The Biology of Confidence: How Cortisol and Power Poses Affect Leadership

Emily Wolf
4 days ago
3 min read

Patrick Star, or in my opinion, one of the most hilarious fictional characters to grace television, embraces a natural pose of a giant starfish, hence his name. His X-shaped arms and legs stretch wide, with his chest up, and like Superman, he manages to perfectly capture the textbook definition of a power pose. Power poses, used by actors, ballet dancers, and many more, are a stance that embodies a beacon of confidence that radiates like a lighthouse and, beyond external images, reduces cortisol (the primary stress hormone).

Regardless of specialties, we all stand as future health professionals. As future health professionals, we must do more than simply understand how the body works; we must project calm, credible confidence for those we care for. This responsibility may present itself when we guide patients through terrifying test results or maybe in the ambulance; however, our duties remain unchanged, keep calm, and aid. According to Harvard Business School professor Amy J.C. Cuddy and her coauthors, high-power poses decreased cortisol by about 25 percent and increased testosterone by about 19 percent for both men and women. In other words, this simplistic Patrick Star-inspired pose of “stand-tall” posture before rounds or presentations could steady your voice and aid you in problem-solving or critical thinking.

I realize that I have thrown around some big words without pausing and explaining (maybe you already understand these words), so here is a quick, oversimplified breakdown:

Cortisol is your body’s stress hormone. Like water in a cup, too much can make it overflow. In short bursts, it can keep you alert, but if it stays high all day, this may lead to brain fog, raised blood pressure, or mood swings/crashes.
Testosterone, falsely thought of as restricted to males, is typically present in varying degrees in everyone. Paired with low cortisol, testosterone can lead to decisive, focused leadership.

A 2017 experimental competition from Smith and Apicella, a PubMed paper from a source of well-indexed peer-reviewed journals that pushes reliance on MEDLINE, nicknamed “Winners, Losers & Posers”, sampled 247 people to display “high-power” or “low-power” stances after a rowing competition. “High-power” stances are generally mimicking what was described earlier in the passage (think of Patrick Star), while “low-power” stances were constricted and forcefully timid. In general, the winners of the rowing competition who held “high-power” reported feeling strong and especially confident, which was to be expected; however, they surprisingly also received a massive testosterone bump paired with a display of a downward trend in cortisol. As expected, the losing group of the competition presented little to no change or the opposite in terms of both external and internal reflections.

However, a shortcoming of this study was that the external and internal reflections were recorded after the race had already occurred. A preregistered replication by Ranehill and colleagues, from PubMed a source of well-indexed peer-reviewed journals that pushes reliance on MEDLINE, sampled from more than 200 volunteers (hint of non-response bias to all my AP Stats friends) and found that the very same poses done and recorded in Smith and Apicella’s study granted the feeling of power to the volunteer but left testosterone, cortisol, and risk-taking untouched. Highlighting the little-to-no hormonal payoff, we must now step away from impractical research and examine real-life strong examples.

A Harvard-led field study of government and military officials and executives conducted by Sherman et al. found that people with strong leadership or managerial roles typically experience a life of lower cortisol, an anxiety decrease, lower blood pressure, and stress than those of non-leaders. This was highlighted due to not only their roles of authority but also by the way they carried themselves, the Patrick Star method.

Pulling different anecdotes of my claim together, striking the Patrick Star stance will not magically turn anyone into a fearless CEO, however, it costs nothing to accomplish. Here is how you can get started:

Find a quiet space where you feel comfortable: it may be in the bathroom, an empty hallway, or behind the stage. Stand tall with your feet wide, about shoulder-width apart, almost as if you’re about to take off for flight. Raise your arms in a wide “V” or confidently on your hips. Have your chest open like a landing lane and chin slightly lifted. Now comes the fun part: hold this position for a solid two full minutes, and while doing so, to spice things up, repeat to yourself that your performance (or whatever your responsibility is) will be the most powerful and rock-star action to grace the audience’s ears and eyes. If you’re not up to that, I suggest you breathe deeply, in through your nose for four counts and out through your mouth for four more, almost like you’re sucking air up through your feet. This short practice, as observed in the studies, can help regulate your heart rate, lower cortisol levels, and shift you into a whole different gear for takeoff!!!