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Jillian Rigert, an oral medicine specialist and radiation oncology research fellow, discusses her KevinMD article, “Is perfectionism something to strive for or heal from?” Jillian explores the emotional toll of perfectionism, its connection to shame, and her journey toward self-compassion and healing. Drawing insights from Brené Brown’s Atlas of the Heart, she shares how unprocessed shame shaped her perfectionist tendencies and the profound impact of letting go of rigid beliefs about achievement. This conversation offers practical takeaways on recognizing the roots of perfectionism, embracing vulnerability, and cultivating empathy and self-compassion for a more fulfilling life.
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Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at kevinmd.com/podcast. Today, we welcome back an old friend, Jillian Rigert. She’s an oral medicine specialist and a radiation oncology research fellow. Today’s KevinMD article is “Is perfectionism something to strive for or heal from?” Jillian, welcome back to the show.
Jillian Rigert: It’s so great to be here, Kevin. Thanks for having me.
Kevin Pho: All right. So tell us what your latest article is about.
Jillian Rigert: My article is a deep exploration into shame. I want to present this in the beginning, knowing that shame seems like a not that deep of a topic sometimes, because not a lot of us allow ourselves to explore just how painful shame can be. That’s by nature. Shame thrives in secrecy, in silence, and in judgment. So many of us that need to be talking about shame are hiding in isolation because we’re too ashamed to talk about it.
My article is about shame but also about perfectionism, and it includes this quote that I’ll read so that people can get kind of an understanding of where we’re going with this. It’s from Brené Brown’s Atlas of the Heart book. “Perfectionism is a self-destructive and addictive belief system that fuels this primary thought: If I look perfect, live perfectly, work perfectly, and do everything perfectly, I can avoid or minimize the painful feelings of shame, judgment, and blame.”
Hearing that, after spending a lifetime of thinking that being a perfectionist was something to, like, walk proudly around and wear as a badge of honor, I realized just how much perfectionism was maintaining this deep sense of emptiness within me. The emptiness, this never-enough feeling, this unworthiness that I kept seeing in so many high achievers, people that I’ve had on my own show, clients I’ve had, that, you know, they’ve gone to the Ivy League schools, they’ve done surgery, the thing that I thought was going to give me my worth. All of them were just having a very similar feeling, this just emptiness of never enough. I really wanted to explore where is this coming from, rather than just saying, “Ah, a lot of people feel that,” and what is this role of perfectionism and its relationship with shame. Thanks to Brené Brown, she helped me put a lot of words and understanding to these two concepts as they’re paired together.
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Kevin Pho: So tell us exactly what you were feeling before Brené Brown articulated it so eloquently in your own life and training. Talk to us about how perfectionism made you feel so empty. What exactly happened?
Jillian Rigert: Yeah. If we think about perfectionism, this ideal of who we think we need to be, and then where we perceive that we are, shame lies in that gap between. So I developed what oftentimes you might have heard of as, like, a shame-based or shame-bound identity, of this pervasive feeling that I am unworthy, I am unlovable, I am never enough, I don’t matter. That ultimately was the belief system that fueled my despair into very intense suicidality. So shame is extraordinarily painful, and I was living with that deep pain. People kept saying, “I wish you could see yourself the way other people could,” and I just kind of shrugged it off, right, like humility, I guess, right? But I was empty, just this pervasive emptiness, and I felt this chase. In order to calm that or quiet that feeling of emptiness, it was, if I could just do this more perfectly and just work harder and just do more and be better, then I will quiet that noise. It just kept becoming louder and louder, and I was more and more exhausted from just continuing to push for more.
Kevin Pho: Now, what happened next once you identified that and made that connection between perfectionism and shame? How did you come out of that? What did you do next?
Jillian Rigert: Yeah, I think it’s really important to say explorations of shame and self-compassion can have this backdraft effect. When I first was like, “Oh my gosh, this is, like, toxic shame,” and then of course I dove into all this research about toxic shame, and opened the books, and took some courses, and this was recently, but I spent a week on the floor, just absorbing this, but it felt like death. So I want to share what I think is important when exploring shame, at least what was important for me. Had I explored shame during my acute crisis years ago, I think that would have put me into a crisis state.
