Diabetes Self-Management Blog

Last week, I wrote about the courage I witnessed in some of the people I’ve worked with over the years. Someone asked me if I would follow that entry up with a note about how courage can be developed. I really think that courage is a combination of several factors converging at the same time.

The first factor is being faced with a circumstance that produces fear of an outcome that we imagine will be hard to tolerate. This imagined discomfort might be pain associated with needles, fear of rejection in relationships, or fear of being controlled by something or someone else. The fear may be real or imagined, but it is usually more than we believe we can tolerate. For example, I have a fear of heights. I have never fallen from a high place, been on an airplane that has crashed, or been on a high bridge that has collapsed into a body of water, yet I persist in this feeling/fantasy that I will feel pain or perish from being in high places. You get the point—the circumstance we fear usually has a bit of reality to it, but then we add our own story to the reality, which makes our fear much worse.

Secondly, risk is a necessary ingredient if we are going to find out if our fantasy of the feared outcome is real. Mental health therapists often talk about taking a risk, particularly when people talk about anxieties. Anxieties are related to imagined outcomes that are usually blown totally out of proportion. For example: “I’m afraid if I ask her out she’ll say no and I’ll be totally devastated, because this will mean I’m unlovable.”

Risk is about identifying what you need to do and then taking that step, regardless of your fear. When I was eight years old, my friends were all jumping off the high board at the local swimming pool. I got in line and, before I knew what was happening, I was halfway up the ladder and could no longer come back down. So, after much agony, I finally moved to the end of the board and jumped. I took the risk of facing my greatest fear, leaping from a high place.

The next ingredient has to do with evaluating the reality of the outcome of taking that risk. Doing this gives us the feedback we need to know that we are still alive and to know how we tolerated the imagined discomfort. This feedback is also necessary for us to compare our imagined outcome with the reality of what we experienced. This is a critical point, because if the reality is worse than what we had imagined, we are far less likely to take a risk like that again. But if the reality is not as bad as what we had imagined, we may be encouraged in our endeavors. I sort of belly flopped from the high dive, but the pride I felt when I looked at my friends looking at me eased my pain.

In many instances, courage is a characteristic that arises out of difficulty and is supported by others who believe that you can survive the risk and who encourage you to take the step. And when you survive, it really helps to recognize that you did something difficult and made it through.

We often think that courage is a big thing—a president making a tough decision, or someone in battle forging ahead—but courage is relative to the threat you perceive. It can be particularly challenging to be courageous, though, if the risk seems so great that you feel you might never be able to take it on. In that case, it may be helpful to break the risk down in to doable pieces. If you just take on what aspects you can handle at a particular time, the task won’t feel so daunting. This way of proceeding will give you manageable bits to do that require some courage but aren’t necessarily overwhelming.

As for the teenager I wrote about last week, we first worked on relaxation skills so he could calm himself down. Next, we identified that he could use some new communication skills to talk with his mom and do some negotiation. Last but not least, he needed to take the risk of actually talking though certain issues with his parents. He did finally approach them for some support in an open way that they could hear clearly.

In essence, we built on the strength of his success. After these first steps, we could continue to count on the positive outcomes of the risks he took.

It is helpful to understand that courage isn’t magic. It’s not genetic and you’re not born with it. Whatever it is you fear, get some knowledge about it, line up your most positive support from the people who believe in you, believe in yourself, and take the risk to discover and act on your own courage.


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