All About Trust

(Scroll to the bottom to hear this post in podcast form!)

The other day, I was doing my normal Q & A and anesthesia consent with a patient who was about to have surgery. After I was finished, I asked (as I always do), “Do you have any questions for me?”

The patient simply replied, “No, I trust you”.

It got me thinking about the concept of trust. As an anesthesiologist, the most challenging part of my job is actually my patient interactions. People underestimate the power of the doctor-patient relationship in anesthesia, thinking we don’t really talk much to our patients. However, the challenge is that we must get our patients, who are almost always strangers, to trust us with their lives in a 10 minute period.

Trust is also very important in the other work that I do: coaching. When I do an initial consultation call with a prospective client, that person must often divulge sensitive information to me over the phone, and they don’t even know me.

Trust is truly the foundation of any relationship – whether it be personal, professional, family, intimate. However, trust is a difficult thing to cultivate because our brains are wired for recognizing danger, biasing to negativity, and scarcity.

In her podcast In Confidence, Lisa Sun talked about a trust pyramid: the pillars of trust that are often seen above the surface are reliability and congruence. Do you act with an integrity, do you do what you say you were going to do, and do you live your life in line with your values? We’re not going to focus so much here and instead focus on what she says lies below the surface, the other pillars: acceptance and openness. These encompass my foundations of lasting, true confidence. In short, true lasting confidence, which forms a foundation for self-trust, is made up of self knowledge, mental fitness, the ability to embrace challenge and a change in mindset from outcome based to journey based.

We all want to enhance our relationships. And we know that relationships are at the heart of better balance, health, happiness, and longevity. How does trust show up in your life, how can you get more people to trust you, and most importantly, how can you learn to better trust yourself?

When I do my anesthesia consents, I’m always trying to strike a balance between exuding confidence and expertise with showing sincerity and humanity. It’s a very fine art. I’m also always reading the patient for cues that I am either giving too much or not enough information, and that their understanding the things I’m telling them

Occasionally, patients have very specific request related to anesthesia, and my ears perk up in these situations. I really want to understand their motivation for their specific request. Sometimes it’s just related to a negative experience that they had, such as very bad nausea after anesthesia. Sometimes it’s related to a very deep fear that they have based on something that happened to them, a family member or a friend. Those are very important opportunities for me to educate them and to possibly spell myths.

In one particular instance, I had a patient coming in saying that she was adamant that she receive absolutely no opioids during her anesthetic. I asked her if she could explain to me why, and at first, she was very stern in the fact that she didn’t need them. I gently probed her further, and she ended up admitting to the fact that her son had died from taking a pain pill that was laced with deadly amounts of fentanyl. As she told me about this, tears started welling up in her eyes.

What I did then was I slowed way down in my movements and in my talking, and I knew this was going to take more time than your typical anesthetic, consent. So I sat down on her bed next to her and I looked straight into her eyes and explained to her the difference between her surgery situation, the kind of drugs that she was going to receive and what had happened to her son. I talked to her about how sad and horrible what had happened to him was, and how frustrating it is to hear about something like this as a physician working with those types of medications.

And I just apologized to her and I was quiet as well. By the end of the conversation, that she had great trust in me. She understood why I wanted to do what I was going to do and how it is very different from the situation that happened to her beloved family member.

 We underestimate the art of listening, but it is the heart of being able to gain trust from others in any type of relationship. It’s also at the heart of feeling like you’re trusted. If you don’t feel like people are listening to you, then it’s very difficult to trust them.

Tips for Effective Listening

Here’s my best advice for good, active listening. Try not to focus on the next thing you want to say, which we are all guilty of, and instead, focus on listening to the exact words of the other person. Try to put yourself in their shoes. You don’t need to be in a hurry. Using eye contact is really important in face-to-face conversations, but if it’s on the phone, obviously that doesn’t apply.

However, a small pause after the other person has said what they want to say goes a long way. And when I’m interviewing people for this podcast or I’m talking to prospective coaching clients, if I think of something that I wanna ask them about while they’re giving a long story, maybe I’ll actually write a single word on a piece of paper I have in front of me to help me to remember so that I don’t feel like I have to keep trying to think of what I’m gonna say.

You don’t want to finish other people’s sentences for them either, no matter how tempting that might be. When responding to a lengthy comment or a story, I try to summarize what the other person is saying by using the phrase, “What I’m hearing is (then summarize what I heard them say)… Is that right?”

The other thing I often do during interactions, both clinical and nonclinical, is acknowledging the tone of the situation. You can do this without co-opting the other person’s emotions. You don’t have to say, “You must feel so …” (scared or proud or sad or happy). You can instead say what it would be like for you. You can say, “Wow, that’s really hard,” or “Oh, that’s so exciting,” or “That is very special.”

In terms of surgery, I make sure that I point out to the patient that we know they don’t have surgery every day, and it’s a really big deal, and it’s understandable if they’re nervous. I do often follow that up with a reassuring statement, like, our team does these kinds of things every day, however, and we know that you don’t.

On Self-Trust

The more you trust yourself, the more you create space for others to trust you. So how can you learn to trust yourself more?

First, you can let go of being perfect. I have talked about this before on the podcast. Mistakes are something we all try to avoid like the plague, because they hurt. They cause shame and embarrassment and that sunk cost feeling. But when you trust yourself, you know that mistakes are an essential part of life that constitute important learning moments. Be willing to take risks starting small, so you realize that you can brave the negative feelings that come when something doesn’t work out.

If you struggle with making decisions because you don’t want to make mistakes, consider identifying every single decision you make every day. Take one day and write down in a journal every single decision, and you’ll be surprised at how many you do make. There are many you make without even thinking about them, lke the decision to get out of bed, to brush your teeth, etc. When you identify all the decisions you make in a day (even the small ones), you become comfortable with the idea that you’re good at making decisions and you know how to make them without fretting the consequences. This then translates to being more comfortable with bigger decisions.

As always, knowing yourself better is the key to many things, including self-trust. Spend time with yourself each day to reflect on your needs, your wants, and your energy flow. Practice noticing things, like what is going on in your gut, your reaction to certain situations, how you feel at work, or maybe when you’re outside, when you’re doing your favorite activity, or when you’re with a certain person, either someone that you love or someone that rubs you the wrong way. Notice how you feel in your body.

I can’t remember where I heard this, but consider taking notice of how you feel when you do something backwards or differently than you normally do, like using the wrong hand to open a jar or standing on one foot while cooking. Doing something unusual and being a beginner again can foster self-trust and also confidence at the same time!

Do you have difficulty trusting other people? Do you struggle to trust yourself? How do you deal with it? Share your thoughts by leaving a comment below!