There has been a lot of talk about physician burnout over the past few years, and as an occupational medicine physician, I’m happy to see that conversation is taking place. For too long, we just saw burnout as an acceptable hazard that just comes with the job.

But it’s become clear to me that there’s a big missing piece in the discussion of burnout — particularly when we try to answer why women physicians are more burned out than men.

In my opinion, the deeper driving force behind the stats is female social conditioning.

Women have been conditioned to think (and feel) about themselves in ways that lead to burnout.

Here are three common thoughts I see routinely in my coaching practice:

“I’m not good enough.” (Imposter syndrome.)

“I have to do it right.” (Perfectionism.)

“I have to make everyone happy.” (People-pleasing.)

“I’m not good enough.”

Imposter syndrome was first described by Dr. Suzanne Imes and Dr. Pauline Rose Clance in the 1970s. It’s when you doubt your abilities and feel like a fraud. Or you don’t think you’re as competent as you should be or as other people think you are. So the result of feeling like an imposter is you work harder to prove to yourself and to others that you deserve to be where you are.

“I have to do it right.”

Perfectionism is when you feel the need to be — or at least appear — perfect to others. You often think there’s a “right” way to do things and hold yourself to that standard. You also place high (and often unrealistic) standards on other people, including your spouse, friends, colleagues, and even patients. Perfectionism is rooted in a fear of disapproval from others and may stem from childhood trauma or rigid, critical caregivers.

“I have to make everyone happy.”

People-pleasing happens when you shape-shift to become whoever other people need you to be at any moment to make them happy. You feel overly responsible for things that aren’t your responsibility while ignoring your needs. You have a strong need to be liked and accepted because you’re afraid of not being part of the tribe. Your value is often tied to how others see you. People pleasing is a trauma response known as fawning, and it’s typically rooted in trying to earn love and approval (aka safety) from an unavailable caregiver, teacher, or other authority figures in the past.

Can you relate?

Now the problem isn’t so much that we have these thoughts. The problem is that we actually believe them. We accept these thoughts as absolute truth. But we know the correlation between our thoughts, feelings, and actions (also known as the cognitive triad). Our thoughts cause us to feel a certain way, then we take action (or not) based on how we feel.

So can you see how these thoughts that come from female social conditioning are so insidious? They are essentially putting gasoline on the fire of burnout. They cause us to feel this constant pressure to perform, produce and prove ourselves. It keeps you stuck on the hamster wheel, over-giving, over-functioning, and overworking.

No wonder you’re burned out.

Here’s the truth: This mythical woman who we’ve been comparing ourselves to — who’s perfect, does everything right, and makes everyone happy — doesn’t exist. She’s a figment of the collective social imagination. So this is not a standard that women today need to hold themselves to.

I believe that when we let go of the struggle to fit into this ideal mold — and start accepting our perfectly imperfect selves instead — that’s when things start to shift.

This is why I always say the actual solution to burnout isn’t outside of you. It would be nice to have more time with patients, the most user-friendly EMR, ancillary support, etc. But having those things would only scratch the surface of addressing our burnout problem.

When we begin to actually think about ourselves in healthy ways, redefine success on our terms and work in ways that support our body’s natural energetic/hormonal cycles, then we’ll feel more empowered — and much less burned out.

Claudine Holt is an occupational medicine physician and life and embodiment coach.