therapy and skills that you have is going to stop the risk of your outcomes focus, which are your testimonials that you are not supposed to guarantee. You cannot put 100% guarantee or money back on your invoices, and you also can't do that on your, on your advertising either, and this is a really great way to do that The most important thing to think about though is the head noise that we are creating. When we start thinking about creating more more knowledge and more evidence that we do actually have really strong skills and strengths, we can start feeling like we can do things. And all of a sudden our mentor, our inner mentor, is louder than our inner critic, because we are not judging ourselves if a wheelchair report gets knocked back. We're not judging ourselves if the client who was hard to engage disengaged, because we're more so focusing on our personable characteristics that we displayed so that we are actually knowing and have the evidence that we are putting our best foot forward and enabling our client to have every aspect that we can. I do this with my team, I do this with my coaching clients, and I make sure... And it's really easy to slip back into the outcomes. So I make sure every time they say a win, what was the outcome or, uh, what was the strength or skill that enabled this outcome to be achieved? What did you actually do? And it could be as simple as communication, it could be as simple as ability to have the growth mindset, or it could be more specific and detailed. But I think it is so necessary as allied health professionals to focus on our actual skills and actually completing these skills and strengths regularly and routinely. I wanna challenge you to, if you have listened to this, I want you to either come over to Instagram and DM me, or I want you to send an email to imogen@onot.com.au with the skill strength/strength that you displayed this week or today that you are proud of, and I want to start facilitating that change. I can support you with finding your skills and strengths in all of my offers. In my Overload to Overflow, I really get to know you, and I really get to start helping you with owning these strengths that you have and supporting you to develop the strengths that you need to develop to get to where you want to get to. And if this has resonated with you, I want you to know that Overload to Overflow is more than just sitting down and setting up apps. It is a complete overhaul of how your brain operates so that you can actually be functional and have capacity for everything, for work, for life outside of work, for you, and I would love to see you in there. Thanks so much for listening, and I'll see you again soon