When “Good Enough” Isn’t Good Enough: Reframing Perfectionism

I’ve been wrestling with something I had to get coaching about yesterday.  I’d convinced myself that everybody thought I was doing a specific task wrong.  It was gnawing at me because I was trying really, really hard to make everybody happy about this thing.  So I went to my coach and said, “I need to believe that what I’m doing is not personal.”  We worked with that thought for a while, but I could not make my brain believe it.  

Here’s how it worked:

My pre-evolution lizard brain: “You’re doing this thing wrong, and everybody hates you.”

My evolved pre-frontal cortex: “What I’m doing is not personal.”

My PELB: “Bwhahahahahahaahaha!  OMG, now everybody hates you, AND you’re a delusional liar!” 

Now, I know my brain is just trying to keep me safe.  The limbic system (the technical term for my PELB) is designed to save us from danger, and being kicked out of a tribe because everybody hates you was really dangerous in pre-evolution times.  But I was tying myself in knots trying to improve the situation while not having any new or creative ideas about it. Interestingly, a friend has offered to help me with this thing, and I always rebuff her.  I’m so busy beating myself up that I don’t notice I’m pushing away a lifeline being thrown at me.  Super helpful.


Since I couldn’t get my whole brain to believe that how I was dealing with the issue wasn’t personal, my coach and I tried out different thoughts. Each solution disadvantages everybody.  It doesn’t matter what people think of the job I’m doing.  Nobody can make everybody happy.  I know I’m doing my best to make everybody happy.  When I thought about that last one, “I know I’m doing my best to make everybody happy,” I felt a distinct difference in my body.  I knew both parts of my brain could get on board with that thought.  The people impacted by the problem I was solving weren’t just my colleagues; they were my friends.  Of course, I want my friends to be happy.  And because we’re friends, they want me to be happy too.  The thought made me feel loving.  Loving towards the people I was worried were angry with me, and loving towards myself because I really was doing my best.  When I feel loving, it just doesn’t cross my mind to beat myself up, the thoughts are too incongruent.  Sure, my brain offered me a couple of arguments. Was I just people-pleasing?  Maybe, but not in a way I felt bad about.  I can’t make anybody feel a certain way.  Very true, but a good person wants happiness for others, and I consider myself a good person.  Was I really trying my best?  100%, yes, I was: I know when I’m being lazy, and I was not being lazy.  Once my brain focused on the fact that I was really trying my best and wanted everybody to be happy, my tension over the situation eased, and I could ask for help.  We got on a meeting, and I showed my colleagues the data, all the issues, and the solutions I’ve tried.  I asked for ways to make it better.  I took their suggestions openly instead of with the defensiveness I’d felt for weeks.  We brainstormed things to try and new we’d circle back in a few months to re-assess how things were going.  Suddenly, the problem wasn’t my problem; it was our problem.  The move wasn’t to make the issue impersonal, it was to make it more personal.  I got a little vulnerable, let my guard down, let myself believe that I was truly doing my best, and asked for help.  

Many of us have gotten to where we are in medicine by telling ourselves that our “best” wasn’t good enough.  Got an A- on a test?  Should’ve gotten an A+.  Only have a rough draft of a manuscript’s introduction?  Ugh, I should’ve had the whole thing finished a month ago.  At some point, the objective performance measures we got so used to during school either got horribly complex (looking at you, Press Ganey scores) or just faded away.  There’s no objective measure, no darling of medicine biomarker, to prove that I was doing my best to fix this problem on my own.  


I think we all know intuitively when we’re doing our best.  Maybe training has just gotten us into the habit of needing objective measures to prove to others that we’re doing our best.  So, what about this: what if I’m honest with myself about whether I’m doing my best and drop the self-flagellation when I hit a roadblock?  And what if I learn to trust that others believe I’m doing my best, even if I don’t have an objective measure to prove it to them?  One can do no wrong following the advice of Maya Angelou, “Do the best you can until you know better.  Then, when you know better, do better.”  I’ll trust that I’m doing my best, as is everybody around me.  

Treading water is exhausting.  I’m off to go pull on some lifelines.  

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