Permissions for Life

Over the past couple years "permission" has become very meaningful word to me. It all started when I first came back from spending the summer in Cambodia a couple years ago. I was struggling with reentry to the States and was reading a wonderful blog post by Rocky Reentry that talked about the need to give yourself permission to grieve when you leave a culture.

Permission. In it I find grace and forgiveness. Through it I find freedom. In this season of life, rather than make a list of tasks or goals to complete this year, here are a few things I'm focusing on giving myself permission for.

1. Permission to say things you're not supposed to say

By that I don't mean I'm going to say things like, "That dress looks terrible with those shoes on you" (I'm not the one to consult for fashion advice anyway). I mean saying things like, "Truth be told, sometimes I get scared, and right in this moment I don't want to go to Cambodia." That doesn't mean I won't step on the plane tomorrow anyway (emotions are fickle, anyway, and in 5 minutes I could be pumped about going). It just means fear gets to me sometimes, and it's a very real battle to walk by faith and not by sight.

After growing up inchurch, it can seem un-Christian to be open about our struggles. It's incredibly difficult for me to be vulnerable about fear and faith when it comes to Cambodia—and any change. Yet perhaps admitting our weaknesses and clinging to His grace is the most Christlike thing we can do in these moments.

2. Permission to feel and own emotions

I'm not sure where the idea that emotions—particularly sadness and grief—are weaknesses came from originally. I believed that idea for a very, very long time, but the opposite is true. It takes far more courage to face fear and grief than to run from it.

I've learned the hard way that when we try to numb an uncomfortable emotion, we end up numbing all emotion. For years, I refused to let myself feel emotions because I didn't want to feel grief. A monumental moment for me last year was purchasing a box of tissues. (I know, kind of lame.) But it meant acknowledging tears and grief and in a way, welcoming them. Sometimes we all just need a reminder that it's okay not to be okay. Though it's difficult to sit with my emotions and feel my feelings (I'm not really an ushy gushy type of person), owning, feeling, and sharing emotions is an incredibly healthy practice.

3. Permission to love and take care of myself

This one can also seem downright un-Christian sometimes. What happened to "put others before yourself" and "God first, others second, and yourself last"?

I'm not sure I believe in that mantra anymore. If I'm not taking care of myself, how can I care for others? This is very obvious in the physical realm: if I have a diabetic patient who doesn't take care of his body's nutritional needs, he'll end up with life-threatening blood sugars, wounds that won't heal, hospital stays, etc that will prevent him from physically being able to help those around him. The same—maybe even to a greater extent—can be said for mental, emotional, and spiritual self care. The Lord commanded us to love others as we love ourselves. I think as we learn to love ourselves better, we will learn to love others better too.

4. Permission to ask for what I need

In a way, asking for what I need is part of learning to take care of myself. It's a way of setting boundaries. This is still new to me, so when I put it into practice it feels awkward and like I'm bumbling my way through.

This process is two-step: it requires me to know what I need (self awareness), and then it challenges me to follow through with the action of asking for it. One reason I'm drawn to this practice is that it helps prevent me from blaming others and playing the victim. It's easy to blame people for "not being more sensitive to my needs" or "walking all over me." But in the long run maybe it's better to muster up the courage to clarify boundaries and ask for what I need instead of assuming others will automatically know.

5. Permission to fail often and miserably

This is perhaps the hardest for me to write and accept. The perfectionistic side of me screams that this is heresy. Yet I have found failing often means more growth than success does, and my quality of life soars when I can accept my imperfections.

It's absolutely impossible to move forward in life without failing, without falling flat on my face. So I may as well make a break for it and stumble my way toward living a more full and joyful life.

Perhaps what makes failure so dreadful is not the falling itself or the pain or the slow process of getting back up or even the guarantee that it will all happen again soon. Perhaps the worst thing about it is the shame of knowing others will see me fall. They will see I am a fraud; I am not perfect. I am weak and scraped up and sometimes so broken I seek professional help to get back up. Yet I am encouraged by the wisdom Elizabeth Gilbert received long ago and now shares in her book Big Magic (p. 174):

"'We all spend our twenties and thirties trying so hard to be perfect, because we're so worried about what people will think of us. Then we get into our forties and fifties, and we finally start to be free, because we decide that we don't give a damn what anyone thinks of us. But you won't be completely free until you realize this liberating truth—nobody was thinking about you, anyhow.'" —Elizabeth Gilbert

I don't want to wait until I'm sixty to live from that truth.

