Lucia Caporaso
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Six behaviors to increase your confidence
When I was in high school, my mom asked me to order a pizza for the family on a Friday night. I looked up the number in the phone book and promptly handed the phone to my older brother to place the call. I was too shy to talk to a stranger. Fast-forward to college at the University of Illinois, my first time away from my small town. I spent the first several weeks crying in my dorm room, too homesick to partake in early freshman partying. The one frat party I did attend was so disappointing. I wanted to trade in my books, abandon my major and head back home to my small town. The confident behaviours I needed to pursue this dream were not yet available. And when I looked around at the confident students walking around me on campus, heads held high, pursuing a dream that they had set out to achieve, I wanted that kind of confidence too. But my behaviours did not align with these confident attitudes. Crying in my dorm room, shying away from social engagement, not showing up for class because I was worried others were smarter than me - these were not going to lead me to achieve my goal. So all I knew was that I needed to change. Research tells us that in order to get people to change, you need to not start with the attitudes, but with the behaviors associated with those attitudes. When people can see themselves behaving differently, they then begin to act differently. So the questions for me were, “Who am I?” “Who do I want to become?” and “How does this person I want to become behave?” The answers were that I wanted a successful career, one that meant something, allowed me to contribute. And for me, that was defined as a career as a sports executive. In order to achieve this goal, I needed to begin to act more confidently. And I did. Because 13 years later, I became the first female general manager of a Triple-A baseball team in nearly 20 years. (Cheers) Thank you. (Applause) I also went on to host the “Leadership is Female” podcast, where I’ve interviewed over 90 female executives in sports, an industry that’s over 80% male at management level and above. And time after time, these women have told me that the number one skill they’ve improved in order to earn their spot at the top of the sports industry is confidence. They, like me, did not possess this confidence necessary to increase their level in their career from the get-go. They had to work on the behaviors associated with this attitude in order to propel their career forward. So I’m here today to share with you six behaviors you can start today to increase your confidence. Why is it important to increase our confidence? Well, think of this: How would you behave or what could you achieve if you were 10 times more confident? Number one, count yourself in. I spoke with a woman about her first time doing sideline reporting at a nationally televised basketball game. She was shaking in her heels, standing courtside, nerves overtaking her until she heard something familiar in her headset. “We’ll be on in five, and three, two, one, you’re live.” And she performed with excellence. The nerves melted away. She’s an athlete, a former basketball player used to performing on the court by the clock. And the tactic remained true. Counting will get you started, and momentum will keep you going. I have used this technique. I’ve had more uncomfortable conversations than I care to recall, but one I’ll share with you today. I vividly remember standing on the warning track of the baseball field 45 minutes before game time, looking at the opposing manager and his team wearing the wrong color uniform. I wanted to turn and run back up to my office and hide. But instead, faced him head-on, and I said in my mind, “Three, two, one, go.” And I started walking towards him. And when I arrived, we had a very uncomfortable conversation about his team wearing the wrong color uniform. Yes, I had to ask these grown men to change their clothes. It was so awkward. But when I asked myself, “Who am I? And how do I behave?” The answer was that I’m a person who’s not too shy to stand up for what I believe, what is right and stand up to conflict. Counting got me started, and momentum kept me going. Number two, what if you only had to be brave for a total of 20 seconds? Give yourself 20 seconds of courage. This behavior helped me enormously when I published my podcast “Leadership is Female,” bold title and all, for all the world to see, hear, critique and have their opinions. I vividly remember sitting on the carpet of my closet floor, holding my computer, looking at the “Upload” button, thinking to myself, “Does it need any more edits? Should I listen to it one more time?” And I told myself, “Emily, give yourself 20 seconds of courage.” And I hit “Publish,” and it was done. And guess what? I kept breathing, and the world kept turning. And the podcast grew into what it was meant to be. All because of 20 seconds of courage. Number three, take a seat at the table. Not metaphorically speaking; actually, take a seat at the table. I spoke with a woman who represents some of the biggest names in baseball, and she told me a story about taking a seat at the table. She noticed women waiting around the edges of the room, waiting for the seats to be filled. And worse yet, she was doing it too. In order to become the more confident woman that she envisioned herself to be, she needed to go in, sit down, speak her mind and get the deal done. That started with one simple action: Taking a seat at the table. Number four, cheer for other people’s success. They say that women will pull up the ladder behind them. What if you didn’t? What if you extended a hand back to lead her forward? What if you celebrated the success of a colleague rather than feeling sorry for yourself that it was not you accepting the accolades? Confident people celebrate the success of others rather than feeling threatened. Think of this great quote from Amy Poehler: “Good for her, not for me.” It turns that pit in your stomach of “Oh, she did that? And I’m still here.” into “Yes! Good for her! Not for me.” This is her celebration, not mine. And when my time comes, isn’t it going to be great to have the support of so many people around me? Wins are so much better celebrated together. Join in; cheer someone else on. Here’s number four in action: Recently, a woman was promoted to chief marketing officer of a major sports league. The offer to interview and ultimately land the job came after her public celebration and sincere congratulatory outreach to the newly named female league president. Confident people support those around them. Cheer for someone else’s success. Number five, bolster your confidence for a new activity through your already great performance in another. What are you really good at? What is easier today than it was one year ago? What is your most proud accomplishment? Answer those questions. Think about those answers. Those answers are where your confidence is born. Confidence is born in all we’ve already done and already achieved. Recently, a woman I interviewed on the “Leadership is Female” podcast was going after a big, big promotion at a top team. Before she went in to pitch to her boss, she reviewed her current job description, made notes of her accolades in all areas mentioned, and then was prepared with examples and the confidence of the success she had in the past. She got the promotion. Use your prior success to propel yourself forward. And number six, celebrate constantly. How often do we reach our goals and then just immediately move on? When we do this, the recollection of that success is diminished. How can we confidently move forward if we can’t remember what we achieved, or worse yet, link that accomplishment to stress? Find ways to celebrate that are meaningful to you, like creating a highlight reel on your cell phone of your most proud accomplishments. Take your team out for celebratory drinks when you close the big deal. Buy yourself a massage or maybe order a pizza when you reach your personal goals. It doesn’t matter how you celebrate; it matters that you do. This will create a marker in your brain to rewire and reinforce the behaviors that led to success in the first place. I’ve come a long way from the girl who couldn’t order a pizza to the woman who became GM of a minor league baseball team, started a podcast and delivered a TEDx talk. All because I made the decision to become a more confident person. And I hope you do too. Because how many runs could you score if you were 10 times more confident? Thank you. (Applause) (Cheers)
By Lucia Caporasoabout a year ago in Motivation
Mental Health for All by Involving All | Vikram Patel
Dr Vikram Patel -Ted Talk I want you to imagine this for a moment. Two men, Rahul and Rajiv, living in the same neighborhood, from the same educational background, similar occupation, and they both turn up at their local accident emergency complaining of acute chest pain. Rahul is offered a cardiac procedure, but Rajiv is sent home. What might explain the difference in the experience of these two nearly identical men? Rajiv suffers from a mental illness. The difference in the quality of medical care received by people with mental illness is one of the reasons why they live shorter lives than people without mental illness. Even in the best-resourced countries in the world, this life expectancy gap is as much as 20 years. In the developing countries of the world, this gap is even larger. But of course, mental illnesses can kill in more direct ways as well. The most obvious example is suicide. It might surprise some of you here, as it did me, when I discovered that suicide is at the top of the list of the leading causes of death in young people in all countries in the world, including the poorest countries of the world. But beyond the impact of a health condition on life expectancy, we're also concerned about the quality of life lived. Now, in order for us to examine the overall impact of a health condition both on life expectancy as well as on the quality of life lived, we need to use a metric called the DALY, which stands for a Disability-Adjusted Life Year. Now when we do that, we discover some startling things about mental illness from a global perspective. We discover that, for example, mental illnesses are amongst the leading causes of disability around the world. Depression, for example, is the third-leading cause of disability, alongside conditions such as diarrhea and pneumonia in children. When you put all the mental illnesses together, they account for roughly 15 percent of the total global burden of disease. Indeed, mental illnesses are also very damaging to people's lives, but beyond just the burden of disease, let us consider the absolute numbers. T he World Health Organization estimates that there are nearly four to five hundred million people living on our tiny planet who are affected by a mental illness. Now some of you here look a bit astonished by that number, but consider for a moment the incredible diversity of mental illnesses, from autism and intellectual disability in childhood, through to depression and anxiety, substance misuse and psychosis in adulthood, all the way through to dementia in old age, and I'm pretty sure that each and every one us present here today can think of at least one person, at least one person, who's affected by mental illness in our most intimate social networks. I see some nodding heads there. But beyond the staggering numbers, what's truly important from a global health point of view, what's truly worrying from a global health point of view, is that the vast majority of these affected individuals do not receive the care that we know can transform their lives, and remember, we do have robust evidence that a range of interventions, medicines, psychological interventions, and social interventions, can make a vast difference. And yet, even in the best-resourced countries, for example here in Europe, roughly 50 percent of affected people don't receive these interventions. In the sorts of countries I work in, that so-called treatment gap approaches an astonishing 90 percent. It isn't surprising, then, that if you should speak to anyone affected by a mental illness, the chances are that you will hear stories of hidden suffering, shame and discrimination in nearly every sector of their lives. But perhaps most heartbreaking of all are the stories of the abuse of even the most basic human rights, such as the young woman shown in this image here that are played out every day, sadly, even in the very institutions that were built to care for people with mental illnesses, the mental hospitals. It's this injustice that has really driven my mission to try to do a little bit to transform the lives of people affected by mental illness, and a particularly critical action that I focused on is to bridge the gulf between the knowledge we have that can transform lives, the knowledge of effective treatments, and how we actually use that knowledge in the everyday world. And an especially important challenge that I've had to face is the great shortage of mental health professionals, such as psychiatrists and psychologists, particularly in the developing world. Now I trained in medicine in India, and after that I chose psychiatry as my specialty, much to the dismay of my mother and all my family members who kind of thought neurosurgery would be a more respectable option for their brilliant son. Any case, I went on, I soldiered on with psychiatry, and found myself training in Britain in some of the best hospitals in this country. I was very privileged. I worked in a team of incredibly