It's easy to feel inadequate or afraid of failing, particularly in the workplace. However, the constant stress caused by these fears can be physically and psychologically detrimental. Learning to understand anxiety and its physiology is crucial in getting it under control.

There are Three Universal Fears:

1. Fear of being found-out or not being good enough
2. Fear of not belonging or not fitting in
3. Fear of not being loved.

(Whiteford 2015)

Of these universal fears, the one that seems to rear its ugly head and do the most damage in the workplace and home is the fear of not being good enough.

Feelings of inferiority stem from striving to live up to the expectations of others, not wanting to hurt loved ones and being afraid to fail. This fear has the potential to destroy relationships with both ourselves and others.

So many people, it seems, do not feel good enough, and are constantly striving to fit in and be like someone else.

This constant fear is far from life and death, however, it may hold you back from moving forward and have damaging effects.

The Fight or Flight Response

When the cavemen/women of prehistoric days were confronted with a dangerous situation, they would engage their sympathetic nervous system to muster up the courage to either fight a dangerous and very real threat or take flight and escape to safety. Their adrenaline would come rushing forward, preparing them to fight that sabre-toothed tiger who was a threat to the tribe.

In high-stress or physically exhilarating situations, the adrenaline hormone is released from the adrenal glands into the bloodstream, rapidly preparing the body for action (Society of Endocrinology 2018).

In the modern world, people are no longer required to fight tigers - but there are countless stressors you face within our daily lives at work and at home, including fears of inadequacy.

Adrenaline, when given to a patient, produces an increased heart rate. This is exactly the same when you find yourself in stressful situations; your heart rate rises to take on the challenge you are presented with.

When you are constantly worrying about whether you are good enough, or allowing yourself to feel less than you are, your body cannot distinguish between real, dangerous threats and perceived threats. Therefore, the sympathetic nervous system takes over, increasing adrenaline and cortisol to potentially harmful levels if not managed (Mayo Clinic 2019).

In survival situations, cortisol helps the body to maintain fluid balance and blood pressure while suppressing other body functions that are not as critical at that moment such as reproductive drive, immunity, digestion and growth (Hormone Health Network 2018).

Constant feelings of stress cause the fight-or-flight response to remain active, leading to chronically elevated levels of cortisol that can lead to health issues such as:

• Anxiety
• Depression
• Headaches
• Heart disease
• Gastrointestinal issues
• Reduce immune function
• Skin conditions (e.g. eczema)
• Issues with the reproductive system
• Sleep problems
• Weight gain
• Issues with memory and concentration.

(Nurse & Midwife Support 2020; Mayo Clinic 2019)

Not Good Enough?

Fear of not being good enough is often at the very core of an individual’s stressors.

You have most likely been in a situation at work when another nurse or midwife has been critical of the care you are giving to patients, or nit-picked over what you should and should not do. If this happens once, you might brush it off, however if this happens often, you may begin to expect it and perceive an impending threat over each task you approach.

You may start to second guess yourself, and if you have an underlying belief that you are not good enough, this will fuel your stress levels and cause adrenaline and cortisol to increase unnecessarily.

Reprogramming Fear

While a caveman would kill the sabre-tooth tiger and return to a calm state, modern-day threats may not have such a clear resolution.

The solution is to understand these fears, teaching the brain to distinguish real danger from perceived danger. The situation can then be addressed in a resourceful, appropriate manner, with a clear head and hormones at a normal resting state.

Without addressing constant fear and stress, long-term activation of the fight-or-flight response may disrupt bodily processes, cause sickness or lead to even more stress (Mayo Clinic 2019).

Some strategies for managing the stress response include:

• Identifying and being aware of stress triggers
• Communicating effectively
• Maintaining a work/life balance
• Maintaining strong personal and social relationships
• Finding ways to grow professionally and emotionally
• Maintaining a healthy diet and adequate exercise and rest.

(Nurse & Midwife Support 2020)

Supporting your colleagues and ensuring the workplace is a safe space will improve health across the board – healthier nurses result in healthier patients.