6. Permission to forgive myself

With #5 comes, in all likelihood, the fact that I will make a fool of myself. And with making a fool of myself comes the challenge of forgiving myself.

A few months ago I was struggling with the concept of mercy, and a friend told me how one of the Hebrew words [checed] in the Bible that's translated "mercy" is also translated "steadfast love." I'm not a Hebrew scholar or anything, but this helped me grasp mercy. It made sense to me. In some cases, mercy and steadfast love are synonymous. This new perspective makes it easier to accept the Lord's mercy and understand how I can show mercy toward myself. To forgive myself, I must love myself. 

I'm still thinking through several other things I would like to give myself permission for, and I have a feeling it'll be a lifelong process to put these into practice. But keeping these in mind helps me keep my inner critic in check, and the liberating thing is there is no time limit—they are lifelong permissions, and they are permissions for a more abundant life.
 

How do you pursue living a more abundant life?

Are there things you would like to give yourself permission for or have learned to give yourself permission for in the past?

Exposing Ourselves for the Frauds We Are

Sometimes when I write, I feel like a fraud because I know I am not the best writer out there. I am not the best writer or editor or nurse or friend or any other role I find myself in.

Every time I decide to show up in those roles, a tiny (or not so tiny) voice inside of me cries out that I’m a fraud.

“Watch out!” it warns. “If you do that, they’ll know you’re a fraud. If you write something crappy, they’ll know you aren’t a real writer. If you say something you regret in a conversation, they’ll know you aren’t a true friend. You’ll be exposed!”

It’s very hard to ignore. If I keep listening, the voice continues: “Better not hit ‘publish.’ Better file the document away and eliminate the risk of being found out. Better not call that friend back. Better avoid having to tell him you don’t know the answers to any of his questions.”

Other times when I write, I feel like my most authentic self. I don’t feel like a fraud at all. It’s just me, typing words from the bottom of my heart, to you. 

I’m guessing the same back-and-forth switch happens to you sometimes, too. Sometimes feeling like a fraud, sometimes feeling authentic, even if it’s the very same action in both scenarios. When we know where that persistent voice telling us we’re frauds comes from, it’s much easier to combat it. So what makes the difference?

When we dissect the voice telling us we are frauds, most likely we will find out the root of it has to do with shame. In one of her TED talks, Brené Brown explains how shame plays two tapes: ‘not good enough’ and ‘who do you think you are?’ Both try to convince us we are frauds.

Most of the time, buying into the lie that we are frauds only makes sense if we are, in fact, trying to put up a false front for other people.

I only believe I am a fraud as a writer if I am trying to come across as the best blogger ever to my audience. I only believe I am a fraud as a nurse if I believe I am supposed to be a super-nurse. It has a lot to do with what we think we should be or what we want others to think.

A while back, I met a woman who served overseas with the International Mission Board for a couple years. I had recently returned from spending the summer in Cambodia and was struggling with some hard things I had seen in Cambodia. She shared some of her struggles overseas and how she too had worked with a counselor when she re-entered the States. She shared how on one occasion her counselor said, “You feel weak? Good! You are weak!” This woman said she sat in shock at the blunt blow of the statement before dialogue began again, but the point was this:

We are weak. It’s good to realize that.

Because we really like to put up a front that we’re strong.

If we are brave, we will admit this truth to ourselves. If we are wise, we will admit it to others as well. We can choose not to admit it to others, but often outside forces unexpectedly reveal that we are not who we say (or want others to believe) we are, generally ending in embarrassment and a deeper shame spiral. Embracing truth, however, leads to freedom—and also just to feeling better in general because it means we can be our authentic selves.

I am a writer. I am not the best. Now that we have that out of the way, we can get down to what’s really on my heart that I want to communicate to you.

I am a nurse. I am not the smartest, most experienced healthcare provider there is. Now that we have that out of the way, we can connect and address what you need most right now.

I am a friend. I am not perfect, and I often forget birthdays. Now that we have that out of the way, we can move on to deeper things—the imperfections that make us need friends and community in the first place.

That is the inner fraud exposed. And when the fraud is exposed…suddenly we are not frauds any longer. We are back to our authentic selves, speaking from the bottom of our hearts, one to another.

And that's a much better place to be.

Hope, Gratitude & Goodbyes

I don’t like goodbyes. I don’t like change. I told myself I'd wait til the last couple weeks at work start facing the transition. 

