Why self-efficacy and believing in yourself matters!
Charles Ruddock, Principal Psychologist, Clinical Psychologist, Director
When life throws you a challenge, are you the kind of person who will rise up to meet it, going on to accomplishing your goal? Or does one of life’s curve balls often have you feeling defeated and in doubt of your abilities? Building the skill of self-efficacy can assist you in becoming the former, rather than the latter.
Self-efficacy is a term coined by the psychologist Albert Bandura (1977) and is related to people’s belief in their capacity to influence events in their own lives, or to overcome challenging situations. These beliefs determine how people might think, behave and feel. When it comes to pain, self-efficacy refers to the degree of confidence a person has in managing their pain and working towards their goals despite having chronic pain. Research (Jackson et al 2014) suggests that higher self-efficacy is associated with reduced disability, distress and pain intensity – so in a sense improving self efficacy is an example of “mind over matter!”
People with chronic pain and low self-efficacy commonly struggle with challenges such as pain experienced with activity, fear of movement, difficulties performing normal work and issues with their personal/social life. This can result in a downward spiral, leading to reduced confidence, mood changes such as depression, loss of work and a sense of hopelessness. The figure below illustrates how this spiral can occur.
People with chronic pain who are stuck in this spiral often believe the only way to move forward is to be rid of the pain first. However, we know that by working on self-efficacy skills even in the presence of pain, people can work their way out of the downward spiral and improve their quality of life.
Self-efficacy is not a fixed state, it is fluid, and we can work on it in order to make improvements. Here are some tips to improve your self-efficacy:
Take time to reflect. Without judging yourself, identify where pain (or other challenges) is keeping you stuck. It is important to understand the areas of your life that are keeping you in the downward spiral, and identify them as an area that could be worked on for improvement.
Identify meaningful goals. Goals gives you something to work towards, even in the presence of some pain. Breaking these goals into short, medium and long-term then provides a map of your journey towards a return to an improved quality of life. Be gentle on yourself in setting very achievable short-term goals, even if this means on increasing your chosen activity by 1%. By working towards your short-term goals, you will build the confidence and self efficacy to take next steps towards medium and long term goals
Understand your chronic pain problem. As they say, knowledge is power. Being able to identify the range of challenges you may encounter on your rehabilitation journey, and knowing the problems you may face before they occur, will allow you to be ready and confident when they arise and allow you to continue working towards your goals.
Experiencing some pain. It is common when working towards meaningful goals in rehabilitation to experience some pain, especially when you’re increasing activity. Pain in response to gradually increasing activity/exercise usually does not indicate any “damage” or significant worsening of your injury. Working on accepting a degree of pain for now, allows you to keep your rehabilitation journey on track.
Problem-solving. This is a useful in overcoming challenges when working towards your goals. Seek support from your practitioners, family and friends to assist you in solving problems related to your pain challenges. With each success you will build confidence and self-efficacy.
The takeaway? If you try nothing, you will achieve nothing! Having the confidence to complete an activity or work towards a goals often comes after the event, not before. For example, someone becomes confident riding a bike after they have ridden, fallen and got back up numerous times. You will gain the confidence to complete activities and work towards your goals with pain by practicing the steps described above. The result will be improved self-efficacy and an upward spiral to recovery!
References
Jackson T, Wang Y, Wang Y, Fan H. Self-efficacy and chronic pain outcomes: a meta-analytic review. J Pain. 2014 Jun;15(6):586-601. doi: 10.1016/j.jpain.2014.01.499. Epub 2014 Feb 11.PMID: 24524845 Review.
Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review. 1977;84(2):191-215. doi:10.1037/0033-295x.84.2.191
Charles Ruddock is a director, principal psychologist and clinical psychologist at Advance Healthcare in Bundoora, Geelong and Hoppers Crossing. Charles has strong clinical skills in a range of mental health areas with an interest in chronic pain, stress, workplace injuries and returning to work after a workplace injury.