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Physician Success Tool: Confidence, Part 3 - A Look at Three More Barriers.

We are in week 3 of a 4-week series on confidence. The first week we reviewed the normal development of confidence and last week, we reviewed a trio of issues that interfere with gaining confidence and actually often unjustly decrease confidence. This week we look at three more common interrupters – comparison, external validation, and projected judgment.


“Comparison is the thief of joy” has been attributed to a few famous leaders. Regardless of who said it, it is so true. Although it’s a normal human action that our brains use to make sense of the world, comparing ourselves to others often leads to despair (“Compare and Despair”). In academics, whether in learners or faculty, I find that the comparison is often apples and oranges—an intern looking at how effortless a senior gets through a complex patient. A junior faculty member comparing themselves to someone in academics with 20 years experience. In addition, we have no idea of what it took for them to get to where they are or, for that matter, how confident they feel inside. We only see a small glimpse. Also, everyone has different strengths, and we all develop at various rates in different arenas. Most of us end up comparing our weaknesses to others’ strengths. Look at your own strengths—work from those. Grow in the areas you want to improve. No self-flagellation or negative self-talk is required. Strengths-based self-value and self-compassion keep your evolving belief in yourself intact. And it's a more effective way to spur yourself on to growing in areas you desire. 


External validation is interesting. In and of itself, it’s not a bad thing. It, too, is natural. However, when we begin to over-rely on it, it can lead to a toxic cycle. Which comes first is like the chicken and egg from my vantage point. You lack confidence, so you seek it from others validating you. That’s fine and good except when there is no positive feedback, whether that’s because someone didn’t find your presentation helpful or they’re all just trying to keep their heads above water and have no bandwidth to pay attention or to put in effort for thanking you. A lack of positive feedback when relying on it so much can reinforce your narrative that you don’t deserve it. You prove your own worst fear – You’re not good enough; you don’t know what you’re doing; etc. Seeking validation fully from external sources feeds the insecurities. And the cycle continues. You become an approval addict and unfortunately, it's like Seymore in Little Shop of Horrors - external validation is never satisfied. There are a couple of key tips to lessen your over-dependence on others’ opinions. Review and be certain of your values, strengths, and your “why.” Also, increase your practice of gratefulness and of acceptance. Learn to celebrate others without it meaning anything about you. I wrote more about it a few weeks ago


Projected judgment narrative  is a term I’ll offer up here as a potential sapper of confidence. Maybe it’s the cousin to the inner critic. It’s where we feel others are watching and judging us in a negative manner. You imagine, the attending is judging your value and worth by reading your note and looking for mistakes. No wonder you might be tempted to over-think, second-guess, and/or hide while your confidence takes a nose-dive. Instead, view that attending as wanting to help you become the best doctor you can be. Remember when we reviewed mastery as the goal rather than performance? You can't actually mind-read anyway. Go ahead and assume, they are like the majority of faculty I know personally. They want to find what you’re doing well and see if there are things that will help you communicate more effectively with colleagues, specialists, billers, etc to become the best physician you can be. 


A word about self-doubt and anxiousness/nervousness. Last week we covered that “run of the mill self-doubt” is not the same as the impostor phenomenon. We covered the inner critic, which increases our usual self-doubt. But self-doubt by itself is a normal, functional emotion until the inner critic over-amplifies it or it grows into impostor phenomenon proportions. And, actually, it serves you to remain humble, especially in medicine. So, I want to challenge you to start to consider that typical self-doubt does not actually sabotage our confidence. Instead, I think of it as a part of the healthy tension that keeps us from being cavalier about important tasks and helps us strive for excellence (not perfection).


Similarly, many see a little anxiousness or nervousness before a task/talk/etc as proof of lack of confidence. Again, I think it is more a heightened sense of alertness that serves you even when you are confident. So many of the things we do in medicine require confidence and self-checking ourselves while being fully aware and alert. They work symbiotically with our belief in ourselves.


Looking at your own confidence patterns, which tend to be the more common sappers for you? How can you become proactive at recognizing and countering it and growing into your own assured self? I’d love to hear from you if there are other saboteurs you see for your own confidence in addition to those laid out these last two weeks. 


Next week, we will look at tools to help you grow into your full confident self.


Have a joy-filled week!


Residency programs can benefit from our Flagship 6-week hybrid coaching course for resident or faculty groups. Learn more here.

Orginal post 12/2021, updated Feb 2024


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