Shame and Perfectionism

Many physicians who struggle with perfectionism don’t identify as perfectionists.

Why?

They think that they are so far away from perfection, that they couldn’t possibly be a perfectionist. Perfectionists would be, well, more perfect.

But if you’ve been here awhile, or read just about anything from Brenè Brown, PhD, LMSW, you know that perfectionisms is really shame avoidance. Shame is a universally uncomfortable emotion, which creates fear that we are not worthy of connection. In Good Inside, Dr Becky Kennedy describes this fear as “this part of me is not connectable – no one wants to know or be with this part.”

If we think of shame in the context of medicine, the roots run right into our training. Not knowing an answer, not being reliable (even if due to illness!) or able to complete a certain task/procedure, etc would make you not worthy of doctoring, not worthy of a spot on the team. And we really wanted to be a part of the team!

This desire to fit in and be a part of the team often led us to fear failure, and thus we worked harder, studied longer, etc to avoid not knowing, not being able to perform, and certainly to avoid seeming to have human needs for sleep, food and bathroom breaks, let alone time to relax, play, connect and be comfortable.

We could argue whether or not this is necessary, really, to learn the art and science of medicine, but it’s still a rabbit hole I’d rather not get stuck in; suffice it to say it happened. And many of us developed a habit of perfectionism that teaches us to continue to avoid mistakes and to feel inadequate frequently, even if we’ve been practicing medicine a long time. Couple that with the dehumanizing healthcare space, and no wonder many of us are struggling with feeling overwhelmed.

How do we fix it?

The antidote to shame is connection. Connection to other people who can offer empathy and support and understanding, rather than adding fuel to the shame fire. If you listen to the podcast, check out episodes 83 (Why Am I Lonely?) and 84 (When There’s Nothing in the Tank) where I talk about this in more depth, but in brief, find humans that you connect with, and can share your inner world with, the good, the bad and the ugly.

Shame leads us to want to hide, and it keeps us as physicians in silos. Counteract that with connection.

Find people that you can share your story with, that you can be yourself with. It’s enough to have a small number of humans on your list. What’s important is that we not sit in shame alone.