Are you ready to hear the truths about perfectionism? [PODCAST]

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

“Are you a perfectionist?

Did you know that perfectionists are actually some of the biggest procrastinators? Yes, really.

In theory, perfectionism sounds like a good thing. Who doesn’t want to do and be their best? It can even seem like a harmless way to motivate yourself.

But the reality is, nothing is perfect.

What does “perfect” even mean? What does it look like? Who has the instruction manual?

It’s different for everyone. What’s “perfect” in your eyes may not be perfect in someone else’s eyes and vice versa.

As you can see, there is no end to this game. There is no way to win.”

Cindy Tsai is an internal medicine physician and can be reached on Twitter @cindytsaimd.

She shares her story and discusses her KevinMD article, “Perfectionism is a myth: Are you ready to hear the truths about perfectionism?”

Did you enjoy today’s episode?

Rate and review the show so more audiences can find The Podcast by KevinMD.

Subscribe on your favorite podcast app to get notified when a new episode comes out.

Click here to earn 1.0 AMA PRA Category 1 CME for this episode.

Also available in Category 1 CME bundles.

Powered by CMEfy – a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info

Do you know someone who might enjoy this episode? Share this episode with anyone who wants to hear health care stories filled with information, insight, and inspiration.

Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show, subscribe at KevinMD.com, and follow. Today we welcome back on the show Cindy Tsai. She’s an internal medicine physician and physician coach. Her latest KevinMD article is titled “Perfectionism is a myth: Are you ready to hear the truths about perfectionism?” Cindy, welcome back to the show.

Cindy Tsai: Thanks for having me. It’s great to be back.

Kevin Pho: Now, we’ve had Cindy on multiple times. For those interested in hearing her story, just go to KevinMD.com/podcast, go to the search bar, search for Cindy, and you can hear all about her story. But today, let’s jump right into your most recent article about perfectionism, and certainly that is something that a lot of physicians have to deal with. So tell us the story of why you decided to write this article, and walk my audience through it if they didn’t get a chance to read it yet.

Cindy Tsai: Sure. For me, I’ve always associated myself with being a perfectionist, ever since I was young. I was this high achiever in high school; with the yearbook superlatives, I was voted “Biggest perfectionist,” and all these things. I just had the idea that things had to be perfect in order to be right, and so I worked really hard, really wanting to perfect things.

Then, especially as I transitioned into entrepreneurship and building my business, it really gave me the opportunity to pause and really think about what perfectionism really is. I saw that it was actually holding me back in many instances, because I was spending all this time really worrying, stressing, and wanting to get it right, when really nothing is perfect. So I think that really inspired me to share this insight with others, because, especially as you say, so many other physicians also deal with this, because we’re such high achievers.

Kevin Pho: So tell me about that contrast. I find that pretty interesting, because in medicine, there’s so much emphasis on being perfect, right? A lot of physicians themselves grew up exactly the way you describe, as being perfect. But you step into the entrepreneurship world, where things ship with plenty of mistakes. You just look at things like Microsoft Windows: They ship out with hundreds of bugs in them, and then they get these versions every few months to fix them. I think one of the mantras that I hear is that if something is perfect, then you probably shipped too late. So it’s a really different mindset when it comes to perfectionism when you contrast that entrepreneurial area with the medicine space.

Cindy Tsai: Yeah, I totally agree. I think that in our medical training, especially with taking the Hippocratic Oath and wanting to do no harm, we think that it has to be absolutely perfect. This definitely came across more in my entrepreneurial journey. As I’m trying different things out, marketing, sales, all these things, writing content, it’s like, just do it, and you learn from experience.

I think to a certain extent we do that in medicine, in terms of our training. If we were waiting to be perfect, and if we were waiting to know all the, to have a full differential for every single thing, we’d probably never get through. So it’s also about that sense of trust, to really just dive in and to learn along the way.

Kevin Pho: So in medicine specifically, give us examples of how perfectionism holds physicians back.

Cindy Tsai: Well, I think for medicine, a lot of times it’s in communications with other people, whether it’s with patients, with administrators, or colleagues. I saw this personally for me when I’m writing an email, or about to reach out to a PI for research and all these things, and I’d be triple-checking every single word, making sure all the i’s are dotted and the t’s are crossed. If you think about it, that takes a lot of time, and that’s essentially precious time you could be using for other things.

