How to Talk to [High Achievers] about Anything

Pushing through Public Speaking Fears in Med School

Episode Notes

To advance her career as a future doctor, Melissa is determined to improve her public speaking abilities, but doing so requires she overcome deep-seated insecurities.  Stevon and Juleyka discuss strategies for tackling impostor syndrome head-on, including collecting evidence from your environment and questioning the stories you tell yourself in high-stress situations.

Stevon Lewis is a licensed psychotherapist and coach. Learn more about his work here. If you loved this episode, be sure to listen to When Your Job is Killing You and Feeling Inadequate Because Her Clients Aren't Making Progress.

We’d love to hear your stories of triumph and what's ahead as you grow. Send us an email or detailed voice memo to hello@talktoachievers.com, You might be on a future episode! Let’s connect on Twitter and Instagram at @TalkToAchievers and email us at hello@talktoachievers.com. And subscribe on Apple Podcasts, Spotify and anywhere you listen to your favorite podcasts.

Episode Transcription

Pushing through Public Speaking Fears in Med School 

To advance her career as a future doctor, Melissa is determined to improve her public speaking abilities, but doing so requires she overcome deep-seated insecurities.  Stevon and Juleyka discuss strategies for tackling impostor syndrome head-on, including collecting evidence from your environment and questioning the stories you tell yourself in high-stress situations.

__________________________________________________________________________________

Clip: She's able to speak when it's a one-on-one situation. She feels really confident and does really well, and so I'm starting there. I'm saying, "Well, if you're getting it done in this one area, what's really happening when it's more than one person?"

Stevon Lewis: What's up everybody? Welcome to How to Talk to [High Achievers] about Anything. I'm Stevon Lewis, a licensed psychotherapist. We are about to dive deep into fears of public speaking, but first I'd like to welcome Marshall's creator, Juleyka Lantigua. What is up, Juleyka?

Lantigua: Sup, Stevon. So happy to be back.

Lewis: All right, here we go. Our guest today is Melissa. Melissa is a med school student who is trying to get over a deep and persistent fear of public speaking. She sees this as a key challenge she must overcome to become the successful physician she wants to be. Let's get into it.

Melissa: My name is Melissa and I'm a third year medical student in Los Angeles. I am the daughter of two Mexican immigrants and that's a big part of my identity and the first to go to college in my family.

A big part of my goal as a medical student and future physician is to mentor others. I didn't have as many mentors along the way on my pre-medical journey and I started an Instagram page many years ago called BrownGirl_WhiteCoat to showcase my journey to medicine and I currently share my medical school experience with others to give them an idea of what it's like to be a medical student.

Right now it's the end of my third year of medical school, and so I'm preparing to apply to residency programs, a psychiatry residency, which I'm very excited about. Also, just hoping to improve my public speaking skills. A lot of what we are evaluated on is based on these patient presentations we give and if my public speaking fears are getting in the way of giving a good presentation, it does impact, I believe, how the physicians evaluate me. And sometimes these evaluations play a big role in our applications to residency and securing a residency spot.

The first memory I have of public speaking and my fears around it, I believe, was in fifth grade in elementary school, that we had to present in front of the whole class. And I just remember feeling very nervous and being worried about what others were thinking about me.

A recent experience was I started an internal medicine sub internship rotation, which means I'm basically expected to act more of like an intern, which is a first year resident. And I think that rotation, I built up a lot of pressure beforehand to do well and perform well. And that added pressure, exacerbated my public speaking fears. And in those first few days when I noticed how difficult it was for me to communicate in front of my team, it was a group of, I think eight or so people, I realized that I needed to work on this more because it was something that I'm going to be doing for the next at least five years in my training.

I do much better one-on-one conversations, even if it's with an attending physician. When it comes to the more public speaking where I'm in front of multiple people, I get really nervous and I get heart palpitations. And when I'm speaking, you can hear my voice shaking. And I think that's a clear indicator to other people who are listening to me that I'm nervous. And that's kind of spirals I guess. And I start focusing on how nervous I sound and then I get more nervous. And so it becomes this vicious cycle of this anxiety and fear over what people are thinking about me and if they think I'm competent to be here and to be a future physician. And so I have a lot of these thoughts that go through my head in the moments before and sometimes even during my presentations.

