62. Letting Go of Perfect: Finding Joy this Holiday Season

As a recovering perfectionist, Dr. Elise Fallucco shares insights ad strategies, for combating perfectionism, especially during the holiday season.   Do YOU have some unrealistic expectations for yourself?  Do you want permission to take some pressure off so that you can enJOY the holiday season? If so, take a listen!

0:00 Letting Go of Perfect

01:02 Defining Perfectionism

02:32 Adaptive vs. Maladaptive Perfectionism

03:34 Self-Critical

05:05 Consequences of Perfectionism

06:29 Perfectionism during the Holidays!

08:54 Examine your own Expectations

10:14 Unrealistic Expectations

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Transcript

Dr. Elise Fallucco (2): 0:21

Welcome back to Child Mental Health for Pediatric Clinicians. I'm your host, Dr. Elise Fallucco, child psychiatrist, and mom. So today we have a special treat for you. We're gonna take a break from learning about child mental health to focus on you and a major threat to your wellbeing. I'm gonna be talking about something that many of us struggle with in healthcare and medicine, and that is. Perfectionism. So our gift to you this holiday season is to share some thoughts, strategies, tips for understanding and combating perfectionism so that you can really enjoy this holiday season. And as full disclosure, I just wanna let you know that I am a recovering perfectionist and recovering may actually be even a nice way of describing that. I think this is something that I personally struggle with, and so I just wanna let you know I have not figured it all out, but I am just. Sharing what I'm learning and what I think might be helpful for you as we walk on this journey together. So first let's talk about what do we mean when we talk about perfectionism? I think some people associate perfectionism with being picture perfect, meaning like everything looks great and everything is in order and all put together and that is really not what we're talking about. So there's two types of perfectionism. there's the adaptive perfectionism where you set really ambitious goals and you work really hard to achieve things and you feel satisfied when you achieve them. And you may hear that and you may think, oh my gosh, yes. This was my entire pre-med class in undergrad. Most of our med school class and most of the people who I work with day to day seem like these type of very driven, achievement oriented people. So that's being an adaptive perfectionist. But then it's really easy to tip over into maladaptive perfectionism, which is where you have really unrealistic goals about how things should be, and you set yourself up by imagining that you may be able to do it all, or that you may be able to exceed and do a plus work in really multiple areas of your life. And most importantly, maladaptive perfectionists really feel a lot of disappointment when they're not able to make these really very high goals In the extreme form some maladaptive perfectionists can really feel a lot of shame or feel like a failure just when they're making mistakes. So let's say a perfectionist mindset is one where you have really overly high standards. So maybe it's like I'm gonna get all of my patient notes done within 24 hours, and in fact, each of my consult notes is gonna be so thorough and comprehensive that. The people who are reading them are gonna be like, who is that? Dr. Fallucco who wrote these notes, man, I just wanna get to know her and I feel like I understand this patient so much better and we should just publish this. I'm being a little silly, and obviously you're not psychotic when you're perfectionistic, but it's like really expecting yourself to be doing incredibly high quality work in all areas of your life, even when you're dealing with a patient crisis. Even when you're dealing with a patient who needs hospitalization unexpectedly, and the family is not on board, you still really hold yourself to a high standard and think, I still need to get these notes done within 24 hours typically people with perfectionist mindsets, not only do they have really high standards, but the other thing is that they tend to be really self-critical. So when you've accomplished a project or a task or something, you feel relief. But often perfectionists will overly focus on the things that they didn't do well and the things that they need to improve. And when you're so critical of yourself, that often spills over into how you view other people and, can tend to make you critical of other people. Okay, so we've talked a little bit about perfectionism and how it involves having really high standards, sometimes unreasonable standards, being really self-critical and tending to focus on the things that you need to do better and the things that you need to improve at the expense of really celebrating the things that are going well. But why are we talking about perfectionism on this Child Mental Health podcast? Well. As you may have already figured out perfectionism is really common in healthcare. It's almost as if we are bred to be perfectionist within the culture of medicine. And some of this is out of necessity. We're all trained to dot our i's and cross our T's and double check orders and, we hold ourself to really high standards to make sure that our patients are safe, that we're delivering the absolute best healthcare that we possibly can, and we usually have a good system of checks and balances to make sure that we have a culture of patient safety and minimal errors We have high expectations and we don't tend to tolerate mistakes. okay, so this doesn't sound like it's all bad, right? Like having high ambitions and trying to do the best you can and holding yourself to a high standard. I don't think anybody would criticize that. But those of us who have lived lots of decades struggling with perfectionism know that the perfectionistic mindset has a lot of negative consequences, mainly on our own wellbeing, and in fact. There's been so much increased attention to physician wellbeing, to clinician wellbeing in general, especially over the past, let's say five years. And so a lot of studies have shown that perfectionist tendencies and these particular personality traits can lead to clinician burnout, to emotional exhaustion, as well as increased risk for anxiety and depression.. So while it seems like some aspects of perfectionism can be really helpful and really adaptive, it certainly can take a toll on us as individuals. One study actually surveyed a bunch of pediatricians and pediatric subspecialists. And they were trying to figure out what is it about perfectionism that could potentially be harmful? And what they drilled down and found is that it's really the harsh self-criticism. So, in other words, it's this mindset that's overly focused on here's what I did wrong and here's what I need to fix it. That, and this type of mindset doesn't necessarily appreciate or celebrate or think about the things that you did right. And gets overly caught up in the problems and that, you know, you can imagine sort of spirals and can contribute to mental health problems. So you may have noticed a Christmas tree in the background. And for those of you who celebrate Merry Christmas, this brings us to the big question of why are we talking about perfectionism now in December? What is this all about? Well, the holiday season, it's really a hard time for people who struggle with perfectionism. I would say the holiday season could be a really hard time for all people. The holidays come with a lot of extra responsibilities and lots of added expectations, like