Understanding the veterinary mindset

The mental health and well-being of the veterinary team played a significant role at this year’s British Small Animal Veterinary Association (BSAVA) Congress. Not only were delegates provided with sessions on well-being as part of the congress streams, but a special Wellbeing Zone, decked out with comfortable bean bags and noise-cancelling headphones, provided a safe space for face-to-face delegates to relax in during the live congress.

The Wellbeing Zone also played host to early morning yoga sessions, workshops, guest talks, campfire chats and calming classes, which covered topics ranging from breathing exercises, active allyship, neurodiversity and life “hacks” (with a wellness focus).

The Wellbeing Zone was brought to delegates by a collaboration between BSAVA, British Veterinary Chronic Illness Support (BVCIS), the British Veterinary Ethnicity and Diversity Society (BVEDS), the Royal College of Veterinary Surgeons (RCVS) Mind Matters Initiative, BVLGBT+, the British Veterinary Association (BVA) and Vetlife. Meanwhile, online delegates had the opportunity to join a host of virtual well-being experiences, including online video tutorials, demonstrations, socials and on-demand yoga and meditation sessions.

But why is mental health and well-being so important? What monsters hide in the minds of veterinary professionals, eating away at their confidence and personal growth? And how can we overcome them? These questions were at the heart of the management stream lectures by leadership and culture consultant Liz Walker and head of training at the Veterinary Defence Society (VDS), Carolyne Crowe. So, let’s peer inside the veterinary mindset.

Inside the veterinary mindset

“Our mental health is a direct consequence of our mind and our mindset,” says Liz, and with a quarter of vets stating that they have experienced a mental health problem in the last year, the state of the veterinary mindset seems to be at a tipping point. In fact, “before we are even getting into clinics, our mental health is at crisis point,” observes Liz after revealing that 38.7 percent of vet students have experienced suicidal thoughts.

With a quarter of vets stating that they have experienced a mental health problem in the last year, the state of the veterinary mindset seems to be at a tipping point

But what is lurking inside our mindset to lead to these disturbing figures? We are all torturing ourselves with “what-ifs” and “should-haves”, and, according to Liz, the driving force behind these negative thoughts is three key things: fear, obligation and guilt.  But it is important to remember that these “what-ifs” are entirely imagined.

Fixed mindset feeds fear, obligation and guilt

Liz suggests that these negative emotions are derived from the “notion that we should have all the answers”. Feeding into this is the imagined suggestion that we should never get things wrong or make a mistake, that we should never show weakness or ask for help, and that everything should be done for free. This is a fixed mindset, states Liz, and one that needs to be broken. The present veterinary mindset is “all-or-nothing”, framing failure as the limit of one’s abilities and this, she argues, breeds “not clinical excellence, but clinical perfection”.

The present veterinary mindset is “all-or-nothing”, framing failure as the limit of one’s abilities and this, [Liz Walker] argues, breeds “not clinical excellence, but clinical perfection”

Perfectionism and imposter syndrome are derived from and feed into this fixed veterinary mindset of fear, obligation and guilt, holding people back from personal growth.

Perfectionism

Perfectionism is the tendency to employ high standards, which is not inherently bad, but when this comes hand in hand with overly critical self-evaluation it can have negative effects on the psyche; most studies, says Liz, agree that perfectionism shows strong and positive correlations with psychological difficulties such as an increased risk of depression and potential for suicidal thoughts.

However, there are two types of perfectionism:

1. Self-oriented: when you believe that being perfect is crucial. This is characterised by setting excessively high standards for oneself
2. Socially prescribed: when you believe others have set high standards for you. This is characterised by the belief that you need to fulfil these standards to be accepted by others

A pet owner survey by VetRunner (2021) showed that 100 percent of the respondents answered “yes” to the question, “do you expect your vet to be able to deal with any medical or surgical situation?” This figure showcases how veterinary professionals are often presented with socially prescribed perfectionism as clients place the expectation of perfection onto vets with the belief that they can have their pets correctly diagnosed and cured just like that. This adds fuel to the fire that is the “all-or-nothing” veterinary mindset.

Imposter syndrome

One hugely contributing fear that underlies the veterinary mindset is the fear of “being found out”, of people realising that we don’t have all the answers, observed Liz. This is an indicator of imposter syndrome. But what is imposter syndrome?

