What is Trust?
I’ve been spending the last few weeks thinking about the direction I want to take this blog. I found it relatively easy to brain dump a list of topics I could write about. Where I was getting stuck was in looking at how all the pieces fit together and determining what to write next.
The goal of this work is to establish a bank of essays and posts that are directly relevant to physicians and leaders in healthcare while, at the same time, remains broad enough to be applicable to other industries. Over the last several years I’ve read books, taken notes, collected highlights and have documented my wins and losses. I thought it would be useful to unpack this collection of “leadership stuff” and use the “Rounds” section of this blog to create a working a manual. What would have helped me ten years ago? What are the fundamentals? How can I help you?
Before jumping into bigger essays and more complex topics, I think it may be more fruitful, and dare I say productive, to lay out the building blocks and pieces and establish a foundation that we can build on.
One of the building blocks is trust. We all know what it is, but how do we define it? For many, it’s a binary gestalt, you either have it or you don’t. That definition quickly becomes problematic because it excludes how we can move from low trusting relationships to higher ones. Without a better definition, it becomes impossible to move things forward.
One of the best definitions of trust I have encountered to date comes from Brené Brown. For the uninitiated, Brené is well-known for her work on emotional vulnerability and has shown how we can harness that vulnerability to lead to more genuine relationships. Better relationships lead to less conflict and better outcomes for teams.
Brené breaks down the definition of trust into seven domains, referred to as the BRAVING Inventory. Taken on their own, each item of the inventory represents a strong trait or skill worth harnessing. Putting them together, they create an excellent outline of what it means to have a trusting relationship.
Boundaries
Respecting boundaries and clearly defining what is permissible and not. All parties need to have safety in expressing their boundaries and be respectful of not encroaching on each other’s defined boundaries. Saying no can be done without causing offence or undermining the working relationship.
Reliability
Being able to deliver is one of the most important aspects of the inventory. Recognizing strengths and limitations and staying true to your word consistently is how you can start to build up reliability with those around you.
Without reliability, the other aspects of the inventory quickly fall apart. Many equate trust with reliability. Without doubt, it is a key component, but we’re only getting started in this broader definition.
Accountability
Accountability is being able to own your mistakes and deliver a genuine apology when needed. This sounds so basic, but you would be surprised at the number of people that would rather pass a kidney stone than say, “You know what - that one is on me. It was a genuine miss and I’m sorry. I’ll make sure that doesn’t happen again.” Taking ownership of your mistakes opens the door for others to do the same.
Vault
The vault is where you keep things in confidence. Information is not freely disclosed. We do so well at maintaining privacy and confidentiality of our patients. It’s drilled into us from very early on in our training. Extending the vault to working relationships with others is just as important.
Integrity
Often, what is convenient or easy is at odds with what needs to be done. It means rolling up your sleeves and doing the thing - swallow the frog and have that hard conversation. Say no when everyone else in the room is saying yes. Spend the extra ten minutes. Not to win points or garner favour, but because it’s the right thing to do.
Non-judgement
High trust implies you have your safe spaces. You can be genuine and express yourself, your needs and desires without fear of judgement. We all want to present the best version of ourselves. Sometimes that leads us to holding back. Even in our most trusted inner circles, there are times when we might feel judged. Creating the space to let that go is essential.
How do you create that space? The simplest and most effective method I’ve found is to be explicit about providing that reassurance and stating, “There’s no judgement here, I just need to understand…” Often times that’s enough to open the door. Establishing a reputation as someone who remains curious goes hand in hand with being nonjudgemental. It also complements the final component of the BRAVING Inventory - generosity.
Generosity
This is the hardest, but one of the most important concepts; taking the generous view of what’s been said or done by others. Too often, we tell ourselves a story that someone was explicitly out to harm or to diminish us so that they could gain. One of the biggest learnings I’ve had in my leadership work is that life is not a zero-sum game. There isn’t a score board of winners and losers. It might not seem that way but staying curious and being generous with our interpretations can often times solves problems and resolve conflict before they even start.
It’s easy to think of trust as an all or none concept, is the light on or off? Practically, that’s how we describe our trusting relationships, we either trust people or we don’t. And yet, I think it’s more complex than that. Many of the traits highlighted here are continuous variables on a spectrum. How do we reconcile these concepts? Lately, I’ve come to the conclusion that we need to reach a certain threshold across all these domains to flip that switch. Once the lights are on, you know.
Trust is one of the cornerstones in being able to realize success in all aspects of our lives. Armed with a clear definition, we can learn how to evaluate trust and grow it within our own relationships. Future essays will highlight more of these building blocks and how they complement each other to grow our clinical productivity.
Sources: Brené Brown
Download: The BRAVING Inventory
