07/28/2025
Performance is not pathology. It is an adaptation.
It begins in childhood, where safety and care are often conditional. We learn to perform — to suppress our needs in order to belong.
“The child’s need for attachment trumps even the need for authenticity.”
— Dr. Gabor Maté
Brené Brown calls this performative belonging, the internalized belief that love and worth are earned through perfection and self-erasure.
This same dynamic reappears in clinical settings. Within a medical system still shaped by hierarchy, productivity, and purity ideals, patients, especially those with complex, contested, or invisible illness must perform not just their symptoms, but their legitimacy. What we call compliance is often a trauma-informed strategy: fawning, freezing, performing wellness to access care.
“Patients shouldn’t have to become medical experts just to be taken seriously.”
— Ragen Chastain
“To get help, I had to act like the kind of sick person doctors wanted to help—cogent, grateful, and above all, not angry.”
— Meghan O’Rourke
This is compliance theater. And when your illness lacks visibility or a formal label, you also lack diagnostic privilege, the social power of being legible to systems designed for the measurable.
“We are trained to be grateful for scraps of care.”
— Leah Lakshmi Piepzna-Samarasinha
“The burden of proof always lies with the patient.”
— Trisha Greenhalgh
Care cannot be extracted through performance. It must be co-created.
“When doctors interrupt patients after 11 seconds, they miss the most vital clues.”
— Dr. Danielle Ofri
“The white coat can be armor, but it can also be a blindfold.”
— Dr. Sayantani DasGupta
“What we practice at the small scale sets the patterns for the whole system.”
— adrienne maree brown
If performance is the price of entry, the system is not healing us. It’s rehearsing us. Real care begins where performance ends—where worth is not proven, but presumed.
Featuring quotes from thinkers and writers who have shaped my understanding of performance and care.
