Over recent years self-talk and self-compassion have been increasingly explored; notably they are key components of performance psychology. These two aspects can influence performance not just of elite athletes but also of medical professionals; while under pressure and following high-stress events as we process and reflect on our decision making. So what are self-talk and self-compassion all about and why are they relevant to us in prehospital and retrieval medicine?
Self-talk: the internal voice in which we all speak to ourselves. It can be positive or negative. There is evidence to show that self-talk can influence performance – Louise Harvey
Self-compassion: a sense of kindness, care and understanding for yourself, versus judgement, alongside a sense of mindfulness. Self-compassion has less impact on performance than on emotional wellbeing – Kristin Neff
Positive and negative self-talk are the two sides of our internal narrative. Self-talk is a mixture of our conscious and unconscious thoughts and might be better recognised as our inner voice. You can think of it as an amalgamation of your values, norms and expectations. Most significantly, it can impact performance and mental wellbeing.
NSW Aeromedical division is incredibly fortunate to have a staff psychologist, Louise Harvey; as part of our Mindhacks series she recently ran session on education day, which she began by asking us what we had said to ourselves that day. Had we reprimanded ourselves for a silly mistake? Complimented ourselves for our efforts? Recognised our own mood and expectations for the day?
The concept of self-talk, whether positive or negative, is well known and utilised; prominent applications include the world of elite sport and the ongoing management of eating disorders and body dysmorphia. Louise highlighted that there is application and relevance to the practice of prehospital and retrieval medicine too.
The way we think about situations, about experiences and about ourselves influences how we feel and respond. This is a bidirectional relationship; the way we feel also influences how we think. If we can strengthen helpful thoughts and feelings, and acknowledge and choose what to do with unhelpful thoughts/feelings, we’ll feel more empowered, confident and tend to perform better. Often the way we speak to ourselves follows unconscious patterns. It is helpful to get to know and pay attention to how we talk to ourselves. Awareness of our thinking patterns gives us the chance to build on what is working and change what is not. Practices that build insight and awareness such as mindfulness help with this.
Helpful positive self-talk has several qualities: it’s balanced, realistic, believable, compassionate, clear and individual – it’s not about ignoring the unpleasant things or sugar coating. Helpful positive self-talk acknowledges the stressful, unpleasant and uncomfortable aspects of life, but with kindness and compassion. Examples of this could be:
• Unhelpful: That was really bad, everyone saw me fail. Helpful: Attempting to do this took courage and I am proud of myself for trying.
• Unhelpful: I’ll never be any good at this. Helpful: If I keep practicing and ask for support, I can grow my skills and confidence.
• Unhelpful: I got that procedure wrong, I’m the worst clinician here. Helpful: I made a mistake and I’m taking responsibility for it.
Looking at some evidence:
Tod, Hardy and Oliver. Effects of Self-Talk: A Systematic Review. Journal of Sport and Exercise Psychology 2011;33(5):666–687
This systematic review looked at 47 articles exploring self-talk and its impacts on performance. Interestingly, whilst negative self-talk wasn’t proven to impede success, motivational and instructional self-talk were shown to enhance it.
Mills J, Chapman M. Compassion and self-compassion in medicine: Self-care for the caregiver. AMJ 2016;9(5):87–91.
Physician wellness is an area of developing interest but there is not a lot of research as yet. This article highlights the importance of self-care and self-compassion, and suggests the more compassion we can show ourselves, the more we show our patients too.
Raab, K. Mindfulness, Self-Compassion, and Empathy Among Health Care Professionals: A Review of the Literature. Journal of Health Care Chaplaincy. 2014.20(3):95-108
Focussing on developing self-compassion amongst health care work has the potential to reduce perceived stress and increasing effectiveness of clinical care.
Anita Alexander is a psychologist and strength finding coach as well as being a Coordinator of the NSW Ambulance Wellbeing & Resilience Program. She also spoke recently at one of our education days about self-compassion, outlining a few simple mind hacks we can all use.
Start off by taking this simple self-compassion quiz to gauge your starting point:
In her talk to us, Anita referenced Dr. Kristin Neff as the leading researcher in self-compassion. Dr. Neff defines self-compassion as having three key components: mindfulness, self-kindness, and awareness of the shared humanity that we are all a part of (an understanding that we all go through difficult phases and to recognise that this is usual). The compassion discrepancy refers to the difference between how we would speak to or comfort others, compared to how we speak to and judge ourselves.
Top tips for increasing self-compassion:
- Identify your own personal stress trigger factors so you can better anticipate them.
- Avoid catastrophic thought processing and worst-case scenarios
- Watch your body for the early signs of stress individual to you.
- Set aside time to let yourself worry and try not to carry it further into your day
- Breathing exercises- there are many online and some modern smart watches will even talk you through these.
- Planning positive or exciting things in your day to focus towards- these don’t have to be grand or epic. Small things have the same benefit.
- Reduce caffeine and alcohol intake
- Plan your time management to empower you at each step. Achievable goals can re-enforce a sense of success.
Self-talk influences our performance but our self-talk is likely to be influenced by our level of self-compassion, so the two very quickly overlap. As clinicians we need to remember to look after ourselves as well we each other and our patients. Self-compassion doesn’t come easily to many of us but we can try to remember to treat ourselves the way we would treat someone we care about. Our work comes with intense challenges – be kind to yourself.
Resources you can turn to if you need any help or support within NSW Ambulance and Aeromedical: Please follow the links to pages on the intranet.
- Peer Support Officers
- Staff Psychology Service
- Employee Mental Health
- Wellbeing Resources on the Sydney HEMS website
Kristin Neff – Ph. D. Associate Professor, Human Development, Culture, and Learning Sciences. Educational Psychology Department, The University of Texas at Austin. https://self-compassion.org/
For further support within NSW Aeromedical Services:
Louise Harvey – NSW aeromedical Senior Psychologist and Clinical Psychologist
Anita Alexander – NSW ambulance Wellbeing & Resilience Program Coordinator