Diabetes and the “Not Good Enough” Syndrome

I love my doctor. I love the diabetes center where I go for regular checkups. The folks on my medical team are all wonderful, kind people who put all of their thought and heart into helping me live a better life. And I am unbelievably fortunate to live a life with access to these people, this diabetes center, and access to good health care that allows me to go there. Having said my disclaimer, there is a nagging part of me that hates going to the doctor. But it’s not for the reasons you would think.

I don’t fear bad news from my doctor; I don’t fear a painful poke, prod, or procedure; no, my trepidation is a symptom of my “Not Good Enough” syndrome. And what’s this “Not Good Enough” syndrome? It’s a condition often associated with diabetes — a comorbid condition that, I would hazard a guess, affects quite a substantial number of us.

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We spend so much of our time tracking numbers, analyzing numbers, and assessing how we’re doing based on those numbers. We’re like Certified Public Accountants, except we don’t answer to the IRS, we answer to the A1C! And all of that tracking and analyzing and tallying can take a mental toll on us! After all, we’re dealing with living systems at all times — the living systems of our bodies! A living system is not always predictable. It won’t always respond the same way to the same set of actions; it can be thrown off course by small changes we don’t even notice.

When our efforts aren’t yielding the results we feel they should; when all of those numbers and stats point to “poor control” (a blame-filled term if I ever heard one), the instinct for self-blame kicks in. The temptation to take out our frustrations AGAINST OURSELVES can be great — because even though self-blame doesn’t feel good, having NO source to blame our “poor control” on is even worse. Having no source means having no agency in the situation, suggesting our control is purely by chance, purely at the whims of the universe. That’s a truly scary thought. And so instead we blame ourselves, because at least that means we had a hand in the process; at least it means the universe isn’t just arbitrarily punishing us.

This is the beginning of “Not Good Enough” syndrome. And when it’s left unchecked, it can tear us apart. It can cause depression; it can cause tension in our relationships; it can destroy our motivation and our energy. It leaves us in a state of hopelessness for the future.

The good news, however, is that “Not Good Enough” syndrome has treatments. I hesitate to say it can be “cured” (unless you happen to be a monk or nun who has reached enlightenment or will be doing so momentarily), because the drive that leads us into it is a pretty fundamental one for humans. We crave predictability and stability. More than pain, we fear uncertainty, and it is, of course, uncertainty that pushes us into the state of “Not Good Enough.” So perhaps a “cure” isn’t within reach for most of us. But we can treat it; we can manage it in much the same way we manage our diabetes.

Probably the most important step we can take is to be aware of the moment we begin to lapse into self-blame. It’s pretty easy to spot, actually. If you’re looking for it, you’ll notice when it happens. What WILL surprise you, however, is how hard it is to HALT the process. There is something so comforting about lapsing into self-blame, and it actually takes some real focus and discipline to push through your own internal resistance and override it. But it can be done. Here, as any faithful reader of my blog will know, is where those wonderful mindfulness exercises like meditation, yoga, and others can really help you out. When you notice the process, bring yourself back to the contemplative, even-keel state with a few deep breaths, and let your calmer self take control.

Sometimes a moment of silent meditation isn’t quite strong enough, though. Sometimes frustration is simply too high. What to do then? If the idea of letting go and calming is too much, try this: Tell yourself to just drop it “for a little while.” Maybe just tell yourself to drop it for ten minutes. I know it sounds silly, but it’s the same idea as waiting before writing an angry e-mail or sending an angry text. It’s amazing what even ten minutes can do for our perspective.

Finally, you can go ahead and just “talk back” to your self-blame. The Serenity Prayer is really powerful for this. I know it can sound almost like a cliché, being used as often as it is, but it really is a powerful set of ideas, and the practice of “letting go of what is beyond our control, and working skillfully with what IS in our control” (I’m paraphrasing a bit) is EXACTLY what we need to do to fight the symptoms of “Not Good Enough” syndrome.

  • Kate Oneal

    Yea my doctor blames everything I do ON ME and I’ve had it up to here with his crap trap. He’s has me on toujeo trdjento s and trulicity and novolog I’m sick up to here why these things aren’t working. My new directive to myself is to tell him Tomorrow is that I want to go to a Endocrinologist STAT before I have another heart attack that will be my fault cause I wouldn’t take advice from this doc for an ingrown toenail. I’ve been seeing the present pcp who is a lso a internist. Ha

  • Joanne Cameron

    Medical Profession is to blame for the You are not doing enough, therefore you are not good enough syndrome.. Even though you are doing everything you can.