Chapter 4 Achievement psychology
Self-motivation
Candidates who do not persist with their desire to succeed do so out of choice! They have chosen not to exercise self-discipline and persistence to work diligently towards their goal. You can choose to be a success or failure: ‘Whether you think you can or think you can’t, you’re right’. Realise that nothing is final until you accept it as such. We all make mistakes, we all fall down and we have all at some time given up under adversity. However, to stay down once you’ve fallen is a matter of choice.
Commitment
Remember the words of the Jedi Master Yoda in Star Wars: ‘Try not. Do, or do not. There is no try’.
Why do you do the things you do?
Create a priority purpose—a mission for yourself. Ask yourself:
1. Why do I do the things I do?
2. What is most important to me?
3. What am I willing to invest?
4. How much am I willing to endure?
5. What am I willing to give up?
6. How much responsibility am I willing to take?
7. Am I willing to begin where I am?
8. Am I willing to settle for anything less than my full potential?
To further your efforts to fulfil your mission, ask yourself:
1. Do I understand the aims and requirements of the examination?
2. Do I have the determination to study seriously? Do I give top priority to study at the expense of time with family and friends?
3. Does my employment provide adequate experience? Do I use my employment to gain experience?
4. Have I discussed my plans with a supervisor or sympathetic consultant paediatrician? Do others feel I have the aptitude for paediatrics?
5. Can I accept constructive criticism from those who want to help me?
You must understand that in any endeavour, obstacles and conflict are inevitable. In your efforts to overcome these factors, at some stage you will experience the pain of present limitation. The only way to overcome the limitation is to push through the limitation towards your objective.
Goal-setting
Here are some guidelines for setting goals:
1. Set specific goals. Specific goals are much more productive than general goals that merely stress ‘doing your best’.
2. State goals positively. For example, set aside 2 hours every evening to study Nelson’s textbook. Effective goals need a positive mental image of yourself achieving what you want or being what you want to become. You cannot picture a negative goal.
3. Set challenging goals. Psychologist Edwin Locke found that ‘the higher the level of intended achievement [that is, the higher the goal], the higher the level of performance’.
4. Set measurable goals. Goals need to be measurable in terms of what is achieved and when it is achieved. A goal of ‘increasing performance in the long case’ is not measurable. Rather, a goal of ‘completing 20 long cases within 3 months’ is measurable.
5. Set realistic and achievable goals. A goal must not be too difficult, otherwise you will not want to try. But it must not be too easy—there is no challenge. State what results can be realistically achieved, given your resources. For a medical student to say ‘My goal is to be professor of paediatrics within 12 months’ is unrealistic. ‘My goal is to be professor of paediatrics in 20 years’ is a more realistic goal, especially if the student sets down the intermediate goals.
6. Set tangible goals. Some of your goals will be intangible. You can accomplish these intangible goals by achieving related tangible ones. The goals you set should always be tangible. For example, if you lack self-confidence, the intangible goal of ‘achieving greater confidence’ is not measurable. How will you know when you have enough confidence? Setting specific, tangible goals fostering development of confidence will be effective (e.g. ‘I speak up at grand rounds’).
7. Make sure goals include behavioural changes. You must set goals of becoming, of developing whatever characteristic you lack before you achieve your tangible goal. You cannot expect to become proficient in short cases if you continue to avoid doing them. You need to alter your behaviour.
8. Write out your goals in present tense. Written goals ensure that you clearly describe what you want and that you commit yourself to its accomplishment. Written goals need to be in the positive present tense, so that your mind accepts them. Written goals force you to establish priorities, for often two very desirable goals will come into conflict. Prioritise your values to determine which is the most important.
9. Vividly imagine your goals. Develop the habit of several times a day vividly imagining yourself achieving your goal.
10. Write down the benefits of reaching your goals. Writing down the benefits of reaching your goals improves motivation and desire.
11. Write out a plan to reach your goal.
12. Write out a list of obstacles that hinder you in reaching your goals. Listing the obstacles that hinder goal achievement allows you to focus on what needs to be done: ‘A problem stated is a problem half-solved’.
13. Set short-term and long-term goals. Set time-priority goals: a 5-year plan, a 1-year plan, a daily ‘to do’ list. Every day, write down the six most important things that need to be done. Rank the six items with the hardest first down to the easiest last. Start on number 1. If interrupted, take care of the interruption and return to finishing number 1. Check off each item as it is completed and carry over into the following day those that were not accomplished. Every night, make out a new list for the next day.
14. Set goals to maintain a balanced life. True happiness can be reached only by living a balanced life. To ensure a balanced life, set goals in the following areas: physical, mental/career, spiritual, financial, family and social.
Affirmation
2. State affirmations positively. ‘I will not be afraid when I perform in long cases’ is not as effective as ‘I enjoy the challenge and sense of achievement I feel when I perform in long cases’.
3. State affirmations in the present tense. Even though you know it is not true yet, affirmations need to be worded in the present tense. Therefore state ‘I am a paediatrician’, rather than ‘I will be a paediatrician’ and see yourself already in possession of your goal.