Imposter syndrome, explained Carolyne, is not a true “syndrome” as it does not have an aetiology, and therefore there is no medication for it. It is also transient, manifesting in different ways and different situations for everyone. Carolyne concluded that imposter syndrome is a product of how our brain works “normally”; it is “an over-inflated strategy of our brain trying to keep us safe. When we find ourselves in a situation where we must learn and grow – when we are out of our comfort zone – our brain tries to protect us. This is the strategy that becomes “over-inflated”.

Seventy percent of people describe experiencing the feelings involved in imposter syndrome at some point in their career

Seventy percent of people describe experiencing the feelings involved in imposter syndrome at some point in their career, observed Carolyne. It is normal to feel this way, and it is vital that we “recognise it and not allow it to define us; not allow it to hold us back”. Recognising the signs of imposter syndrome can be difficult when it is so transient, but there are some recognisable ways that it can manifest in the veterinary mindset:

• Difficulty accepting praise
• The thoughts you have (Box 1)
• Reluctance to seize opportunities and accept new positions
• Reluctance to acknowledge your contributions, or stepping back from recognition
• Trouble asking for and/or accepting help

How do we overcome this?

We cannot hold ourselves to the impossible standards of always getting things right and always knowing the answer, because “if we hold ourselves to these socially prescribed standards,” says Liz, “we are setting ourselves up to fail”. But how do we change this? Carolyne and Liz describe two key areas to make a difference: building up and practising emotional resilience and adopting a growth mindset.

Emotional resilience

“We need to be building up our ability to cope when things don’t go to plan,” stated Liz, and developing emotional resilience can do this. Emotional resilience can also help you cope with emotional blackmail, a form of guilt transference that occurs when people use the fear, obligation and guilt you feel to manipulate you.

A fundamental aspect of building emotional resilience is self-care, because, after all, “we can’t lead when we are exhausted,” observed Carolyne. Here are a few of Liz and Carolyne’s self-care tips and tricks to help you become “responsibly selfish”:

• Don’t hyper-fixate on the negative. Keep reminding yourself of the successful cases and work you are doing, and don’t forget to celebrate your successes
• Get self-aware. It is essential you understand how you work, what you feel and when you feel it. Knowing and becoming comfortable with yourself can help you recognise what situations are more likely to trigger negative emotions. Then you can prepare for these eventualities as “forewarned is forearmed”, says Liz
• Have an outlet outside the consult room.“Find something you can almost lose yourself in,” says Liz, as a hobby that takes your mind off the working day can prevent hyper-fixation and relieve stress
• Learn to take a break. It is crucial that you put “strategic resets” in place, argued Carolyne, so go outside and get fresh air, even if it’s just walking around the car park. Especially after an emotionally charged moment, remember that the client can wait, says Liz
• Talk things out and build your support network. Talking with friends, colleagues and support groups and reaching out to places such as Vetlife for help will help you feel supported

Growth mindset

It is rarely a lack of clinical or technical skills that hold us back in our career, observed Carolyne; instead it is a lack of confidence and our mindsets that stop us from achieving and enjoying what we can. Adopting a growth mindset can help you reframe failure as a learning experience, giving you the confidence to embrace the new and helping you enjoy the challenges presented to you.

It is rarely a lack of clinical or technical skills that hold us back in our career… instead it is a lack of confidence and our mindsets that stop us from achieving and enjoying what we can

Reframing failures and setbacks as springboards for personal development is the essence of a growth mindset. So, start by acknowledging and understanding that everything is a continual learning journey and that you do not know all the answers, suggests Liz. And remember these three key things:

1. That things do not always go to plan
2. You can only ever do your best
3. Doing your best will never equate to getting it wrong

Once you have done this, share “the good, the bad and the ugly”, advised Liz. Arrange clinical rounds, discussions and case studies with colleagues, or start your own regular “wine and cheese nights” where you can talk about your cases and collaborate with others, suggested Liz. But it is important to do this regularly, says Carolyne; have five-minute morning huddles, evening debriefs, or discussions at the end of each case rather than for 40 minutes now and then. Be adaptive and remember that learning is a cycle: “make a decision, do something, see the outcome and review it,” said Carolyne. 

In summary

Reframing failure as a learning process and practising self-care and resilience is crucial in overcoming the fixed veterinary mindset, which fosters fear, obligation and guilt, leading to mental health problems. But at the end of the day, says Carolyne, the most important thing to remember is that “however you feel today, you don’t need to feel tomorrow”.