• Sara & Colin Taylor


How do we build trust? How do we decide who we trust? What really is trust? This is actually a huge concept, but we'll try to dissect it into a bite sized message so here it goes.

As physicians, trust is a significant part of our profession - with patients, families, society, other members of the healthcare team, our colleagues and administration. In many of these cases, trust feels shaky or nonexistent, and in turn, a real source of stress and discomfort. And it matters. As Brené Brown says in Dare to Lead, "Trust is the glue that holds teams and organizations together." 

We often 'feel' trust more than we intellectualize it. When we come to really trust another person, what is it that led to that belief and feeling? Brené has researched the concept of trust and has found that it's the small moments that build it, not grand gestures. She often describes trust using 'the marble jar' as a metaphor. The idea came from an experience with her daughter as she describes in the "Anatomy of Trust" (and elsewhere) which is worth listening to. The very shortened explanation is that we trust the people in our life that earn marbles, such as when they "show up" at important, hard moments in our life as in a funeral of a loved one; or remember things that are important to us, such as the name of family members or an upcoming doctor's appointment we're worried about. They become marble jar people in our life when they continue to earn marbles, in these small moments.

We heard Brené talk about 'the marble jar' in her work years ago and use the analogy often in our own lives. It becomes apparent quickly that even though the marbles are attained in small moments, not a lot of people in our lives have earned enough marbles to be coined "marble jar people". We also realize that the small gestures we make toward others matter. These same moments can lead to mistrust and betrayal. We've likely all felt the sting of a friend or a colleague who doesn't acknowledge something really difficult in our life, and we know they know. Sometimes these moments warrant losing more than one marble.

One other thing we wanted to point out about Brené's work is that she talks about asking for help as a sign of trust. You might be thinking... what?! But as she describes, if you consider yourself someone who likes to help others and likes to be looked upon as such (hands raising here), but you aren't willing to ask for help in return, that's doesn't form a trusting relationship. When we assign value to needing help, offer it, and don't let someone reciprocate it, then we're judging them for needing help. That's not the basis of a trusting relationship. This makes so much sense and confirms what we know - asking for help is a sign of strength and people connect with our vulnerability. "Trust is the stacking of small moments over time, something that cannot be summoned with a command - there are either marbles in the jar or there are not." ~ Brené Brown

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