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Every doctor wants to be perfect. We want to make sure our diagnosis is perfect. Our treatment plan is perfect, and our outcome will be perfect. Patients want the perfect doctor. They want us to get it right on the first try, each and every time. The problem is perfectionism, as hard as we try to achieve it or wish for it, is not attainable. Perfectionism will kill you.
Most doctors and surgeons are perfectionists. We are applauded for it and even take pride in it, as perfectionism in this profession is perceived as a good thing. In fact, it's considered the only acceptable thing to be: perfect. The reality, however, is that perfectionism is just a defense mechanism to help us cope with the fear of inadequacy, the fear of being wrong, or the fear of being perceived as a failure.
Too much of a good thing is never good, and the need to be perfect all the time leads to constant self-judgment, the judgment of others, and eventually isolation.
Self-judgment and judgment of others: When you are a perfectionist, any other doctor appears sloppy, lazy, uncaring, or just simply bad. Being critical of others can make perfectionists feel better about themselves, allowing them to focus on something other than the pressure they put on themselves. Perfectionists are experts at negative self-talk and/or bad-mouthing others (out loud or privately). This makes connections and relationships with others very difficult and leads to feelings of loneliness.
Chronic anxiety: Obsessing over every little detail out of fear of being inadequate leads to chronic anxiety, stress, and unnecessary worrying. Over time, living in a state of constant stress and anxiety leads to a physical and psychological breakdown.
Shame and low self-worth: Perfectionists lack empathy and self-compassion, which they often confuse with self-indulgence. They experience shame for any imperfect result or outcome, which feeds a deep sense of feeling inadequate. Imposter syndrome is common in obsessive doctors.
Need to defend themselves: In general, any constructive feedback feels like criticism, a direct attack, and even betrayal. It burns like fire and triggers defensive reactions that are often excessive. Healthy individuals receive feedback or critique as what it actually is -- someone else's opinion. Perfectionists take it as further proof that they are, in fact, inadequate, which further feeds into their imposter syndrome.
If you recognize some of these traits in yourself, dear colleague, worry not. There is a treatment for it. The first step is always diagnosing it. Start by saying I (insert name), am a perfectionist and recognize that I need help.
What to do:
- Open up about these feelings to someone you can trust. Do not keep them for yourself. You are far from being alone. As stated above, this is extremely common among physicians. Overcome shame by speaking to someone who you know will be compassionate when you have a hard time being compassionate for yourself – if you have a hard time trusting, start by writing it down, voice notes, or talk to a licensed professional – the point is to not keep it inside you.
- Bring yourself back to the present moment. Realize that whatever is happening or not happening has very little to do with you personally. Realize that you are having thoughts that are trying to torture you, but in reality, do not have the power. Think of these thoughts as clouds -- you see them and you let them go on by. Do not allow yourself to become these thoughts. Yes, that is mindfulness. Not too scary, is it? Mindfulness is simply being conscious and aware of what is happening in your fearful mind.
- Show compassion to others when you feel like judging them or criticizing them. If someone screws up, ask yourself how you would like to be treated if you were the one who had messed up. What words would you like to hear? What look or nod would you like to receive? Learning to accept someone else's flaws can help you own your own.
- Stop believing that you can be perfect at all times; perfectionism doesn't exist. Have the integrity to recognize that you are not superhuman and, therefore, cannot be perfect. What you can do is do your best each and every day, and even that will change. What your best is today will change tomorrow and the next day, which is OK. Aim to do your best, and that's it. Stop setting yourself up for failure.
If, in spite of trying all of the above, you are still struggling, then do what you would do when a patient comes to you with something outside your field of expertise -- seek the help of someone who specializes in this and refer out. In this case, you are the patient and you need the help of another professional.
Jean Paul Brutus, MD, is a hand surgeon.
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