I think a lot of these fears and this worry that I'm being judged or people are thinking I'm not good enough comes from, as a pre-medical student in college, I was the first person in my family to go to college and I really struggled academically despite doing really well in high school. I wasn't prepared for the rigor of what a university would be like, and so I didn't do as well as I expected. And I had a lot of people, advisors and deans tell me that I would never get into medical school.

I'd wanted to be a doctor since I was five. And so that was a big shock to me to hear that my dream wouldn't be possible. Thankfully, I found people who supported me along the way and I was able to apply to medical school and get in, but there's always that feeling of it was a fluke or I somehow was able to bypass all these people and trick them into thinking that I'm smart enough to be here. And so I think a lot of it stems from this experience I had as a pre-medical student.

Things I've tried are meditations. I've looked up YouTube videos on how to meditate specifically for people with public speaking fears. I've tried to journal. I've tried to do some deep breathing exercises. In the future I really hope that I look like somebody who's confident in their abilities and believes in themselves and trust that all the hard work that they've done in the past is what's let them be at this point in their career. And I just hope to exude confidence and I think that's something that I am currently working on.

Lewis: Thank you, Melissa for sharing what you're going through.

Lantigua: All right, Stevon, this one is textbook imposter syndrome, so break it down.

Lewis: You are absolutely correct. When I heard Melissa's story, I immediately said, she sounds like pretty much everyone I work with. Being the first one in her family to go to college, being in med school, being in environments where it's not expected that she would achieve at the level that she has, and it's doing all this stuff and fighting against the information that suggests you shouldn't be where you are and accepting the results or the evidence that says, "Well, you're here." She has a really difficult time doing that. And so when everyone is listening or has listened to her story, they're like, "Well, girl, you got this. You're doing it. You're crushing it. You'll be just fine."

And internally she's like, "I do not know."

Lantigua: So basically imposter syndrome is ignoring all of the evidence that you belong to continue to tell yourself that you don't belong?

Lewis: Exactly. We'll get into it after this short break. What we would expect is that after some mastery or some success that we would let go of the idea or that self doubt that we don't know what we're doing.

Lantigua: So we were joking as we were getting ready for the session that I went to her Instagram and she has 27,000 followers, and I'm like, "Girl, you've been public speaking."

Lewis: Exactly. You don't get 27,000 followers accidentally.

Lantigua: All right, but let's talk about what she wants to talk about, which is basically Melissa is really afraid of public speaking because of the fear of essentially being found out as someone who doesn't belong there.

Lewis: Listening to Melissa's story, I personally kind of identify with it. I used to have a huge fear of public speaking, so I understand Melissa's experience. Also, you're doing the thing, let's not really fear that you're going to be found out. 

I often joke with the high achievers that I work with, the ones that are struggling with imposter syndrome, that if you are not really as good as people think you are, then at least give yourself credit for being really good at fooling people. They're saying, "I've been tricking everyone." And so what I'm telling them is that, "Well, if that's the case, you're really good at tricking people. Why don't you just have some confidence in your ability to do that? Because at least we know that you can be successful doing nothing." And-

Lantigua: And how do people get react to this?

Lewis: They get mad at me.

Lantigua: Okay, I was going to say it. And what is the response?

Lewis: They get mad. They do not like when I say that. The reason I tell people to start there is because I want them to start saying, "Well, at least one thing you're doing well is fooling people. Let's start with that and say, well, maybe there's some other things you're doing well that you aren't also acknowledging."

Lantigua: Absolutely fascinating. It reminds me of something that I do with my sons. They're 11 and 13. When they're being very critical of themselves, "I'm not smart. I'm not good at this. I'm not good at that." I'll say to them, "All right, but you're still handsome." Or, "All right, but you still smell good. Let's find some other thing to focus on."

Lewis: Right, right. I love that. Because What you're doing is that you're saying, "Well, you're focusing on this one part that you aren't really confident in and you're defining yourself by that, but there's also these other things that really make up who you are and some of that stuff is going to contribute to your success as well."

Lantigua: Yeah. So I want to actually pull apart something that, Melissa, I think illustrates really well, and it goes back to a point you've made on another episode about the false beliefs that we have. And so in her mind, she has decided that not being a, "good public speaker," is going to hold her back from opportunities, is going to lead to people discrediting her. She has decided these things, with no evidence. What do we do?

Lewis: The interesting thing is two things. One, she's still progressing, even though she is determined that she doesn't speak well in public, so it hasn't really stopped her. The second thing is that she's able to speak when it's a one-on-one situation, she feels really confident and does really well. And so I'm starting there. I'm saying, "Well, if you're getting it done in this one area, what's really happening when it's more than one person?" It's not about her ability. It's really about what she's telling herself, and that's where we got to start to pull it apart. 