So here I am. Today is my last day at work.

I’ve been freaking out on the inside and occasionally freaking out on the outside. There’s been this big ol’ bundle of sadness that wells up from the pit of my stomach when I've thought about moving. When I let it, it rose up in my body until it caught in my throat and caused my eyes to leak and my nose to run.

I don’t think I’ll ever get used to transitions. I don’t think I’ll ever like change. I don’t know that goodbyes will ever get easier.

What I do know is that change is inevitable. I know that transitions are part of life, whether I like it or not. I know that there are things we can do to make transitions easier…and apparently ignoring the entire situation isn’t one of those things. So even though it’s tempting to binge watch Netflix and continue denying that change is occurring (I may have had a Netflix tab open at this very moment for that very purpose), I am taking a moment to focus on the things I’m learning about transition.

The “goodbye” matters. 

Transitioning doesn’t just involve adjusting to something new; it also involves adjusting from the old. 

A few weeks ago a friend was helping me process the move to Cambodia when I realized I really liked Waco. That’s when it hit me: I am going to grieve leaving Waco. It’s not just the transition to Cambodia that will be hard; it’s also the transition from Waco.

I’ve been watching the TV show “White Collar,” and at one point, two of the main characters are moving to another city. Elizabeth and Peter are packing up their house when Elizabeth pauses and comments (I’m paraphrasing), “We have a lot of memories here.” Peter immediately jumps in, “But we’ll make new memories.” The rest of the episode continues like that. Every time one of them mentions how sad it is that they’re leaving, the other pipes up about all the new things they can look forward to. When I watched that, it didn’t seem natural or healthy. Sometimes we need to be intentional about giving myself permission to grieve leaving the life we've built in a place.

Adjusting to Waco involved countless steps outside my comfort zone (new job, new home, new roommates, new church, new friends, etc.). It took a lot of work to build a life here, and it’s sad to leave just as I’m getting established. There’s much to look forward to, yes, but there’s also value in acknowledging that there’s a lot to leave behind.

Happiness isn’t a place.

I have been happier this past year in Waco than I have been in a long time. Not because it’s a magical place (I know that’s your first thought when you hear “Waco”…) and not because it was the easiest place to settle, but because of what I have learned here. I have wrestled through fears and shed many tears, and I have come to have a clearer view of who God is. And the more I know the Lord, the more content I become. 

Contentment, I believe, breeds happiness. I have learned to be happy here in Waco, and it was a process; it didn’t instantly appear. I will learn to be happy in Cambodia too, even if it is another long process, and then I will learn to be happy the next place I move, and the next place, and the next place.

I’m not leaving everything.

I happened upon Hebrews 13:5 recently, which reads, “Keep your life free from love of money, and be content with what you have, for He has said, ‘I will never leave you nor forsake you.’” This reminded me: God’s presence is a big deal.

Out of all the things I value most—my church, friends, family, community—there is not one thing I can take with me. I have nothing…except Jesus. But, Be content!, the author of Hebrews urges, because you have God’s presence. 

I’m leaving a lot. But I’m not leaving everything. He promises He will be with me. I will have Jesus, and His presence is enough.

Hope and gratitude change the game.

I can—and will—be sad about all that I am leaving. I will let myself grieve. Yet grief and gratitude are not mutually exclusive. I can be sad to leave new friendships and be grateful for them, too.

Grief with gratitude cultivates hope. (I’m still not really sure how, but if you’ve figured out how this works, let me know.) There is a next step.

All I know is gratitude focuses on the good, and grief acknowledges the sad, and somehow in the end, hope is born.

And hope makes any transition a little bit easier.
 

Whatever transition you’re facing in life—and we’re all about to be in some transition because we’re about to enter a new year—I pray it’s softened by hope and marked by His presence.

The HCAHPS Approach

Adobe stock photo

There is a problem on the floor. Not the literal floor. I mean the medical-surgical hospital floor that I work on. And every hospital floor, for that matter.

I have named this problem “the HCAHPS approach.”

For those who are not in the healthcare profession, let me briefly explain. HCAHPS [pronounced H-caps] stands for Hospital Consumer Assessment of Healthcare Providers and Systems. When patients leave the hospital, they receive a 32-question survey asking them to rate various aspects of their care. Examples include how quickly their call lights were answered, whether nurses and doctors treated them courteously, and even how quiet the halls were at night. The idea is to measure quality of patient stays and not just quantity, which is a good thing in of itself.

Here’s the catch. Hospitals’ reimbursement is linked to HCAHPS scores.

I could go on and on about the flaws in the system (like have you ever noticed the people who have dissatisfied are the ones who are more likely to complete surveys?), but that’s beside the point.

Broken system or not, I can tell you the effect it has on the hospital floor. Nurses and other staff are more stressed out, feel pressure to perform, and are always trying to please everyone, even when patients' demands are unreasonable. Hospital units track scores, huddle over scores, post graphs of scores. Sometimes we even talk about which patients wouldn’t give us a high score during shift change huddle. You would be amazed at how much time, money, and effort goes into trying to improve patient satisfaction scores.

But then again, maybe we shouldn’t be amazed. 

It’s Everywhere

When I look around myself—and more importantly, when I look within myself—everything I just described is present: high stress level, pressure to perform, working to please everyone…

Toward the beginning of this year, I sat across from my therapist and told her I felt like I was on a treadmill of perfectionism. I kept running and running and running, trying to go faster and work harder and be better, but I was getting nowhere. It was only exhausting me and made me feel like a failure.

I was applying the HCAHPS approach to life—and so is a large portion of society. We pressure ourselves and others to perform, and we measure our self-worth by what other people think of us. Many of us openly admit to being “people pleasers.” (The opposite response is also dangerous—dismissing everyone’s opinion and deciding not to care about what anyone thinks, even if they have valuable feedback. But that’s a whole different topic for another day.)

Though there’s nothing inherently wrong with ensuring quality patient care and assessing how others feel about us, there is a fine line between assessing and obsessing. 

When satisfying others and controlling their perception of us becomes the focus, toxic environments are created. That toxic environment can exist inside ourselves, in our work places, in our homes, etc.

Why It’s Toxic

When our whole focus is on what others think, we operate from a belief that we are not enough and maybe if we try harder, are nicer to that co-worker, answer that patient’s call light faster, we will be enough. We believe we will get all top scores and everyone will love us and we will feel worthy and loved.

Yet this feeling of enough-ness will never come from others. We may feel liked and valued for a while, but striving for worth is a vicious cycle that always calls for more. A little more work. A little more makeup. A little more money. A little more studying.

The truth is, we will never be perfect in the eyes of the people around us…because we are not perfect. And they are not perfect.

We carry around invisible satisfaction surveys and, gauging everyone around us, silently (and maybe subconsciously) rate ourselves based on our perception of their perception of us. I bet that person would give me a ‘1’ on promptness. He would give me a '10’ on friendliness. She would give me a ‘5’ on fashion sense. No wonder we’re stressed out and exhausted!

Toxic environments lead to sickness and death. In my case, it led to deepened depression and anxiety. For others it may manifest in physical sickness, anorexia, addiction…

Getting Out

Ironically, it’s when we stop caring too much about what others think that our relationships improve. When we direct all our energy toward pleasing others, we forfeit the opportunity to do our best work. It takes great courage to admit that we are not enough, and great humility to admit that we can never be enough. But there is freedom if we can embrace the truth that because God is enough, we don’t have to be enough.

When we believe this, we shift from operating from a place of frantic striving to a place of confidence in God’s enough-ness. We operate from a stable place rather than from a place where success is defined by others or even by ourselves. We are able to focus on doing our best rather than exhausting ourselves attempting to achieve perfection. We are able to be instead of do, and out of just being come our gifts to the world—the gifts that so often get squelched in our efforts to please others: our compassion for our patients, our ability to motivate our students, our passion for our workplaces, our unique skills and talents for serving and creating and inspiring.

Good News

The bad news is that we live in a society that embraces the HCAHPS approach to life. Regardless of whether or not you work in a hospital, I imagine that all of our workplaces have a tinge of the HCAHPS approach, subtle or blatant.

We may not be able to change society completely—or hospital reimbursement policy—but the good news is that we do not have to keep the HCAHPS approach as our approach to life. We can replace it with the liberating approach of recognizing our need and operating from a sufficiency outside of ourselves. Somehow, when our internal approach shifts, it doesn’t matter so much that the people around us—at work, at school, or at home—are hung up on performance and people pleasing. 

They can post it on a wall I see every day at work, but they cannot post it on my heart. I choose to leave the HCAHPS approach behind. What about you?