I have struggled with confidence and the one thing i found woefully lacking was practical advice on how to be more confident . . .
Trainer: ‘Be more self-confident!’
Me: ‘Ok how?’
Trainer: *blank look and uncomfortable squirming*
So what is confidence and what affects it.
My wordy definition – ‘Confidence is a self-belief drawn from an accurate appraisal of our knowledge and skills and our ability to portray this through our actions.’ Being confident requires having a realistic sense of one’s capabilities and feeling secure in that knowledge.
It is pretty much normal to not feel quite comfortable in many situations we may find ourselves in. This is imposter syndrome and almost everyone I have spoken to suffers with this. It boils down to that ubiquitous sense of ‘winging it’ and fear of ‘being found out’. This can spur us on to better ourselves, but is an issue when it causes us to become frozen in self-doubt.
So a pre-requesit of having an appropriate level of confidence is having the skills and knowledge required. (Yet another planned post will focus on tips for studying!)
If a trainer is telling you to be more self-confident then this translates as – ‘Your perception is not a true reflection of your skill and knowledge’ and this means you are being overly negative. If you are too positive then you become arrogant and cocky!
Self-Confidence is our own perception, which is based on our own thought patterns. External factors such as illness, changing circumstances, bullying or domestic abuse can also have a massive impact. If this is you, seek help. I needed counselling after suffering mental health issues after the birth of my first child.
So to improve confidence we need to challenge our perception of ourselves and ultimately change our thought patterns. There are two ways to challenge your perception. You can seek extrinsic reassurance or you can promote intrinsic change.
Extrinsic reassurance is definitely the easier to come by although people suffering from low self-confidence tend to shy away from it for fear it will confirm as oppose to quash their insecurities.
The single best external reassurance i have found was hearing things I wasn’t supposed to (namely whilst hiding behind a door crying). But more practically you can ask for feedback and loads of it – you are better than you think.
Secondarily learn with your peers. In all likelihood they are no better than you and may be suffering the same insecurities. Attendance at a BOA instructional course taught me two things
1) My expectation of what I needed to know was far too high
2) I was actually performing at the same level as everyone else
To increase confidence for procedures ask the consultants to walk through things before cases and debrief after so you know what is expected and how you compared to that.
Intrinsic change is more difficult to come across and may involve a long dark night of the soul. Although this is an excellent TED talk on faking it:
Fake it ’til you become it: Amy Cuddy’s power poses, visualized
So this comes back to our thoughts and trainees who suffer from anxiety and low self-confidence are engaging in negative patterns of thinking.
The first step is to recognise the negative thought, then check our perception of events and either challenge the unnecessarily negative thoughts or change our future behaviour accordingly – you may recognise this process as reflective practice, but many of us do this fairly superfcially!
First I write down the events from my emotional brain (Katrina Ubell’s thought download). I encourage myself to be as emotional and true to my feelings as possible at this point. Then after some time (very variable). I review from a more rational place and identify negative thought patterns. Then I challenge these thoughts and choose better ones – easy huh! I’m a stationery lover so I have a specific notebook for this and coloured pens to add my reflective observations when I look back.
Initially you may need a trusted mentor or friend to help you challenge this view of yourself. Although I would recommend an initial edit alone as I would often come across as slightly unhinged if I let anyone read the first version!
Some personal examples of my negative thought patterns. . .
Boss texts to say ‘can you pop in to see me?’ I immediately think I have fucked up the procedure. I did alone over the weekend and catastrophise all the way to work – ‘I’m in so much trouble’, ‘what if their arm has fallen off or they are dead!’. In fact he just wanted me to pass on a message to someone!
I’m doing my second hip replacement and it is not perfect. Deride myself until the boss dispels my unrealistic expectations.
Difficult trauma case with multiple medical complications. Blamed myself for not being able to care for this patient alone. Consultant pointed out that I am not trained in intensive, renal or respiratory medicine and as such I should not be expected to manage complex conditions pertaining to these specialities.
As you can see in each of these cases I needed the external validation of the consultant to adequately challenge my negative thoughts, but to get this I had be brave and talk to them.
Finally we also engage in negative bias believing the one bad comment, amongst all the good. Research has shown that thinking about 3 good things that we bought about that day before we go to sleep every night for 2 weeks is as effective as a 6 month course of antidepressants. This you tube video is excellent https://m.youtube.com/watch?v=hZ4aT_RVHCs
By changing my thoughts, I change the way I feel and voila – a growing sense of confidence. This is very much a work in progress and I suspect something I will need to do forever more. But i am now at the point where I happily volunteered to do my first unsupervised humeral shaft fixation , rather than being terrified at the prospect of a carpal tunnel decompression when I already had more than 50 under my belt.
There are great resources for more information about negative thought process and access to online CBT resources. See the Useful links page.
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