And so I think for high achievers, like Melissa, that are struggling with imposter syndrome, you really got to start paying attention to what is true. Let's start with the stuff that really is happening. You can do it when you're in the one-on-one situation. People are recognizing that. What is it that they are seeing or noticing about you that you aren't believing about yourself?

Lantigua: Let's also talk about the fact that for some of us, we physically experience some of this anxiety around our imposter syndrome, and Melissa is among us. What do we do when we're physically uncomfortable, physically in a place where we are unable to really be ourselves as a result?

Lewis: The reason imposter syndrome is so good at doing what it does is because the feelings attached to it. The feelings are very, very real. And that's what we notice first. The way our brains work is that we have this physical sensation connected to negativity. We feel sick, we feel nervous, anxious, and so our brain gets this message, "We're not okay." You have to slow that down. You have to say, "Okay, I have this feeling. Let me investigate whether it's appropriate or not based on what's going on in the environment." And that's where we fail most times, myself included, I've had to learn this to not just blindly accept the feeling as fact.

Lantigua: So you're trying to say, look at your sweaty palm and go, "That's not a fact. What?"

Lewis: The sweaty palm is a fact. Is it a fact that I am in danger or I need to be afraid or nervous about something? That's not a fact. And so I want people to use those negative emotions as a catalyst to do further investigation into what's happening in the environment. And what I believe will happen for them is that they will get to a place where they're saying, "Well, I'm telling myself this story about what's happening right now. Everybody thinks I sound stupid. 

Everybody thinks that I'm stumbling over my words. Everybody thinks that I'm not making sense." You're telling yourself that, but the evidence doesn't support this. Are people nodding in the audience? Are they engaged in what you're talking about? Do you have 27,000 followers on Instagram?

Lantigua: Okay, so I love that. Find the evidence. And in the absence of evidence, accept what actually is. And she's starting to be a doctor. And in the medical field, it's all about what can you prove?

Lewis: Yes. Use the scientific method. I'm a fan of it. She's trained in it. It works. You come up with a theory, the irrational belief or that narrative that you have, and then you test to see if it's true or not.

Lantigua: All right, so let's deal with something that is a little bit more nuanced than finding the evidence, which is she's got a little bit of trauma from when she was a young woman in high school being told by authority figures, by teachers, counselors that she wouldn't get into medical school, and she's still carrying that around.

Lewis: One of the commonalities that I talk about for people that struggle with imposter syndrome is being in environments that aren't affirming of who you are. Oftentimes what we do is we don't question the environment and we kind of take the onus on ourselves, which is interesting with imposter syndrome. We're willing to believe more the stuff that people say that's negative about us as opposed to the stuff that's positive.

All of the stuff that people say, "Oh, you're amazing. You're good. You do this." "No, I'm not that." But then someone says, "Well, I don't think you can do med school. I don't think you can do these things." "Oh, they're probably true. I don't belong here." And so I'm really wanting people to push back to say, "Hey, well, there aren't a lot of me in this environment. Maybe that says more about the environment than it really does say about me."

Juleyka, thanks so much for being on the show today.

Lantigua: Man, thank you for having me. I got so much out of our conversation today, as always.

Lewis: I get really happy when I see high achievers like Melissa achieving on their own terms, pushing past their discomfort to reach their goals, being aware of areas where they can grow while acknowledging their strengths and trusting themselves along the journey.

And that's a wrap. Thank you so much for listening to How to Talk to [High Achievers] about Anything. We want you to be a part of our show. 

We want to hear about your successes and challenges, your sacrifices and celebrations, and what's ahead on the journey for you. Send our Producer Virginia an email and we'll get your story on the show. She's at virginia@lwcstudios.com. 

How to Talk to [High Achievers] about Anything is an original production of LWC Studios. Our show is produced by Virginia Lora, Tren Lightburn mixed this episode, Juleyka Lantigua is the Creator and Executive Producer. I'm Stevon Lewis. 

On Twitter and Instagram, we're @Tal toAchievers. Bye, everybody.

CITATION: 

Lewis, Stevon, host. “Pushing through Public Speaking Fears in Med School” 

How to Talk to [High Achievers] about Anything, 

LWC Studios., October 2, 2023. Talktohighachievers.com.