4 easy ways to combat toxic perfectionism

By | July 29, 2019

What was the first question that popped into your head last time you had an adverse outcome with a patient? If you’re anything like me, it was: “What did I miss?”

As physicians, we tend to be very hard on ourselves. It starts as undergrads (we must get perfect grades, scores, activities, and clinical experience), and it escalates from there. Whenever we fail to be perfect, we inundate ourselves with, “What did I do wrong?”, “How did I miss that?”, or “Why didn’t I know all the answers and execute everything perfectly?”

Here are four ways to turn perfectionism on its head and make room for self-compassion, something greatly lacking and much needed in today’s health care climate:

1. Revisit the Golden Rule. If we’re hard on ourselves, “doing unto others as you would do unto yourself” is not such a good thing. Most health care professionals really take pride in being kind and compassionate towards other people, so I invite you to treat yourself the same way you would treat other people.

2. Revisit what perfection actually is. We tend to think of perfection as the best patient satisfaction scores, or the shortest length of stay, or the highest teaching scores, or the most first author publications on our CV. Further, we are expected to be able to balance everything in our lives and do it perfectly: Be the perfect spouse and parent and master clinician and K Grant winner.

There is no such thing as perfection! All of the people that seem perfect from the outside have their own struggles and secrets that they are hiding. I invite you to redefine perfection as being the perfect expression of what you are supposed to be in every moment. Sometimes being the perfect version of “you” at that moment means ruffling some feathers, or making a clinical mistake and learning from it, or acknowledging your limitations. Perfection is about being the most authentic version of yourself, from moment to moment and day to day.

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3. Even though our medical training tells us otherwise, it’s OK not to know everything. Even (especially) as a doctor. It’s OK to embrace uncertainty or to think outside the allopathic box. There are a lot of valuable ways to improve our patients’ health, and it’s impossible to be experts at all of them within four years of medical school and 3+ years of residency. I invite you to take the pressure off.

4. Stop listening to the negative inner critic. Our negative inner critic is that voice that says, “You don’t read enough medical journals,” “You are an imposter,” “It’s your fault that patient with 15 chronic illnesses didn’t survive sepsis.” That voice has evolved over millennia to protect us from external threats. It puts a wall up around us and creates fear and a sense of “other.” Instead of protecting us, however, we can get quite isolated, lonely, and scared. Here’s what’s important to remember: you are not that inner critic! You are the awareness behind the inner critic, the being that hears the inner critic. At your essence, you are perfect just as you are.

So next time you hear that inner critic saying, “What did I miss?” or “I am the worst doctor because I wasn’t perfect,” I invite you to pause and take a moment to ask: “Who is it that is hearing all of these horrible things?”

Sound impossible? It’s not. High-performance tools such as meditation can activate the right side of our brain, which helps us to turn the volume down on that inner critic. It’s always going to be there, but we can change how much attention we give it. And when we free up that all-consuming perfectionistic energy, we create so much more space for compassion: for our patients, and more importantly, for ourselves.

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Jill Wener is an internal medicine physician and can be reached at Meditation in Medicine.

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