Spring Break Rerun: ICE Book Review – Daring Greatly

“When there is nothing left to learn from the winter, move on to the spring!”

―  Mehmet Murat ildan’

ICE Blog will be off for spring break this week. As we move from one season to another, we will be re-running Rob Cooney’s excellent review of Daring Greatly, a book about having the courage to move beyond cold feelings of shame to something warmer. You might also want to check out a recent article by Will Bynum and colleagues on this topic called Sentinel Emotional Events: The Nature, Triggers, and Effects of Shame Experiences in Medical Residents (PMID: 30277959).

                –  Your ICE blog Editor-in-Chief, Eric

By Rob Cooney (@EMEducation)

Most of the books that I read teach me something new. Rarely, I will pick up a book that causes a fundamental shift in my worldview. Daring Greatly by Brene Brown is one such book. I was completely unfamiliar with Dr. Brown’s work until I was fortunate enough to catch an interview between her and Krista Tippett featured in the book Becoming Wise: And Inquiry into the Mystery and Part of Living

Daring Greatly.pngDr. Brown is a professor of social work who has spent the last 10 years studying vulnerability, courage, authenticity, and shame. Her work has been featured in two separate TED talks, the first of which has been viewed over 28 million times and ranks as one of the top five most watched talks.

In her book Daring Greatly, Dr. Brown explores the roots of a very uncomfortable human feeling: shame. Shame is an experience that we can all relate to as physicians. As Dr. Brown explains, shame is triggered by how we feel others perceive us. As social animals, we seek the basic need for connection, love, and belonging. Any time we believe we are unworthy of those feelings, we experience shame. Thus, shame makes us “play it safe” and avoid situations that may cause us to feel shame. It causes us to keep our feelings hidden, avoid trying new experiences, and even putting our work before an audience.

In our modern society, with infinite connections, it is quite easy to feel unworthy, and thus, experience shame. The “always on” and constantly “sharing” culture breeds a sense of “never-enough.” This “scarcity mindset” causes us to live in (subconscious) fear that we are inadequate.

So how can we escape this destructive cycle? The remainder of Dr. Brown’s book focuses on overcoming shame by embracing vulnerability. Unfortunately, the concept of embracing our vulnerability is not one that we would consider positive on face value. For this reason, Dr. Brown explores the meaning of vulnerability and provides suggestions on how we might embrace it to improve ourselves and our relationships with others. She also explores the concept of “vulnerability armor.” These are behaviors that we engage in an attempt to shield ourselves from feeling vulnerable. The concluding chapters of Daring Greatly focus on how embracing the notion of vulnerability can lead to improved resilience as well as removing shame from our schools, workplaces and homes.

As I mentioned at the beginning, this is a book that caused a fundamental shift in my worldview. As a physician, I have long recognized the effect of shame in my own practice and the harms that our “shame and blame” culture cause when trying to recognize shortcomings and failures or to improve the care that we provide.  Consider, for example, how these concepts might relate to the provision of feedback, especially negative feedback. Having read this book, I now recognize how my reluctance to be vulnerable has inhibited my ability to improve my own teaching practice.  The concepts that Dr. Brown outlines are certainly not easy, but, by exploring and implementing them in our hospitals, clinics and classrooms, it will certainly leave the world a little better than we found it.

Featured image via Pexels