“Be present, be curious, be confident.” This is the phrase I adopted a few weeks into my second clinical to help with the crippling angst I was feeling. Since the start of the clinical rotation, I had been struggling to feel like me and hold myself with confidence. To put it bluntly, I felt completely incompetent. That is not to say I wasn’t properly prepared or had the information necessary to succeed. Regis had done an excellent job preparing me to work in an outpatient musculoskeletal setting, I simply did not feel that I was capable of putting it all together.

For the first few weeks of clinic, I would spend my 26-minute commute from Salida to to my clinic in Buena Vista, trying to slow my breathing and allow my mind to relax, to cease the endless fixations on my errors, missteps, and awkwardness. I was frustrated with my ability to mentally walk myself through a situation or a particular patient presentation with ease, but when confronted with the real situation I felt scattered, unintelligent, and forgetful. Those feelings then turned into embarrassment because I wasn’t meeting my own expectations or what I perceived were my clinical instructors’ expectations of me. This became a vicious cycle, taking my farther and farther away from the confident individual I so desperately wanted to be. 

Normally I would reach out to close friends to help process these difficult emotions, and yet, because the vast majority of my close friends are also in the DPT program with me, I kept these feelings more to myself. The sneaky thief of comparison and the shame of inadequacy would creep in every time we discussed our different experiences in clinic, and I would find myself pushed further into my depressive thought patterns and even less willing to engage in conversation. I became angry with myself that I couldn’t simply hear my friends and classmates’ stories from the clinic, their successes, without comparing their experience to my own. I was frustrated that I was unable to simply be happy for them and their experiences.

At about the three-week mark, I took a purposeful step away from our large class group message and even my discussions with closer friends. To protect my own mental and emotional state and keep myself away from the thoughts and feelings of incompetency, I intentionally did not engage in much talk about the clinic or experiences there. This, on top of cancelling my social media accounts, seemed to help. A lot. While I still struggled to feel fully confident and capable, I spent less time feeling like an utter failure, comparing myself to others, and was able to focus on my individual success and goals. This is also when I began to adopt the mantra, “Be present, be curious, be confident.” It kept my busy brain quiet, allowing me to fully sit in each moment. Around this time, another physical therapist I shadowed spoke to me about her way of staying present within herself during patient care. She conducted “somatic check-ins” two times per patient session. The process was simple: she would take a round of breath to feel her feet were against the floor, sits bones against the chair, the expansion of her rib cage with each breath; bringing her attention back within herself to keep anxious energy at bay. It was comforting to hear I wasn’t alone in feeling frazzled, that someone who has been practicing for 10 plus years continues to need to check in with herself to make sure she is centered.

Be present, be curious, be confident.

Hannah Mattson

And so I tried this. I tried the somatic check-ins, every time I notice my mind drifting or fixating on things, I would use my mantra even if it was simplified to just “Be curious”. I wish I could say this magically cured my feelings of inadequacy, but of course it did not. It got better, slowly but surely, but never fully dissipated.

For those of you who have not had the opportunity to explore Salida, CO, it is a big, beautiful playground. For the outdoor recreationalists, there is always something exhilarating to do. My favorite activity available in Salida is river surfing. I am an obsessive river surfer. If I had my way I would surf multiple times a day, every day. The surging power of the water, the twinkling of leaves in the wind and the sun beating down on you in thick neoprene never gets old. The Salida river wave is like the rest of the waves in Colorado, dependent on the flow of the river supplied by snow melt, and therefore limited in time. I was fortunate to have the last four weeks of my clinical line up perfectly with optimal river surfing season. And surf I did. Almost every day, if not multiple times a day, I would be out there, flopping around in the rapids, having the time of my life.

This is where my confidence changed. On top of surfing regularly, I had begun sitting in silence on my deck more, doing quiet activates without the addition of other distractions like music, podcasts, tv shows, or movies. I was sitting with it all: my thoughts and emotions without overthinking, shaming, or coercing. I was filling myself up with surfing and processing. And one day something clicked. Something in me said, “F*** it. I am me and I am where I am and I get to decide what to make of this.”

Those last three weeks of clinical went astronomically better than the first six weeks. The internal dialogue, while not silent or suddenly only positive, was quieter, a little gentler and constructive instead of destructive.

Retrospectively, I can say it had been months since I had given myself permission to simply exist, to not keep myself occupied with plans, noises, or activities. I hadn’t given myself the opportunity to feel and process and play without restraint since before the start of the spring semester. I had been going full steam ahead and my confidence is what finally alerted me to the inevitable crash. What I have learned is to monitor my energy and protect it. I cannot function effectively for myself or my patients if I am not taking the necessary measures to care for myself. I had always thought I was good at self-care. Turns out I am really good at distracting myself, and that doesn’t necessarily equate to self-care.

While not many people know of how much I struggled during CE II, I know I am not an anomaly. Many of us PT students struggle with feelings of inadequacy, and even more of us struggle to find a healthy balance of personal and productive time. This will be something I continue to work on throughout the entirely of my career and likely my adult life. I want to normalize not feeling like a superhuman health care provider and reassure those reading that you are more than adequate. Sometimes it just takes a little time for yourself and healthy dose of play.