I shared an example in the article about that sense of rewriting and rereading emails, and clicking send, and then realizing, “Oh, I have a spelling mistake,” or whatever. Then in that moment you feel the sense of doom and gloom, like, “Oh no, how could you have missed it?” But then, in the grand scheme of things, is it really going to make or break things? Probably not. So I think that there are so many examples in your every day where perfectionism can seep in, and so it’s just helpful to be mindful of it and aware: Is it helping you, or is it holding you back?

Kevin Pho: So let’s talk about your story specifically. How did you make that transition outside of that perfectionist mindset, especially as a physician? How difficult was it for you, and what are some of the steps that you took to break that mentality?

Cindy Tsai: Yeah, well, I think it’s a constant learning process and journey. I think a big part was definitely having support, mentors, coaches, and really working on my own mindset. With perfectionism, especially if you’ve had this tendency for many years, it’s probably a part of your identity, and it very much was a part of mine, and it is still something I have tendencies toward. So I think the big thing is really looking at it and learning different ways, tools, and techniques to shift out of that mindset, and asking questions, being curious about what perfect really means. That’s how you can start to unravel some of those beliefs and stories that have been so deeply ingrained, and then recognizing that you have control; you have choice in terms of how you want to think and proceed.

I think, especially when you’re starting a business, doing something new, everything is foreign and you have no idea what’s going on, and so it’s so important to be able to really be open to that. For me personally, especially in the beginning, wanting to get things right was really holding me back, because I wouldn’t want to post on social media, and I wouldn’t want to go out networking and do things, because I’m like, “Oh, I don’t know what to say,” wanting a perfect script and everything. So I think it’s also a muscle. The more you do it, the easier it is, and you just learn along the way.

Kevin Pho: Now, what would be a typical physician coaching scenario? Let’s say I was one of your clients, and I came to you and I said, “I can’t leave the office until nine o’clock at night because my notes have to be perfect. I have to spend many hours, and I know it has to be grammatically correct. It has to list every differential, like I did as a medical student, and I just can’t break that habit.” So if you’re coaching someone like that, which I assume would be a not uncommon scenario, what kind of things would you say to that person?

Cindy Tsai: Yeah, well, I think the first step is to recognize where you are, because we can’t change what we don’t know. I always like to give the example of, let’s say, the light bulb in your attic is out, but you never go into the attic, so how would you know that the light bulb is out? But then, the moment you’re like, “Oh, I need to grab something from the attic,” you go up to the attic, and you try to turn the light on, and it’s not turning on, you’re like, “Oh, something’s going on here,” and you switch the light bulb, and then you can see again.

So it’s the same thing here. I think the first step is always to pause and acknowledge where you are, recognizing that. In this case, it would be really seeing perfectionism as a habit, and really learning and recognizing that we are basically always acting out our habits, and so the key is to develop new habits instead. It’s a process that takes intention and practice. It’s like a muscle that you’re strengthening when you go work out.

So the first step is acknowledgment, and then really being curious and open about why it is that you feel the need for things to be perfect, for all the grammar and all the spelling to be right. I find a lot of times it’s because we’re concerned about how things would look to other people. It’s like, “Oh, if I have three spelling mistakes, if I get this wrong, other people might think I’m not competent or not good enough,” and all these things.

So I think it really gets back to the inner work of connecting to yourself, and trusting and knowing that you are enough and that you do have everything it takes, that you have the best intentions. I also like to bring in the idea of self-compassion, and really learning to be kind to yourself and to bring that in, so that you’re not so hard on yourself. I think a lot of times with perfectionists, we hold ourselves to this impossible standard, and then when things inevitably don’t work out, we’re so hard on ourselves, and it’s kind of this negative downward spiral. So self-compassion, learning how to be kind to yourself, is really important. The research has shown it really helps with burnout, resiliency, and all of these things too.

Kevin Pho: So one of the truths about perfectionism that you wrote was that perfectionism will not make you happy or fulfilled. To that point specifically, go into more detail about how perfectionism is actually a detriment to your happiness.

