One by one, the consult cases were presented and reviewed. The fellow outlined each case and invited discussion of the particularly difficult ones. The conversation could be lively and, at times, pointed. My client dreaded those ninety minutes, especially when she was the attending responsible for the cases. On other days, she might appear quiet while her mind filled with questions she wanted to ask and perspectives she wanted to offer. She worried about saying something wrong, then left feeling ashamed that she had said nothing.
She described the problem as a lack of confidence. She read extensively and frequently discussed cases with several colleagues, yet still found it difficult to stand behind her own judgment. She knew she had something to contribute. What troubled her was how difficult it had become to let anyone hear it.
She also remembered a time when she had felt very different. As a child, she had been bold and outspoken, with visions of greatness ahead. She wondered what had happened to that girl.
When I asked when she first remembered feeling afraid to speak, she returned to her clinical rotations in medical school. There was no single defining incident. But with her eyes closed, she pictured herself on surgical rounds, feeling unsure and wanting to become smaller and smaller.
How Medical Training Can Affect Self-Trust
Many of us can recall a version of that experience. Being intimidated during medical training is so familiar that we can overlook what we learned about ourselves as it happened. Alongside clinical knowledge, we learned how to be received.
We noticed which questions earned respect and which invited embarrassment. We learned whose judgment carried weight, how uncertainty was received, and what made us easier to accept. Much of this learning began long before medical school. Training gave it new stakes.
Being prepared, composed, and correct could help us succeed. We learned to anticipate what others expected and to consider how our ideas would be received before sharing them. Over time, even a thoughtful question or a potentially helpful perspective could become difficult to offer as our attention shifted from what we wanted to contribute to how we might be judged.
Our knowledge and experience continued to grow. But we could still find ourselves looking outward for permission to trust what we knew.
Recognizing Self-Abandonment in Women in Medicine
You may recognize this in the decision you revisit after everyone has left the meeting, or the question you hold back until someone else asks it. You notice a limit and immediately wonder whether you should be able to manage more. You have a perspective, then spend so long considering how it might be received that the conversation moves on without you.
Repeatedly setting aside our own experience can become a form of self-abandonment. Eventually, consulting ourselves feels less familiar than checking what everyone else thinks.
And yet you may already have a sense of the woman you want to be in those moments. She contributes thoughtfully. She takes her judgment seriously and stays open to new information. She can act on what she knows and revisit a decision when something new becomes available. When a conversation is difficult, she can reflect on it without spending the evening putting herself on trial.
That steadiness grows through the relationship she builds with herself.
How to Rebuild Self-Trust
For my client, reconnecting with her younger self helped her approach her fear with compassion. The image of the medical student wanting to disappear gave her a way to understand something she had been criticizing for years. She could recognize how familiar the fear felt and consider what she needed now, with the experience and perspective she had gained since then.
I think there is value in listening to these younger parts of ourselves. They can help us recognize old expectations and fears that still influence how we move through the world. We can acknowledge what they carry while allowing our present-day judgment to guide our choices.
Rebuilding self-trust involves listening with enough curiosity to recognize what we think, feel, need, and value before automatically editing it. It also requires self-regard: allowing what we learn to influence what we do. A limit we consistently override, or a perspective we repeatedly dismiss, tells us something about how seriously we are taking ourselves.
Acceptance matters here, too. We need a way to meet mistakes and limitations with honesty and compassion. We can acknowledge what happened, learn from it, and remain worthy of our own care.
Intentional action brings these pieces into daily life as we consider our own experience alongside others’ experiences and how our choices may affect them. We can care about that impact without taking responsibility for managing everyone’s feelings. This allows us to make choices that honor our values and what is true for us while supporting the relationships and communities we are part of.
Speaking Up With Greater Confidence
For my client, that began to look like asking her questions and sharing her perspective more often in conference. Speaking still required courage. She was learning to recognize the fear, respond to it with care, and allow the capable woman she had become to participate.
Rebuilding self-trust meant learning to care for the frightened medical student she still carried within her. She could acknowledge that younger self’s fear while drawing on the boldness she remembered and the judgment she had spent years developing. All of those experiences belonged to her, and she could choose how she wanted to participate now.
You may have a question you are ready to ask, a decision you are ready to stand behind, or a need you are ready to acknowledge. Taking your own experience seriously in one of those moments is a place to begin.
In RECLAIM Your Life, I work with women in medicine to rebuild this relationship with themselves so they can lead, practice, and live with greater confidence, steadiness, and ease.