The Two Words Keeping You Stuck in Burnout (And What to Say Instead)

I stayed late at work the other day.

Not because there was a crisis. Not because someone guilted me into it. I stayed because I looked at my desk, looked at the clock, and made a decision: getting caught up today felt important to me.

And here's the part that surprised me — I didn't feel resentful. I didn't spend the drive home replaying it in my head, mentally drafting a list of all the ways my job takes and takes and takes. I just… drove home. Satisfied. Present.

What was different?

Two words.

Instead of telling myself "I had to stay late," I told myself the truth: "I chose to stay late."

It sounds almost too simple, doesn't it? But that tiny shift in language — from obligation to ownership — changed everything about how I experienced that evening. And honestly? It's been changing everything about how I experience my life.

How "I Have To" Keeps You Stuck In Burnout

If you're a physician, a nurse, a PA — really, any woman in healthcare — you probably say "I have to" dozens of times a day without even noticing.

I have to finish these charts before I can leave.

I have to go to that meeting.

I have to stay up and prep lunches.

I have to answer that email tonight.

I have to be the strong one.

Each time you say it, something subtle happens in your body. Your jaw tightens. Your chest gets a little heavier. Your shoulders creep toward your ears. You feel a quiet, simmering resentment — and you probably don't even know why.

Here's why: "I have to" is the language of powerlessness. It tells your brain that you're trapped. That someone or something else is in charge of your time, your energy, your life. And when your brain believes you have no choice, your nervous system responds accordingly — with the tight chest, the racing thoughts, the exhaustion that never quite goes away even after a full night's sleep. And over time you start to feel stuck in burnout.

Research backs this up. A landmark study published in Psychological Science found that when people framed their actions as obligations rather than choices, they reported significantly lower motivation, less satisfaction, and more emotional exhaustion — even when performing the exact same task. The framing alone changed the experience.

And for women in healthcare? This language of obligation is everywhere. A 2025 study in PLOS ONE found that female physicians experience burnout at rates 60% higher than their male counterparts. The reasons are well-documented: disproportionate emotional labor, more after-hours EHR time, more "office housework," more invisible tasks that no one asks you to do but everyone expects you to complete. But underneath all of that is something rarely discussed — the story we tell ourselves about why we're doing it.

I have to because that's what a good doctor does.

I have to because no one else will.

I have to because if I don't, everything falls apart.

Sound familiar?

The Moment Everything Shifted for Me

I'll be honest — I didn't always catch this. For years, I was the queen of "I have to."

I have to be the hardest-working person in the room. I have to prove I belong. I have to earn the respect of my colleagues by never saying no, never leaving early, never admitting I'm struggling. That perfectionistic survival strategy I learned as a little girl — the one my fourth-grade teacher tried to warn me about — it followed me through vet med, through medical school, through residency, and straight into attending life.

And it showed up most dangerously in my language.

I had to stay late (because good pathologists don't leave cases on their desk).

I had to miss gymnastics (because the cases came first).

I had to sacrifice my evening (because that's just how it is in medicine).

None of that was actually true.

The truth was: I was choosing to stay. I was choosing to prioritize work in that moment. And that's okay — sometimes work genuinely matters more in a given moment. But the lie of "I had to" robbed me of ownership. It made me a victim of my own choices. And victims don't feel empowered. They feel trapped.

The shift happened one evening a few weeks ago. I'd stayed late — again — but this time I caught myself mid-thought. Instead of the usual "Ugh, I had to stay late again," something different came out: "I chose to stay late because getting caught up felt important."

And just like that, the resentment dissolved.

Not because the situation changed. But because I changed — or more accurately, because I finally told myself the truth about my own agency.

Why This Matters More Than You Think

Here's what I want you to understand: you never actually "have to" do anything.

I know that sounds radical. I know your brain is already protesting — But I HAVE to chart! I HAVE to show up to work! I HAVE to feed my kids!

And yes, there are consequences to not doing those things. Real consequences. But consequences and obligations are not the same thing. You could, technically, not chart tonight. You could call in tomorrow. You could order pizza instead of cooking.

You choose not to because the consequences matter to you. Because your patients matter. Because your family matters. Because showing up matters to who you are.

