Self-belief: what Ted and Taylor get wrong

Psychologist Roger Bretherton questions whether believing in ourselves is all it’s cracked up to be, despite what culture icons might say.

Roger Bretherton

Roger Bretherton is Associate Professor of Psychology, at the University of Lincoln. He is a UK accredited Clinical Psychologist.

A man in a blue jumper holds a yellow sign reading 'believe'.

Ted and that sign.

Psychotherapists can be really irritating. You may not have noticed how irritating they are, but I have. And that’s saying something. Because I am one - an irritating psychotherapist that is. In nearly two decades of practicing and training people to counsel, coach and generally therapize (I know that’s not really a word, but I can’t help irritating you by using it), I have curated an ever-growing list of the therapeutic practices by which I am most likely to be irritated.

To my mind, the gold medal in the irritating therapist Olympics goes to a winsome and playful hypnotherapist called Stephen Gilligan. Some psychotherapists treat everything that comes out of their clients’ mouths as treasures to be prized, it clearly wasn’t the way Gilligan saw it. In fact, he developed a therapeutic strategy designed to confront any sense that it is possible to define ourselves simply. Every time a client made an ‘I am…’ statement, he would respond with a twinkling eye and a lilting voice, ‘Of course, you are [insert dramatic Pinteresque pause here], except when you’re not.’

Consequently, the pantomime of therapy goes like this. You think you’re a failure? Of course, you are... except when you’re not. You think you’re a coward? Of course, you are... except when you’re not. You think you’re a control freak? Of course, you are... except when you’re not. You think you’re always punctual? Of course, you are... except when you’re not. You think you’re disciplined? Of course, you are... except when you’re not. You think you’re accepting of everyone? Of course, you are... except when you’re not. You think this is all really irritating? Of course, it is... except… You’ve probably got the gist of it by now.

But why would Gilligan, with all his charm and playfulness, risk infuriating his clients like this? Perhaps because he knows something important about human identity that most of us tend to forget. None of us can be summed up in a single sentence, and whenever we try, something grates against us. Any attempt to cram the complex fabric of our lives into the all-too-tiny suitcase of our self-definitions causes us pain. After all that’s what irritation is. It is the gnawing sense that something doesn’t quite fit.

Psychologists note the difference between anger and irritation. When we are angry, we are usually angry at something. Someone or something has blocked our plans. We’re frustrated. It’s not right and we fight against it. There is a sense of indignation and injustice. But with irritation we’re not always sure what’s bothering us, and if we are sure what it is, we’re not sure it should bother us. It’s the young couple whispering behind us in the cinema, the door that only closes with just the right pressure, the person who subtly insults us. Not quite enough to make us leap into action, but just enough to steal our attention. To be irritated is to be slightly annoyed that we are annoyed; to be annoyed while wondering whether we have any reason to be annoyed.

We are whole and perfect just as we are, and no can tell us otherwise. It is the gospel of self-belief, that lingers on the lips of cultural icons from Taylor Swift to Ted Lasso: believe in yourself.

Stephen Gilligan was confronting his clients with the fact that we often wear our identities like this, like ill-fitting clothes that bulge or chafe in the places where the tailoring fails to match the way our lives really are. We can be described in many ways, but we cannot ultimately be contained in, reduced to, or summed up by any single concept. Some part of us always colours outside of the lines. The human equation always leaves a remainder.

The idea that we are ultimately a glorious mystery, even to ourselves, is not a comfortable thing to live with. We would much rather come up with a bold simple label and stick ourselves to it. At least then we’re safe from uncertainty. At least then we’d be something. Most of us to some extent play this game, and the good news is that our culture offers us numerous ways to play it. The bad news is that none of them really work.

Perhaps the most popular way to play the identity game is to believe that we already are everything we need to be. We are whole and perfect just as we are, and no can tell us otherwise. It is the gospel of self-belief, that lingers on the lips of cultural icons from Taylor Swift to Ted Lasso: believe in yourself. You’d think that would be a good thing to believe, but it does run into problems, particularly when the rest of the world fails to hold the same opinion of us.

If we believe ourselves to be wonderful in every respect it comes as a bit of a shock to discover that not all our colleagues, bosses, or friends regard us with the same breathless awe. At this point, many of us modify our view of ourselves to something more realistic. But if we are not prepared to do that, there are only a limited set of options by which to square the circle of knowing ourselves to be magnificent in a world that refuses to agree with us. We can attack the world in rage, we can flee from it in fear, we can hide from it in shame. A surprising number of people respond with paranoia. Which makes sense. If almost everyone you speak to seems intent on undermining your matchless brilliance, you could be forgiven for thinking the world was out to get you. None of these responses are good.

Thankfully, in recent years, therapeutic psychology has issued a corrective to the shortcomings of the self-esteem movement. More nuanced practices of self-acceptance and self-compassion, recognise that it is part of being human to not always be as we would like to be, and we will certainly not always be treated as we think we should be treated. A simple grandiose belief in ourselves is too flimsy to endure the buffeting of real life. Self-belief is not enough.

Accepting acceptance is a radical reorientation of the self because it doesn’t start with us

Some psychologists have argued that the twentieth century should be named ‘The Century of the Self’, the historical period in which Self replaced other larger concerns, such as Country or God, as the ultimate reference point for good human living. The fact that so many of us unthinkingly endorse the need for self-belief, suggests it is a popular option in our current cultural menu of ways to live with ourselves. But it is difficult not conclude that the cultural currents in which we swim are somehow misaligned, or that we suffer from a widespread lack of imagination if the lynchpin of our aspirations doesn’t really deliver. It makes me wonder if we have taken a wrong turn somewhere.

The Christian view of all this is that we as human beings, far from being selves to believe in, are the recipients of a radical kind of acceptance. We are not called upon to generate self-acceptance out of thin air. We have been divinely accepted at the deepest possible level, not because we are special or exceptional, but as a gift to us from a generous God. All we have to do is accept that acceptance. Which is harder than it sounds, because we’d rather believe we did it under our own steam.

Accepting acceptance is a radical reorientation of the self because it doesn’t start with us. It starts with a God who is willing to do whatever it takes to close the distance between us and Him. If God wasn’t like this, if he was vindictive or didn’t care, or if he refused to come anywhere near us until we’d reached the required height of spiritual perfection, there would be absolutely nothing we could do about it. But as it stands, all our attempts to impress God are pretty much useless. There is little point frantically reeling in a god who is already closer to us than we are to ourselves. What’s the point of trying to justify our existence if our existence has already been justified. This is where Christianity begins, but not where it ends.

Divine acceptance does something more. If self-belief asserts that we are what we are, and no-one can tell us any different; then divine acceptance takes us as we are but refuses to leave us there. Something happens to us when we know that we are known and loved right to our bones. We no longer fear being abandoned because of our flaws, and we start to harbour a growing hope that we may be able to overcome them. Our self-awareness improves, we see ourselves more clearly. We learn to live life dynamically, with nothing left prove, but a lot still to learn.

Article

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?"

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.