“I liked it better when you were a surgeon.” My daughter said this to me in February 2021, halfway through my palliative medicine fellowship. Her reason? It was harder to tell people what I did for work - most people recognize what surgeons do; palliative doctors, not so much.

I’ve been thinking about how much space my professional identity consumes in my overall identity. Who am I without my job title and professional accomplishments? This isn’t the first time I’ve thought about this. Over the years, I’ve read articles about how non-Americans find it strange that Americans always introduce themselves with their professional title - “What do you do” tends to come up very early in introductions. People talk about being counter-cultural, but attempts to bypass this script by talking about personal passions or hobbies usually results in awkward conversations. The default programming is deeply ingrained (and already obvious to 12 year olds!).

This month I dug in past the cultural default to look at how it directly impacts my behavior. As I explored the psychology of contingent self-worth, I learned that a good portion of my self-worth is contingent upon competency and success. While there are other domains of self-worth, this competency-contingency is a primary one for me (and many high-achievers). My desire to be competent and successful means I generally struggle to pause. The inability to pause is not driven by desire to succeed but by a fear of becoming useless or unvalued. Logically, I know the value of rest (see my April newsletter!). What has become obvious is how my own internal psychology keeps me from fully realizing the benefits. This month, I have implemented strategies with the specific intent of counteracting the contingencies in my self-worth. Modifying the cultural environment that creates the contingencies is not reasonable - changing my response is entirely within reach.

One strategy is to participate in activities that are process-oriented rather than goal-directed. I see that there are many process-oriented activities that I enjoy, but I see how my desire for constant productivity puts a spin on them as being productive, which can rob them of their joy. As an example, I love reading fiction and getting lost in stories, which doesn’t serve a specific goal. For many years, I deprived myself of this restorative joy because it was not a productive endeavor.