in addition to having to do all of the things that we normally do to take care of ourselves and our families and our various responsibilities, we have a ton of bonus once a year. Extra responsibilities. So, outside of work, the holiday season means preparing a lot of meals, buying a lot of gifts, some, for some of us it involves traveling and spending time with extended family and which can carry its own stress level. And those are just some of the things that are happening around work that are kind of adding to our mental to-do lists and to this. Kind of psychological burden that you're carrying around and thinking about how am I gonna get all of this done and how am I gonna do it all well? Add into that, that we have a lot of work related responsibilities. Everybody gets sick in the winter.. The end of the calendar year coincides with flu season with increased patient volume for mental health related problems, and the end of the year is also when a lot of patients have met their insurance deductibles, and so everyone is trying to cram in their healthcare before the last day of December. Bottom line as a perfectionist, if you're trying to do it all and do it all well to a plus level, the holidays represent the perfect storm. And so we're here to talk about what can we do about it? How can we release some of this burden? And bring back joy into the holiday season. And I'm gonna be really honest, especially as somebody who struggles with this personally, it's hard to change who you are and who you are at your core. And it's not something where you're just gonna wave a magic wand and and all of a sudden become super laid back. But I think if we're more aware of our own tendency to hold ourself to sort of unrealistic standards, We may be able to temper some of these traits and just give ourselves permission to enjoy a little bit more and to not put so much pressure on ourselves. So really the most important thing that we can do to address perfectionism is to examine our own expectations. So the thing is, a lot of times we're not even aware of the fact that we're putting a lot of unreasonable pressure on ourselves. And so what can be really helpful is just to stop and ask ourselves, what am I really expecting of myself during this season? I'm just gonna share an example. I think at work I'm always holding myself to pretty high standards in terms of my performance, like hoping to do the very best I possibly can and to show up in the best way, even when I'm not feeling well, even when there's a lot of stress happening and things that are going on at home. I think we've been trained through med school residency all of the years of practice that we've gotta put our personal stuff in the back and sort of shove it in a closet and close the door and just keep soldiering on. But I think we. I can't be in denial about the fact that we are going through these things and that it's unrealistic to think that just by pretending that we're not going through a lot of stressors, that it's not gonna leak into our work and into our day-to-day lives. So I've talked about having really high expectations for performance at work. Many of you who are frequent listeners on the pod are really familiar with this or probably heard me talk about it a little bit.. And you may know that I love to swim and I'm lucky to have a really great master swimming team locally with really great coaches and teammates where I get to train and exercise. But I'm gonna tell you that it is really hard for me to just get in the pool and swim and not create unrealistic expectations for myself. In my head, I'm like, well, Dara Torres, who is a very famous US Olympic swimmer, made it to five Olympics and she was in her final Olympics when she was in her forties. So obviously I need to be. Swimming as fast as I possibly can and make it to certain meets and meet certain time standards. I really do have specific goals for what I wanna achieve in swimming. And if I think about it, they are not super realistic. They're not super realistic in part given my own athletic ability and experience in swimming, but more to the point, these are not particularly realistic goals given that I'm a working mother of three kids and that there's a lot of stuff going on in our life and it really isn't realistic to believe that right now I will be able to. Get in the pool six times a week consistently and lift and do whatever I need to do to be able to achieve these particular goals. But I just share this as an example and to encourage you to really ask yourself to really be honest with yourself about. What are you pushing yourself to do and could it maybe be unrealistic given your circumstances? And is there a way to dial back the intensity just a little bit where you still remain ambitious and hardworking, but that you're not setting yourself up for failure or disappointment? The most important thing that we can do, especially during the holiday season is to really look at our own expectations for ourself. And this is really hard, because we may not even be aware of what our expectations are. Maybe let's dig into some holiday specific expectations. And I'm just coming up with one that's personally been tough for me. I've noticed that anytime when I get together with. My colleagues and friends around the time of year, inevitably we end up talking about holiday cards, like, oh, I got your family's holiday card. Thanks so much for that. And then someone will say, oh my gosh, we're not doing that this year. I feel so guilty, but I can't make it happen. And it's made me realize that for a lot of us, there is this standard of we've gotta get this family photo shoot. Picture Perfect card sent out to our loved ones and it has to be done by a certain time. And I don't know if I've personally stepped back and asked myself Why are we sending holiday cards? Do we have to, why do we have to feel guilty if we don't send them? Are there other ways to do this? But it's really worth taking a step back and just asking yourself about some of these things that are driving you crazy. Like, is this really necessary? Do I have to do this? What is really motivating this, and is it worth it? So to wrap up, for those of you who are listening in the car, first of all, congrats for making it this far. You have prioritized your wellbeing just by thinking about these things over the holiday. But your assignment after you pull over or get wherever you're going, is to really think about three things that you're expecting yourself to do today. And for some of this that's easy. You're just looking at the top three things on your to-do list and decide which one of those is something that you don't have to do or that you can delay or postpone or delegate. And I know that this may actually bring up some intense emotions, and a lot of us will feel like, all of these are non-negotiable, which is usually a response that I hear and I'm familiar with. And while that may be true, I often wonder sort of a deeper question, which is I. What are you afraid of? What are you afraid will happen if you don't meet all of these expectations that you set for yourself? And that's a bigger question, probably for your own therapy. But for now. I wish you and your family a fantastic and restful holiday season, hopefully full of joy, and I wish also that you would give yourself permission. To let go of some things that are causing stress and that are not worth the stress that they're causing, and to make sure that you're able to enjoy time with loved ones this holiday season. I really appreciate you for listening. see you next year.