Breaking Free from the FOPO (Fear of People’s Opinions)

"Care about people’s approval, and you will be their prisoner." — Lao Tzu

We’ve all certainly experienced it.  Remember stepping into the exam room, or the conference room, your heart racing and mind buzzing with thoughts of what the patient or your colleagues might think?  The professional pressure to be flawless – feeling the need to continually live up to the expectations of others, can feel suffocating.  This mental burden has a name: the Fear of People’s Opinions or FOPO. 

I remember vividly a time early in my career when I was struck by what I now understand to be FOPO.  It was the first grand rounds I gave as a resident, and I was presenting a complex and potentially contentious ethical case, surrounded by peers and seasoned faculty whose opinions I highly valued.   Though well-prepared, as I spoke, I became tentative and unfocused, and a sense of uncertainty overwhelmed me.  All I could think about was whether they would agree with my conclusions.  Would they judge me for taking a then quite controversial position?  Would they think I was negligent, or naïve, or even incompetent? 

Psychologist Michael Gervais, who coined the acronym FOPO and works with some of the highest performing athletes and leaders in the world, suggests that feeling trapped in a cycle of self-doubt and overreliance on external validation is one of the greatest obstacles to reaching our full potential, particularly in high-stakes fields like medicine.  Research shows that when we’re preoccupied with what others might think, we’re less likely to take risks, make decisions confidently, or speak up with new ideas. This is particularly damaging in healthcare, where appropriate confidence and timely action is essential.    

Reflecting on that meeting years ago, and many since, I now recognize my fear wasn’t really about the presentation; it was about seeking approval.  Certainly, it is normal to want to feel validated, but when that desire leads to fear and even emotional paralysis, we can no longer show up as our best selves.  Gervais’s teachings have helped me realize that during that meeting I was giving away my power by depending on others’ opinions rather than being open to them while staying true to myself.  He indicates that the antidote is to shift our focus from primarily what others think to aligning our actions with our core values.  When we focus on what truly matters to us, we gain greater freedom to act authentically, even in high-pressure situations, and in doing so, become more effective, resilient, and fulfilled in our work – and less attached to the fear. 

This week, let’s challenge ourselves and each other to identify one area of our professional (or personal) lives where FOPO might have a grip, and to take one step toward letting go of that fear.  Sure, we can still value other’s opinions, but do not have to be dependent on them.  Instead, consider speaking up in a meeting when moved to do so, proposing a new idea you are excited about, or sharing something about yourself that is important to you, but that you may be withholding out of FOPO.  You might just find that this opens a deeper level of connection with colleagues, loved ones, and even yourself.