Personal and Professional Perfectionism
To be perfect means to be “excellent or complete beyond practical or theoretical improvement.” Perfectionism is multi-dimensional and can be described as “a combination of excessively high personal standards and overly critical self-evaluations.” Perfectionistic standards and criticisms can be internally driven and directed toward oneself, toward others, or believed to be coming externally from societal expectations. No matter the direction, we are living in a time period of the “irrational ideal of the perfectible self.”
I don’t know when my own self-directed perfectionism began, but I do know I am finally ready to let it go. I imagine it was partly hardwired into my genes, a DNA driven energy to not only do more, but to do everything impeccably. My childhood and young adult experiences only served to fuel my efforts of constant flawless achievement: quarters for every A on my report card, dollar bills for a spotless bedroom, photos in the local newspaper for winning athletic events, and college scholarships for a 4.0 GPA. So many years of my life were sprinkled with dopamine releasing verbal praise and attention whenever I got it--whatever it was at the time--perfectly right. I learned erroneously and early on that being perfect was not only achievable but was also the one thing that could bring me, my family, my teachers, and my coaches true happiness. To survive and thrive I had to be perfect.
There have been gifts from my perfectionistic drive, which would fall into the category of positive or adaptive perfectionism. My motivation to achieve has brought me a lot of success in my life. It kept me organized and focused on moving forward, helping me accomplish the necessary steps to become a physician. But the downsides to perfectionism are much greater, so that the harm far outweighs any possible benefit. This is the negative or maladaptive side of the perfectionistic trap. I have allowed my sense of self-worth to be tied to my achievements, which inevitably creates a fear of failure. I continue to move the goal post further ahead, as the sense of satisfaction from my accomplishments are increasingly brief. Nothing is ever good enough when perfection is the goal, when there is no room for mistakes and growth.
Evidence shows that this type of self-oriented perfectionism is associated with mental health crises such as depression, eating disorders, stress related illnesses such as high blood pressure, suicidal ideation and early death. I know this to be true because I have myself have suffered from ill physical health as well as depression, which I attribute in part to my unhealthy attachment to perfectionism.
Socially prescribed perfectionism throws even more expectations onto the perfectionism pile. Social media platforms are bombarding all of us with unrealistic images of a perfect life, body, family, vacation, etc. which only compounds our sense of dissatisfaction, isolation, and the belief that we are not good enough. Unfortunately for many, the arrival of social media has brought along with it increases in eating disorders, body dysmorphia, and plastic surgery. We live in a culture full of false promises of a perfect life.
Perfectionism also invades the hallowed halls of medicine. Many medical students are perfectionists, something that helped us climb to the top of our classes so we would be accepted into one of the coveted medical school spots. Yet, there is a tremendous downside to being a physician in a culture than demands perfection. As Dr. Adam Hill writes in his memoir, A Long Walk Out of the Woods, “Perfection is required 100% of the time in medicine, in technical practice, in outcomes, in cures. Any other outcome for our patients other than getting well is a failure.” The assumption of failure often co-exists with imposter syndrome, something every physician I have ever known has admitted to experiencing at some point in their careers: the belief that we are not competent doctors and should therefore consider hanging up our white coats and stethoscopes in shame.
The thing I have finally come to realize, and as Dr. David Burns comments in his book Feeling Good, perfectionism is an illusion. Something not attainable because it doesn’t exist in the real world. Everything can be improved upon. Absolutely everything. Not only that, the striving for perfection interferes with being present in the moment and accepting what is truly good in one’s life. “Don’t let perfect be the enemy of good,” was sage advice by the philosopher Voltaire. I’m finally opening up to this wisdom. I’ve turned a corner in my perfectionism and it’s no longer something I actively strive for. I now dare to be average. To be good at my job as a physician. To learn from my mistakes and take daily inventory of where I need to grow. To allow myself to be imperfect in my marriage, my friendships, in mothering my adult daughter. To let myself be human.