Cindy Tsai: Yeah. I think a lot of times we think about life, and we’re like, “Well, I just want to be happy.” And we think that, especially with all the fairy tales growing up, it’s like, “OK, happily ever after,” and we think that it looks a certain way. I find that a lot of times we don’t pause to reconsider. We don’t give ourselves permission to change, to pivot, and then we kind of keep going, especially with medical training and how long it takes. Maybe 10 years ago you were like, “I am going to be a cardiothoracic surgeon no matter what,” and then you go through med school, you go through rotations, and you’re like, “I really hate surgery.” But then you’re like, “No, I can’t. I told everybody I’m going to be a surgeon.”

So I think so much of it is just really about staying present, being mindful, practicing mindfulness, and just recognizing that you’re here for a reason, and that you are allowed to create your life the way you want it to be. Happiness comes from how you’re thinking about your circumstances. I think that’s really the most empowering thing about coaching, where you feel like you get to kind of create your own life, instead of maybe going along with the flow or doing what you think you’re supposed to do.

So with perfectionism, when you feel like things have to be perfect, you are always constantly doing, overworking, overthinking, and you always feel like it’s never enough. When you’re in that state, it’s hard to be happy and satisfied and kind of be at ease. So that’s why I did put in there this idea that perfectionism will not make you happy or fulfilled. You think it might, but then, if you really think about it, we really don’t know what is perfect, and perfect is different for everybody. So it’s just learning to be present and really practicing gratitude in every moment.

Kevin Pho: We’re talking to Cindy Tsai. She’s an internal medicine physician and physician coach. Her latest KevinMD article is titled “Perfectionism is a myth: Are you ready to hear the truths about perfectionism?” Cindy, let’s say I’m listening to you in this podcast, and what you’re saying about perfectionism resonates. What’s the immediate next step, or what are some immediate next steps I should take?

Cindy Tsai: So I think the first thing is to really acknowledge yourself, because it starts with awareness, and knowing that this is a good thing, because then you can choose how you want to respond. You don’t have to kind of go on as is. So you’re welcome to reach out to me, but also really be curious, as I mentioned, and understand and get to the root of it, of where this is coming from.

I always like to talk about the importance of looking at the whole picture. Yes, you might think about perfectionism, and you want to change it, and maybe you just start to distract yourself, maybe by scrolling on social media, eating, whatever, all these other things, because you’re like, “I don’t want to think about it.” I think that if you’re really serious about wanting to change, it’s really taking a moment, being present, and learning to offer yourself that compassion, to be like, “Huh, I wonder why this is coming up. And then I choose to be kind to myself and know that I can change it and I can make it work for me.”

I think that’s the really important message: that we’re all different, and the things we need are different, and different circumstances and events are happening throughout our lives. So I think it’s really just knowing that nothing is permanent. You can always change, and reach out for connections, for help.

I also think it’s helpful to just have these conversations, to know that you’re not alone. I think a lot of times perfectionists especially want to give this image and idea that everything is well and perfect, and everything is this perfectly curated bubble. So I think it is helpful to find connection and to get support, to know that you’re not alone, and know that this doesn’t have to be your reality. If you’re stressing, if you’re having challenges, this is a perfect time to really work on it and to look at how you can change and develop new skills and habits to help you.

Kevin Pho: And my final question: Any take-home messages that you want to leave with the KevinMD audience?

Cindy Tsai: Yeah. I think something that’s interesting to think about is that perfectionism often comes from fear. It’s the idea of fear of not being perfect, fear of not being enough, making mistakes, being judged, and all these things. So just recognize that this is very common, and that it’s just about really recognizing it. Once you see it, it’s like you’re shining a light on the fear, and then you can bring in the techniques, tools, and skills so that you can transcend and move past it.

I think it’s really important, again, just going back to self-compassion, to not be hard on yourself. We’re always trying our best with what we know at that point in time. The next moment, the next minute, the next hour, after a podcast, a book, whatever, you’re like, “Oh, I have more insights, and I would do things differently,” and that’s great. It’s really trying to kind of veer away from the right or wrong, because I think a lot of times that keeps us stuck, when we’re like, “Oh my gosh, I made a terrible mistake. I failed. I’m awful,” and going down that shame spiral. So it’s really just being present and developing that open-minded, curious observer state, so that you can move forward and create your life the way you want to.

Kevin Pho: Cindy, thank you so much for coming back on the show and sharing your time and insight.

Cindy Tsai: Thanks so much, Kevin.

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes