When I was accepted to medical school, a slightly younger friend exclaimed “Wow! Your life is completely planned out now. All your decisions are made.”

Lord have mercy — she really thought that!

Once she entered medical school herself, the truth was out. But through her eyes at least temporarily, it looked like the pressure was “off” for me. Attending a college from which no one had gotten into medical school in over 10 years, we’d both been concerned about our chances. My news seemed a “breakthrough” of sorts. 

From my own perspective though, many new and terrifying possibilities loomed. Would I flunk all my classes? Would I get along with my new classmates – none of whom I knew? Where would I live? I’d be on my own for the very first time, some 3000 miles from home. How would I pay for tuition, books, and living expenses?

Neither my friend nor I were able to see the situation clearly. For each of us, it was laden with various beliefs, hopes, fantasies, and fears. What might lead her to make the assumptions she did, and me to be more fearful than excited?

Career choice brings out many questions like this, and I’ve found the concepts of “Authentic Self” and “Conditioned Self” to be helpful in exploring them. They’ve provided a lens for review, appreciation, and understanding in my own life.

Authentic Self

We’re born as an “Authentic Self” – which includes our genetics, innate qualities, gifts, preferences, temperaments, and more. At some level we know our purpose for being on the planet. Even babies can make their feelings known, and there’s initially no conflict about it. We want what we want, and we express those desires simply – sometimes loudly! We sleep, eat, and poop according to our own inner clocks. We respond to others, and spontaneously smile and laugh. Hopefully our parents accept us exactly as we are.

Conditioned Self

But things become more complex with time and proximity. The mutually reverberating, emotionally charged connections between ourselves and our parents continue to develop. We learn what makes them smile and frown – and it feels better to experience the former than the latter. In order to fit in and be loved, we unconsciously tailor our responses accordingly. This process creates the “Conditioned Self,” which grows layer upon layer over time.
Our Needs for Connection

Our needs for connection can make us gradually move farther away from our natural, “Authentic Self,” and more into “Conditioned Self” mode. We can also become fearful or distraught when our natural urges seem to conflict with the preferences of important others we love and want to please. Our survival instincts rear up to keep us safe – sometimes at odds with our desires for adventure and growth.

As Kabir, the 15
th Century Indian poet, once wrote:

“Now you are tangled up in others,
and have forgotten what you once knew.
And that’s why everything you do
has some weird failure in it.”

Both types of “Self” have perfectly healthy reasons for existing. One is our unvarnished, energized, Authentic Self, and the other (our Conditioned Self) helps us navigate through the world and society. Both modes are part of us, and each has value.

What happens to us though, if we really “have forgotten what [we] once knew” about being ourselves – unentangled from others?

We might feel confused about – or not even be able to know — what we truly want. In extreme cases, ALL our activities and interests can become conditioned to the responses of others. In that case, something precious and vital is disconnected or completely lost.

My friend’s Conditioned Self had the [limiting] belief that “if only I can get accepted to medical school, everything will be all right and I will never have to worry anymore.” Her parents were heavily invested in her success – and I well remember how hard she worked in all our shared classes. Although she was innately brilliant, she lived in fear that she might be stupid (another “conditioned” belief). She also feared there were no other acceptable ways for her to live or be, if she did NOT get accepted to medical school. The need for perfection ruled her life. All this affected what she allowed herself to express, and with whom – a mindset common to many.

When I ask fellow physicians about their dreams for their lives and work, many have difficulty answering. A loooong pause results. Maybe no one has ever asked them that before, or they don’t feel worthy of having what they want. Why dare think about it?

On reflection, some even realize that they became physicians in order to please others, rather than expressing their truest selves through that life choice.

I’ve learned that if we’re ever to develop lives and medical careers that feel truly “alive” to us, we must each become aware of our Authentic Self. Our Conditioned Self often keeps us stuck doing what we feel is required for others’ love and acceptance – as we interpret this, anyway. Used exclusively, this mode leads to feeling stuck and miserable.

How can we recognize the important differences between these modes? Are there any reliable guideposts?

My colleague Shelley Riutta MSE, LPC of the Global Association of Holistic Psychotherapy and Coaching, has created a table of characteristics that I’ve found very useful — and can serve as a tool for inner calibration:

Conditioned Self vs Authentic Self: Where are you right now?

Signs you are in your Conditioned Self

Signs you are in your Authentic Self



Holding Back

Expressing, moving forward

Worrying what other people think

Focusing on what YOU think about you,

and loving yourself


Taking positive, consistent action


Getting support from your Spiritual Connection, self, and others

Contractive Thinking

Expansive Thinking

Negative Thinking

Positive Thinking

Pessimistic about the future

Hopeful about the future

Seeing yourself and others through a distorted lens of judgment/fear

Seeing yourself and others through
the lens of love

Feeling energetically heavy

and weighted down

Feeling energetically light

Feeling like the Universe is against you

Feeling like the Universe is for you

Feeling like a Victim –

life is just happening to you

Feeling empowered and that you are co-creating with the Divine

Using addictions to avoid feelings

Using Loving Actions to take loving care of yourself

Tension in the body

Body feels relaxed and open

Constrictive breathing

Expansive breathing

Familiarizing ourselves with these signs, it’s possible to track where we are multiple times a day – especially when learning to reconnect with our natural, spontaneous state (Authentic Self).

Most of us need to coordinate with important others at times. Doing this consciously and wisely differs a lot from doing it rigidly and unconsciously – as our Conditioned Self tends to be. The latter can cut us off from our own life force, whenever it perceives its aims as “dangerous.” Resentment and awkwardness can result (“everything you do has some weird failure in it”).

Maybe the difference between these modes resembles the difference between an aircraft flying with the Jet Stream, vs flying against it. Ever gotten on a plane in Phoenix, and reached the east coast way early? That’s how the Jet Stream moves you along. Shelley’s chart has helped me tap into my own inner “Jet Stream”; maybe it can serve you too.

Ultimately, my college friend was accepted to medical school and did very well. She also experienced the myriad anxieties, possibilities, and choices that come up in most medical careers. No, medical school acceptance did NOT magically resolve all future decisions. “Drat!” she said.

On my own end, I’ve had much healing and growing to do — along with all the intense learning and training required in Medicine. Everything becomes useful for my coaching clients, though, and no topic is off limits for discussion. Have questions about your own Authentic Self and Conditioned Self scenarios? Please let me know!

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