There's a way of knowing your self-worth without trusting that knowledge. Like a bad joke about Gödel's work or an overzealous pronouncement of incompleteness, this distrust of a hard-won epistemological model wears at any tool you might use to work your way out of the quagmire. A writer who doesn't trust words. A musician who doesn't trust rhythm. A baker who doesn't trust ovens. Becomes hard to see why one holds fast to being a writer or a musician or a baker or anything at all.