Perfectionism

While there can, on occasion, be some benefits to perfectionism, it is generally detrimental to wellbeing in situations where doing all the tasks you have to do ‘perfectly’ is not possible.

Perfectionism has been associated with a vulnerability to developing psychological disorders, including depression, obsessive compulsive disorder, eating disorders and indeed thoughts of suicide. Perfectionists are often very self-critical, which can also cause mental health difficulties.

People struggling with perfectionism can get caught up in the belief that the only route to love and respect is through high achievement, through faultless, extraordinary work.  This is almost always a trap and doesn’t lead to the sort of lasting happiness people are looking for.  It leads to years on a work-treadmill and never really feeling fulfilled.
Rosie Allister, veterinary surgeon and mental health researcher

One thing highly driven people do is they have a hyperactive coach (in their head) condemning things and rethinking what it is they’re doing.  That can cause anxiety and depression.  I try to make them aware of the voice in their head.  I have them count how many times a day it is critical and help them reframe that, rather than let it control them.  It’s not magic, but it’s a toolkit that if applied, does work.
Kathleen Ruby PhD, Director of Counselling & Wellness, Washington State University College of Veterinary Medicine

Recognising Perfectionism

This is not intended as a diagnostic tool, but you might want to consider how many of these statements apply to you:

  • Nothing ever gives you a feeling of lasting worth
  • Achieving perfection at work will earn you love and respect
  • You achieve goals but are left feeling unfulfilled
  • You often think your work is not good enough and compare yourself to others
  • You measure your self-worth by your achievements
  • You can’t give yourself permission to do a ‘good enough’ job
  • You feel pressure to be extraordinary and faultless
  • Even when you do achieve you feel you don’t deserve it

What can you do?

  • Reflect on its origins. Ciaramicoli’s book on Performance Addiction suggests reflecting on which situations you first felt that perfection in your work would earn you love and respect. By identifying when it started, you may be able to better understand what the early influences were
  • Reflect on who it  is you feel you have to prove yourself to. If the only answer you have is yourself, are the effort and disruption really worth the short lived feelings of achievement?
  • Take a weekly personal inventory. Check that the basics of self-care and wellbeing are included in your week and don’t get lost in your quest for achievement at work
  • Learn something new just for the pleasure. Recapture the joy of learning a skill without the burden of assessment or exams and without competing to be the best
  • Spend time with people who respect you for who you are, not what  you do
  • Find role models with a good work life balance
  • Seek help if you can’t tackle it alone or you feel it is coexisting with other problems

TED Talk: Doctors make mistakes. Can we talk about that?

Real Stories: Perfectionism is a big part of who I am

I’m a perfectionist as defined by Frost and colleagues: “the setting of excessively high standards for performance, accompanied by overly critical self-evaluation” along with “concern over making mistakes”.
Perfectionism is a big part of who I am. I am grateful to that facet of my personality for many of my achievements, but I can see it has also caused issues in my personal and professional life.
I read comedian Jon Richardson’s book It’s Not Me, It’s You about his search for love as an obsessive perfectionist. While it made me laugh out loud a lot, at times I also found it worryingly close to home, and it reminded me what a pain I must be sometimes.

I suspect everyone in this profession has perfectionist traits, or at least they did when they first graduated – otherwise they would not have been able to arrive at that point.
Leaving university with a veterinary degree, one can be forgiven for thinking veterinary science is black and white, and that there is a right way and a wrong way to do everything in practice. It soon becomes clear that is not the case. For me, that was a very stressful learning curve.
Our natural tendency is to do everything perfectly – sooner or later that will not happen and a mistake will be made.
I think there are many things we can do, as individuals and as a profession, that can help us be more resilient. This can only be good for our patients and their owners, as well as ourselves.

Be aware

Firstly, be aware we all have perfectionist traits. This trait can help us to achieve success academically, but can also make us not only self-critical but also critical of others. Try to practice some self-compassion, and where you see others being overly self-critical try to help them to be more compassionate towards themselves.

Ask for help

Many people wait too long to reach out for support. We need to lower the threshold for asking for help. eople often try to ignore or avoid their problems so that support is not sought until their mental health is seriously damaged. Vets are less likely than the general population to seek help.  It may be we feel it is an admission of failure, that we are concerned we will be “found out” and judged incapable, or that we simply do not think it will help.  Vetlife Helpline, for example, is there for us – we should use it at an early stage, preferably before we have got to a critical point.

We need to recognise how stressful clinical veterinary work can be at the coalface. If a complaint is added to that underlying stress, it can sometimes be enough to tip someone’s mental health balance. As well as telephoning your professional indemnity provider (and it has to be said Veterinary Defence Society is incredibly supportive in this situation), it should be the accepted norm to speak to trusted colleagues or supervisors or telephone Vetlife Helpline as well.

Create a more open environment

When we become so concerned about mistakes and have a huge fear of any failure, any suggestion we have got something wrong is a blow to our very being. We may react by thinking we are a bad person who should not be doing the job at all, which can cause our mental health to go into a tailspin. This then can lead to our trying to protect ourselves by hiding our concerns and fears inside, not talking about it nor admitting to ourselves or anyone else that perhaps we are not 100% perfect.

We need to change the culture so that mistakes are not treated as some sort of guilty secret,;instead we should accept they are inevitable in human beings. We must create a personal, practice and professional environment where we can think and talk about things that went wrong and caused a suboptimal outcome for our patient in an open, no-blame way.

In this way, we will realise all blame does not rest on one individual, but that many other factors will always play a part. If we can facilitate a no-blame approach to how we deal with situations where things have not gone as we would wish, this will help us minimise the future incidence of similar mistakes.

While not a disease, being a perfectionist can certainly be very bad for our health, and a risk factor for mortality in some individuals. Being aware of its role in our lives may help us to treat ourselves and our colleagues more sympathetically. It is a message we need to tell ourselves every day. Doing our best is good enough, we will never be perfect and that is okay.