As the HeadSpace Coaching program that we initiated in March 2023 gets more and more traction, a frequent challenge appears to be a lack of confidence among some of the chiropractors who are participating.
It’s often the underlying reason for all manner of practice pathologies, from self-sabotage and seeking approval to failing to offer optimum care recommendations and a reluctance to promote the practice. Each of these unhelpful effects can be addressed individually. But resolve the confidence issue and the others significantly diminish.
Confidence can be divided into two groups—those related to chiropractic and its practice, and the more fundamental issue concerning one’s identity and self-esteem.
Self-Esteem and Identity
Since I’m not a therapist, this is the greater challenge, often getting a stranglehold long before the individual even becomes a chiropractor.
Self-esteem, what we think of ourselves, doesn’t respond to praise, encouragement or even rational argument. We know ourselves better than to fall for that!
So, here are a few things I check for:
Deserving of Our Life – This can be at the heart of deferring to the needs of others and generally living a life of self-sacrifice. Maybe as a child we overheard our parents talking about us in a minimizing way—and are now living into it. Or maybe we don’t feel like we belong or that we’re even entitled to have a say in our own lives. Conforming to the expectations of others is the perfect coping strategy that gives us a life of mediocrity and struggle.
Taking More Risks – Conduct an inventory of the behaviors of those with a poor self-image and it’s often a study in risk aversion. It can include everything from taking an unpopular stand and conservative wardrobe choices to anything bordering on the unknown. This lack of risk-taking makes such individuals indecisive with an inclination to procrastinate. Their beliefs (and introversion) make life far too scary to be proactive or outspoken.
Living to Survive – This is the most diabolical scheme of the enemy. It prompts those so afflicted with the desire to play defense rather than offense. It’s as if the part of their brain used for dreaming has been surgically removed. Life becomes the burden of merely surviving to the end. Rather than a grand adventure, we play small to avoid mistakes.
Self-Talk of Condemnation – The running commentary in our mind as we talk to ourselves about our circumstances can be cruel. If we talked to others, like we talk to ourselves, we would be friendless, living in a box under a bridge. This comes to an end by first noticing our internally generated commentary, then catching ourselves when we’re being needlessly harsh, substituting more positive affirmations. Important, because the relationship we have with ourselves sets the tone for every other relationship.
Seeking Approval – Rejection and abandonment become a form of death and to be avoided at all costs. Because the need to be liked is so essential, it’s difficult to make optimal recommendations and show up as a leader—important traits for effective doctoring. What makes this especially tragic is that with all the walking on eggshells and second-guessing about what others think about us, there are still people who don’t like us.
Raising Self-Esteem – If self-esteem isn’t improved by others praising us or persuasion, what does? I only know of one: attempting something difficult—and succeeding. But it risks possible failure! Exactly. That’s how you put the bully of fear in its place. That something difficult needn’t be overwhelming. It could be making decisions faster, stating your opinion, insisting on your preference, trying sushi, wearing loud socks, etc. Start small. When you discover the world doesn’t end, it increases your confidence, and everything starts changing for the better.
Chiropractic Confidence and Proficiency
When there is a lack of confidence surrounding the delivery of adjustments or the practice of chiropractic, it is often related to setting appropriate boundaries. This often manifests as taking on a responsibility for which the chiropractor has no “ability to respond,” such as the pace of a patient’s symptomatic improvement. There are others:
Lack of Identity – Chiropractic colleges are complicit in this because they increasingly teach a medicalized version of chiropractic that would cause the discoverer and developer of chiropractic to roll over in their graves. With the founding principles of chiropractic absent from most curricula, the newest generation of chiropractors are hobbled by a form of limited physical medicine focused on spinal pain syndromes. They’re in chiropractic, but chiropractic isn’t in them.
Taking Blame – When the practitioner (or the intervention) is given heroic status, it comes with the additional obligation of taking blame when it doesn’t produce the desired outcome. This is among the greatest challenge of those who have embraced a therapeutic model of chiropractic. This can create a constant, chronic low-grade form of defensiveness and a patient-pleasing persona that tend to keep practices small and manageable.
Constant Struggle – Being able to just barely survive for years is an astonishing feat. It requires tapping on the brakes ever so slightly when things get too busy, or too many patients are waiting, or your tax bill is getting too large, or some other sign that tells you to slow down. How does barely surviving serve you? In other words, what are the secondary or tertiary gains that emerge from just getting by? How does struggling provide a get-out-of-jail card?
Fearful of Abandonment – With the entire relationship based on producing symptomatic improvement (in a time frame set by the patient!), monitoring the patient’s commitment becomes an obsession. Patients are seen as a continual flight risk. When they do drop out these chiropractors are inclined to imagine it was due to something they forgot to say or do. That’s rarely true, but that’s the feeling it often creates.
Suboptimal Recommendations – When the need for patient approval is combined with clinical uncertainty, care recommendations are often less than ideal. The use of minimizing language is common, such as “You have a little problem” or worse, “Let’s give chiropractic a try and see how it goes.” When combined with an attempt to minimize the financial burden, patients detect a tentativeness that often creates a self-fulfilling prophecy.
Poor Practice Promotion – When a lack of confidence is combined with the belief that practice promotion is a cost rather than an investment, the tendency is to do little to raise the profile of the practice. The resulting obscurity contributes to the struggle. A practice website, if there is one, offers superficial stock content and reveals little about the practitioner that a patient would find compelling.
It’s no surprise that these and related symptoms conspire to make practice a constant battle. Solutions are possible, but it requires identifying and replacing limiting beliefs and obsolete stories we created to make meaning of our circumstances.
It’s what humorist Will Rogers observed, “It’s not what we don’t know that gets us in trouble. It’s what we know for sure that just ain’t so.”
Learn more about HeadSpace Coaching and review the 40-week curriculum that provokes new ways of thinking about patients, practice and even your identity as a chiropractor.