I think what allowed me to explore shame now and keep myself safe was that I have developed self-compassion in a way that I could be there with myself and know that these shame-based thoughts were thoughts I was having and not fully me. I could separate myself and the experience and be there in a way that was supportive of what I needed at that time, which was, like, love and compassion and, like, nurturing. I have a community who I could lean on who loves me unconditionally and authentically, whereas back in surgery I felt very isolated, and I think that could have set me up for a lot of problems had I explored the shame then. So that’s just to say, when I first opened up my eyes to this, I felt a lot worse.
When you sit with the feelings, any feelings, it can bring up memories of those times where you felt similarly, those emotions that feel more pleasant and energetic and those emotions that feel more unpleasant and low energy. If you are allowing yourself to sit with them, often what happens is we recall all those times that we felt that way. So I was being flooded with memories of when I felt shamed, when I felt enough, those times where I was acutely suicidal and thought I would never be able to be enough and didn’t matter.
I think ultimately it was important for me to sit with that, because I think, just like burnout, you know, I think burnout oftentimes is overused when we’re really referring to moral injury, spiritual crisis, existential crisis, PTSD-type responses. Where that does a disservice is, if we’re naming the wrong thing, then our solutions are not directed into the right healing modalities. Because I was able to sit and explore and get to the bottom of this toxic level of shame and where it likely often originates, I could find the resource to say, “OK, what’s the true antidote to shame?” Because it’s not perfectionism. So what is it, actually? What I realized is how much medicine is very shame-based, and it often perpetuates the same by putting stigma on struggles and also putting people into this place where they isolate, they’re in secrecy, and they’re judging themselves, fueling shame, where the antidote is connecting with people. Huge shout-out to your platform, because it reminded me of the times that I released the shame, which was one huge time. It was the “I risked my career to save my life” article that saved my life, just sharing the article, because that’s what actually originally broke me out of that deep layer, level of shame and started catalyzing my healing. So huge shout-out to you.
It brought up all those things of when I felt shamed and when I was able to release it, and it reinforced the solutions and the evidence of that connection being accurate. It’s like, yes, I did share my article, and it brought so many people into my life who provided empathy and who could see me, and they shared their stories. So again, the antidote to shame is connecting with people who don’t provide you more shaming words but provide you empathy, and internally self-compassion. But shame is really a social feeling, because it comes evolutionary from this, like, if you do something wrong, you know, you can get rejected from your community. But now it’s been weaponized against us in ways that make it more toxic.
Kevin Pho: I love that framing about how you said medicine is almost a shame-based profession. If doctors in training and physicians are anything less than perfect, chances are that they’re going to have a shame-based response. They’re not encouraged to show vulnerability. They’re not encouraged to seek help. I think a lot of that perspective and a lot of that attitude in medicine is leading to moral injury, is leading to burnout, and is leading a lot of physicians, frankly, to drop out of medicine. And like you said, platforms like the one you have, your podcast, and of course what we’re discussing here and on KevinMD, I don’t want to say normalize shame, but I want to say that it’s a safe space to connect with others who are definitely going through the same thing that you are.
Jillian Rigert: Yeah, actually, you’re so right. Even the things like workaholism, that’s often an antidote to shame. The addictions that are normalized, often the underlying thing is to reduce that noise of shame, that pain of shame. And even we see a lot of people in leadership who are a little bit more emotionally immature, or we, you know, hear a lot about the narcissistic type of personality in the leadership. Those are very shame-based identities. They are individuals that often are not willing to face their shame, so they shame people.
I noticed for me that was the avatar where I felt just the pain, because with a shame-based identity, I was very vulnerable to emotional, I still am very vulnerable to emotional manipulation. If people aren’t willing to feel their shame and they project it on you and you’re shame-based, for me that made me, and they could very much easily emotionally manipulate me because they’re leveraging my own internal shame in order to control me, because they don’t want to feel their own shame. So it’s just interesting for me once I realize that the vulnerabilities that I have from shame being such a very much ingrained in my identity, that people could really use it to weaponize me, because they were just making those beliefs I had about myself a lot louder, and they saw that I was vulnerable to that. So in observing my vulnerabilities, I can then protect myself better, because I’m like, “Oh, I can see that that’s that person, and I can feel what’s coming up in me, and I can say it’s also not true.”