4. State affirmations with emotion. The more feeling you can generate when repeating the affirmations, the more effective they will be.
5. Write out affirmations. Write down your affirmations on 3 × 5 cm cards and carry them with you (in your pocket, wallet etc) and place them in areas where you will see them (e.g. study desk, bathroom mirror, dressing table, dashboard). Repeat them throughout the day, especially first thing upon awaking and before going to sleep.
Self-talk
1. Magnify the obstacles and underestimate their own resources.
2. Think irrationally and feel that the examiners dislike and are ‘out to get’ them.
3. Visualise the outcome they fear or do not want to happen and not concentrate on what they want to achieve.
4. Try too hard with ‘do nots’ and ‘must nots’.
5. Worry about criticism, rejection by others and embarrassment.
1. Repeating negative thoughts aloud as soon as they come to mind helps some individuals get rid of them.
2. Thought-stopping. As soon as you are aware of negative thoughts, say ‘STOP!’, ‘CANCEL!’ and/or imagine a red light or the word ‘STOP!’, and then focus on something else, such as your breathing. Another technique is to wear an elastic band around the wrist, and to pull and flick it each time a self-defeating thought comes to mind.
3. Being aware that everyone has negative thoughts, particularly in pressure situations, helps to lessen their impact.
4. If you fight negative thoughts, you concentrate on them and make them worse. You need to replace them with positive thoughts.
5. Encouraging negative thoughts to go through your mind and then allowing them to pass out may also get rid of them (e.g. saying to yourself ‘Come on, I’m waiting for you’).
6. Asking yourself questions such as ‘Why am I doing this?’, ‘What’s my plan?’, ‘What do I have to do now?’ and ‘What’s the worst thing that can happen?’ may also reduce self-defeating thoughts.
7. You can stop undesirable self-talk by taking a few slow deep breaths and thinking positive affirmations. For example, say to yourself ‘Take a few deep breaths, relax and take control’, ‘You can do it!’, ‘Relax and flow’, ‘Slow down’, ‘I perform better under pressure’.
8. As James Rohn states, ‘Don’t say “If I could, I would”. Say, “If I can, I will” ’.
Visualisation
Visualisation or mental rehearsal is the technique of picturing the results you would like to see happen, and using these images to focus all your energies on attaining your goals. Visualisation reinforces affirmations. Visualisation becomes several times more effective when three or more senses (sight, smell, touch, taste, hearing) are involved in the process. There are two aspects to visualisation. One is picturing a future desired result as being already in existence (e.g. picturing yourself seeing your name on the ‘pass’ list for an exam, being congratulated by your colleagues, friends and spouse and then savouring the emotions of joy and happiness you feel). The other is mentally rehearsing a physical act, the actual process or performance (e.g. picturing yourself going through a perfect short case). There are slightly different guidelines for each form of visualisation.
It is crucial that you practise this reprogramming exercise consistently, because establishing a new conditioned, stimulus-response (thinking, feeling and acting differently) needs continuous reinforcement of the programming in your subconscious. Your subconscious mind becomes so familiar with seeing and feeling yourself being the ‘successful you’ that in time you’ll find yourself actually behaving this way. This technique should be used each day and night until you’ve experienced a satisfactory change (usually takes between 21 and 90 days).
Mental toughness
1. Learn everything you can about individuals who have overcome adversity and succeeded.
2. You do not need to experience a setback to get ahead.
3. Provide solution-oriented feedback when problem-solving.
4. Expect the unexpected—stretch yourself beyond your comfort zone. Expect the best, but plan for the worst.
5. Strengthen your abdomen. According to sports psychologist James Loehr, ‘The foundation of mental toughness is grounded in the physical. You want to develop a tremendous capacity for absorbing physical stress’. Your abdomen determines your posture and breathing, and supports your lower back. To strengthen your abdomen, do 100 abdominal crunches daily.
6. Practise interval training by contrasting periods of stress with rest and recovery. Aim to exercise your body for 30 minutes daily, using the interval training principle. For example, if you are a jogger, run fast and then slowly.
7. Develop performer skills. Acting ‘as if’ you feel a certain way, such as confident, causes biochemical changes in your body. Physically relax, breathe and hold for about five heartbeats between each inspiration and expiration until your mind is calm. Recall a positive emotionally loaded memory and get fully associated with it, then magnify it many times and step into it. Repeat with a second positive memory, then see and feel yourself facing the impossible and succeeding. Open your eyes and perform your task. Remember ‘Practice makes the impossible possible’.
8. Practise winning rituals. Establish a consistent schedule of eating, exercising and studying. Highly ritualised routines will enhance your effectiveness when so much of your life is out of control.
Failure
1. Your attitude and approach.
2. Whether or not your experience was adequate to allow you to deal with the examinations.
3. Whether or not you studied sufficiently, sought the necessary experience and avoided distractions during your training.
4. Whether or not your training is of the required standard.