And that reframe — from "I'm forced" to "I'm choosing" — is everything.

When you say "I choose to finish my charts because my patients deserve accurate records," you're no longer a prisoner of your to-do list. You're a woman who knows what she values and acts accordingly.

When you say "I choose to stay home tonight instead of going out because rest is what I need right now," you're not being boring or antisocial. You're being intentional.

When you say "I choose to leave these two cases on my desk and go to my daughter's gymnastics class because I trust myself to get them done tomorrow" — you're not being a bad doctor. You're being a whole human being who has decided that quality of work and quality of life can coexist.

How ALIGN Helps You Change Your Language

This is exactly the kind of work we do in the ALIGN Method — and why I believe it's so powerful for women in healthcare who've been running on the "I have to" treadmill for decades.

A — Acknowledge what's actually happening. Separate the facts from the story. The fact might be: "It's 5 PM and I have three cases left on my desk." The story is: "I HAVE to stay and finish them or I'm a bad doctor." Can you see the difference? The fact is neutral. The story is where the suffering lives.

L — Listen to your body. When you say "I have to," notice what happens physically. For me, it's jaw tension and a heavy feeling across my shoulders. Your body always knows when you're telling yourself a disempowering story — it tightens, braces, prepares for the obligation. When you switch to "I choose to," notice how your body softens. Even slightly. That softening is your nervous system recognizing the truth: you are not trapped.

I — Inquire with curiosity. Ask yourself: Is it true that I have to do this? Is this thought useful? What might be true instead? One of my favorite inquiries is: "If I'm choosing this, what am I choosing it for?" That question alone can transform resentment into purpose.

G — Ground yourself in compassion. Of course you've been saying "I have to." You learned it from a system that rewards self-sacrifice. You learned it from a culture that tells women — especially women in medicine — that their worth is measured by how much they give. Give yourself grace for the years you spent in the "have to" trap. And give yourself credit for being willing to question it now.

N — Navigate forward with intention. Now that you see the pattern, you get to choose differently. Not perfectly — differently. Maybe tomorrow you catch yourself mid-sentence: "I have to — wait. I'm choosing to." Maybe you start a practice of rewriting your to-do list with "I choose to" at the top. Maybe you notice that some things on your list don't actually align with your values at all — and you give yourself permission to let them go.

The Ripple Effect

Here's what I didn't expect when I started this practice: it changed more than just my relationship with work.

It changed my relationship with time. Instead of feeling like time was always slipping away from me, I started to feel like I was directing it. I stopped canceling personal plans because I "had to" catch up and started protecting my white space like the sacred resource it is. (Last week, I had a completely unplanned afternoon with my daughter — playground, hide and seek, snuggles on the couch — all because I had white space on my calendar. I didn't "have to" take her. I chose to. And it was one of the best afternoons I've had in months.)

It changed my relationship with guilt. When you choose something consciously, guilt has less room to operate. Guilt thrives on the belief that you should be doing something else. But when you've intentionally chosen your current action — I am choosing rest right now because rest is what my body needs — the "should" loses its power.

It even changed my relationship with grief. I'm in the middle of a big career transition right now — packing up my office, saying goodbye to colleagues I love, closing a chapter I once thought would be my "forever." And instead of drowning in "I have to leave" or "I have to start over," I'm practicing: "I am choosing to walk toward something that aligns with who I'm becoming."

That doesn't erase the sadness. But it holds the sadness alongside something else — agency. Purpose. Forward motion.

Your Invitation

If you're reading this and feeling that familiar tightness — the one that says "This sounds nice, but my situation is different, I really DO have to…" — I want to gently challenge you.

You don't have to believe me. Just try it.

For one day this week, catch every "I have to" and replace it with "I choose to." Write it down if that helps. Say it out loud in your car. Whisper it to yourself between patients.

I choose to chart now.

I choose to pick up the kids.

I choose to skip the gym today because rest matters more.

I choose to go to bed early.

Notice what shifts. In your body. In your mood. In the story you tell yourself about your own life.

Because here's the truth that nobody in medicine teaches you: you were never powerless. You just forgot you had a choice.

And remembering? That's where everything begins to change.

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Ready to reclaim your agency — and your time?

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You don't have to do any of this. But you might just choose to.