In the article, I share the words that came out of my mouth that actually brought up the shame, when my therapist asked me how I was doing, really, and I said, “I am struggling.” I immediately went into shame because I’m not used to admitting that.
Kevin Pho: Now, as we know, the culture of medicine is notoriously slow to change. So in that context, how do you advise physicians that you coach and on this podcast, and the physicians that you talk to? How do you counsel them to let go of their perfectionism, knowing that the culture of medicine still values perfectionism? What do you tell other physicians?
Jillian Rigert: Yeah. Well, this is just observing what it is, what it does to us when we’re holding on to this belief that we need to be perfect. So it all starts with us. Often even exploring shame, we’ll realize where it was. It’s transmissible, so it’s often been brought down by our own family systems. In order to create change within our own family dynamic, a lot of people are saying, “Well, I don’t want to pass this down to my child. What can I do?” I feel the best thing we can do is to heal the toxic shame within ourselves. Truly, we are the change.
And then for me, it’s seeing which aspects of medicine am I able to stay in, because people are noticing that the moral injury has been created by staying in aspects of medicine where the values are just clearly misaligned with what truly matters to them, which is leading them to devastating states of illness of the mind, body, and spirit. So knowing that you matter enough to reclaim the narrative in your own mind, your own body, and your own soul, and heal that toxic shame within, and reject and reclaim that narrative for yourself, I think that’s what we can control, and that will be the ripple of change and the healing that even needs to happen in what areas matter most, our relationships with all the people around us.
I’ve been on your channel before. I almost died from anorexia. I sat on my hospital bed. I was very alone, and that pivotal moment made me realize none of my achievements, none of my credentials, none of the people from work were there to give me the support that I needed, right? Those things don’t matter as much as the people in your life that you love, and shame often makes us not love ourselves. So that’s where we start. We love ourselves enough to do this work, to release ourselves from the toxic shame. And then the culture changes as quick as it can, but also we reclaim our lives in the meantime.
Kevin Pho: We’re talking to Jillian Rigert. She’s an oral medicine specialist and a radiation oncology research fellow. Today’s KevinMD article is “Is perfectionism something to strive for or heal from?” Jillian, as always, let’s end with some take-home messages that you want to leave with the KevinMD audience.
Jillian Rigert: Yeah. First, exploring shame. We know that shame comes from a lot of trauma. So first, if you’re going to explore shame, I would love to normalize that it can get worse before it can get better. So making sure that we are adequately resourced, that includes self-compassion and a community who loves you for who you authentically are and doesn’t require any sort of examination of your credentials in order to provide you that worthiness. Know that shame thrives in secrecy, silence, and judgment. The antidote to shame is connection with a community who can provide you empathy and support. And that we are led to believe that more and more achievements and doing more and perfection will quiet that noise and bring us some sort of peace from that feeling of never-enoughness, of that unworthiness, of not being loved, of not mattering. Unfortunately, that often comes very early on from what we might have experienced in childhood.
So I think having a lens of compassion, curiosity, and nonjudgment as we examine how shame was passed down to us, and look to see, you know, our parents and their parents probably didn’t get everything that they needed. Multiple things can be true at once. We can be very privileged in many ways and also not have been given what we needed in order to feel that unconditional love, worthiness, mattering. And so what need wasn’t met when we were little, and how can we give ourselves that now so that we can be whole, so we can truly embody the belief that we matter? We are lovable, we are worthy, we are enough. I love to say, and I don’t need your CV to know that. We believe these things about achievements for so long, so it will take time to rewire. So patience, and of course not perpetuating the shame. Shame begets shame. So if we start judging ourselves for doing things like continuing to fall into perfectionism, that’s often going to just make things worse. So patience with ourselves, compassion, curiosity, nonjudgment. I don’t think I can say that enough.
Kevin Pho: Jillian, as always, thank you so much for sharing your story, time, and insight. Thanks again for coming back on the show.
Jillian Rigert: Yeah, thanks for having me, Kevin.
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