talented, compassionate, but most importantly, highly trained, specialized mental health professionals. Soon after my training, I found myself working first in Zimbabwe and then in India, and I was confronted by an altogether new reality. This was a reality of a world in which there were almost no mental health professionals at all. In Zimbabwe, for example, there were just about a dozen psychiatrists, most of whom lived and worked in Harare city, leaving only a couple to address the mental health care needs of nine million people living in the countryside. In India, I found the situation was not a lot better. To give you a perspective, if I had to translate the proportion of psychiatrists in the population that one might see in Britain to India, one might expect roughly 150,000 psychiatrists in India. In reality, take a guess. The actual number is about 3,000, about two percent of that number. It became quickly apparent to me that I couldn't follow the sorts of mental health care models that I had been trained in, one that relied heavily on specialized, expensive mental health professionals to provide mental health care in countries like India and Zimbabwe. I had to think out of the box about some other model of care. It was then that I came across these books, and in these books I discovered the idea of task shifting in global health. The idea is actually quite simple. The idea is, when you're short of specialized health care professionals, use whoever is available in the community, train them to provide a range of health care interventions, and in these books I read inspiring examples, for example of how ordinary people had been trained to deliver babies, diagnose and treat early pneumonia, to great effect. And it struck me that if you could train ordinary people to deliver such complex health care interventions, then perhaps they could also do the same with mental health care. Well today, I'm very pleased to report to you that there have been many experiments in task shifting in mental health care across the developing world over the past decade, and I want to share with you the findings of three particular such experiments, all three of which focused on depression, the most common of all mental illnesses. In rural Uganda, Paul Bolton and his colleagues, using villagers, demonstrated that they could deliver interpersonal psychotherapy for depression and, using a randomized control design, showed that 90 percent of the people receiving this intervention recovered as compared to roughly 40 percent in the comparison villages. Similarly, using a randomized control trial in rural Pakistan, Atif Rahman and his colleagues showed that lady health visitors, who are community maternal health workers in Pakistan's health care system, could deliver cognitive behavior therapy for mothers who were depressed, again showing dramatic differences in the recovery rates. Roughly 75 percent of mothers recovered as compared to about 45 percent in the comparison villages. And in my own trial in Goa, in India, we again showed that lay counselors drawn from local communities could be trained to deliver psychosocial interventions for depression, anxiety, leading to 70 percent recovery rates as compared to 50 percent in the comparison primary health centers. Now, if I had to draw together all these different experiments in task shifting, and there have of course been many other examples, and try and identify what are the key lessons we can learn that makes for a successful task shifting operation, I have coined this particular acronym, SUNDAR. What SUNDAR stands for, in Hindi, is "attractive." It seems to me that there are five key lessons that I've shown on this slide that are critically important for effective task shifting. The first is that we need to simplify the message that we're using, stripping away all the jargon that medicine has invented around itself. We need to unpack complex health care interventions into smaller components that can be more easily transferred to less-trained individuals. We need to deliver health care, not in large institutions, but close to people's homes, and we need to deliver health care using whoever is available and affordable in our local communities. And importantly, we need to reallocate the few specialists who are available to perform roles such as capacity-building and supervision. Now for me, task shifting is an idea with truly global significance, because even though it has arisen out of the situation of the lack of resources that you find in developing countries, I think it has a lot of significance for better-resourced countries as well. Why is that? Well, in part, because health care in the developed world, the health care costs in the [developed] world, are rapidly spiraling out of control, and a huge chunk of those costs are human resource costs. But equally important is because health care has become so incredibly professionalized that it's become very remote and removed from local communities. For me, what's truly SUNDAR about the idea of task shifting, though, isn't that it simply makes health care more accessible and affordable but that it is also fundamentally empowering. It empowers ordinary people to be more effective in caring for the health of others in their community, and in doing so, to become better guardians of their own health. Indeed, for me, task shifting is the ultimate example of the democratization of medical knowledge, and therefore, medical power. Just over 30 years ago, the nations of the world assembled at Alma-Ata and made this iconic declaration. Well, I think all of you can guess that 12 years on, we're still nowhere near that goal. Still, today, armed with that knowledge that ordinary people in the community can be trained and, with sufficient supervision and support, can deliver a range of health care interventions effectively, perhaps that promise is within reach now. Indeed, to implement the slogan of Health for All, we will need to involve all in that particular journey, and in the case of mental health, in particular we would need to involve people who are affected by mental illness and their caregivers. It is for this reason that, some years ago, the Movement for Global Mental Health was founded as a sort of a virtual platform upon which professionals like myself and people affected by mental illness could stand together, shoulder-to-shoulder, and advocate for the rights of people with mental illness to receive the care that we know can transform their lives, and to live a life with dignity. And in closing, when you have a moment of peace or quiet in these very busy few days or perhaps afterwards, spare a thought for that person you thought about who has a mental illness, or persons that you thought about who have mental illness, and dare to care for them. Thank you. (Applause)
By Lucia Caporasoabout a year ago in Psyche
