• 

• 

• 

Here’s an interesting phenomenon that happens when you reach your goals: you question if you deserve to have achieved whatever you achieved. I remember when I passed my NP boards feeling proud of myself for maybe 2 days, and then having the thought, “You don’t know anything. These patients are going to come and see you, and they’re worried and scared, and they’re trusting you to make the right decisions, to calm their fears or figure out how to treat their issues, and they have no idea that you shouldn’t even be here.” 

I was talking to a friend who said something similar. The feeling pushes you to work harder, study more, push yourself to the limits. I did that, and I always thought it would eventually pay off because then I would feel like I deserved to be where I was. I would be proud of myself for all I had overcome. I would feel less of a need to strive. Instead, I moved to a higher level of knowledge, but the pressure felt greater. Accomplishments, once recognized, breed the expectation for more accomplishments. The pressure to be the best increases, so then you have to work even harder because if you don’t, if people find out that you’re not really as smart or talented as they thought you were, then the charade is over. They won’t want you anymore and you’ll be alone left with only memories of the days when you were on a pedestal you never deserved. Christina Yang and I have a saying when we feel we’re hitting new lows: “The mighty have fallen, and there was a thud.” That’s my fear.

What I find interesting about all this is that it’s a double-edged sword. On the one hand, you are essentially being motivated by fear. Fear of failure, fear of loneliness, fear of loss. And fear is never a good motivating factor. But the flip side of that is that you’re always improving. Never believing you are good enough forces you to seek out new knowledge, new experiences, new challenges, and that is what makes you good at what you do. Who wants to see a doctor who is content to practice with only the knowledge they had when they graduated twenty years ago? Who wants to read a book written by someone who never tries to improve at their skill? When I read novels by my favorite author, I can see progression. I can see experience. I can see blood, sweat, and tears that have gone into learning how to construct more complex stories and character development. That is what separates the best from the rest. 

The American Psychological Association has a label for this phenomenon: Imposter Syndrome. According to my scholarly research (aka, google search), Imposter Syndrome is “the internal experience of believing that you are not as competent as others perceive you to be.” I read that and thought, “Wow. You just summed up my entire career in one sentence.” And it’s true. People have often complimented me on my drive, my work ethic, my willingness to study or read or practice. Their compliments feed my fragile self-esteem, alleviating my anxiety for short bits of time, and then when the anxiety returns, I’m compelled to repeat the behavior of pushing myself to the limit all over again. The thing was, I didn’t even care. I loved every minute of all of this. The intellectual stimulation alone was reward enough in itself because I didn’t realize that this practice of mine was feeding into all the things I didn’t like about myself. Being a workaholic. Being a people pleaser. Feeling insecure all the time. Never being satisfied. Reaching a goal and then discovering that there was no true satisfaction, only a mirage in the desert of self-doubt. 

And so I stopped. Somehow I have gone from one extreme to the other. I have gone from 80 hours each week to the minimum 40. I have gone from constant studying to instead pursuing creativity. I have morphed into a person I don’t recognize. I’m in a new environment now, and I thought this would be a reset button. That I would have the freedom to re-invent myself. Instead, what I feel is lonely. Without the people who pushed me to be better, I feel lost. It’s that feeling that you get when you lose a parent, or when you turn to the person who has always been able to “fix it” and they suddenly have no plan. The sense that your safety net has been removed. That you have to stand on your own two feet. I told my therapist that it’s an odd feeling. This sensation that no one has my back anymore. Like I’m completely on my own, and I’m not sure I can do what is expected of me, or if I even want to try. She called it what it was: fear and loneliness, lies that my brain tells me, a constant torment which has somehow become a friend. A voice in my mind that I have come to trust almost more than any other. 

As I was on one of my winding drives, I was thinking about all this, wondering why it is that in this time of my life when I’ve reached a place where I should be comfortable, when I should be proud, when I should be contentedly enjoying time with my family and basking in success, I find myself praying more than I ever have, more insecure than I’ve ever been, more fearful than maybe any other time in my life. I think it’s one of the factors in my life contributing to my questions about the goodness and sovereignty of God. If I’ve worked so hard, and I’ve tried to love my people the best way I know how, and I’ve given as much as I could, but it didn’t spare me any pain, what’s the point? In some ways it made everything worse because I expected things to always work out in my favor if I could just work hard enough, but all my efforts failed.

And some verses came to me, written by the apostle Paul when he was experiencing the greatest time of spiritual revelation in his life: “Therefore, in order to keep me from becoming conceited, I was given a thorn in my flesh…three times I asked God to remove it, but he said to me, ‘My grace is sufficient for you, for my power is made perfect in weakness (2 Corinthians 12:7-9).’”  It reminded me of something I read this week in a book by Sarah Bessey (Out of Sorts: Making Peace with an Evolving Faith). In discussing the concept that, in sovereignty we assume that God is choosing not to intervene just to punish us for our failures, she writes, “Sovereignty is redemption, it’s not causation.” 

And it’s true. All of this crazy that I struggle with doesn’t mean there’s anything wrong with me. It just means I can rest in the knowledge that somewhere, some way, somehow, redemption can be found in the midst of my struggles, and it can be beautiful. I’m not an imposter. I’m just a work in progress. I can choose not to believe the lies that my inadequacies are responsible for the situations in my life, that maybe instead I’m believing lies, convinced that because they are saying the things I’ve always feared that they are true. I can work at being better for the sake of being better, not because I’m afraid of disappointing other people. I can choose to harness my talents and be proud of the work I have put in, and still be humble enough to admit that sometimes my best won’t be good enough, and that’s OK. I can choose to learn to stand on my own two feet instead of waiting on someone else to come and rescue me. I can let myself breathe, and maybe this constant tightness in my chest will loosen up. I can choose grace for myself, extending the same mercy to myself that I seem to find easily for the people I love but never seem capable of accepting.

It’s not a quick fix. As my therapist reminds me often, “Those are some deeply ingrained thought patterns you’ve had. It took a long time to form them and it’ll take a long time to break them.” But there’s hope in that, and sometimes hope is all you need.