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Shame, guilt, perfectionism and ego: a terrible combination

Diana Londoño, MD
Physician
April 29, 2022
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The levels of physician burnout which are a constellation of symptoms including feeling apathy, fatigue, depersonalization, and detachment are a group of feelings that have plagued health care.

But within the last two years, burnout has exploded to upwards of 65 percent in specialties like emergency, critical care, and infectious disease. It is not surprising, as these specialties have been on the frontlines of COVID care.

Why does this matter?

Because — we are all patients.

No one is immune from needing health care, and the consequences of physician burnout have a large rippling effect. Not only will the quality of care be diminished, but medical errors will occur. Physician burnout is also associated with depression, anxiety and physician suicide, which more than 400 physicians complete yearly.

The consequences of losing so many qualified physicians in an era of physician shortages are impactful to all. Many of us today, waiting for a specialist to see us, realize the soonest appointment offered is in two months. The wait times will only increase due to physician and health care staff shortages if we do not make changes to stop the great resignation of so many in health care.

However, many physicians experiencing these levels of stress and burnout are reluctant to slow down and seek professional care, whether it is to seek care from a therapist, a coach or even to take time for self-care.

What barriers could there be?

There are many, yet medicine has cultivated a culture in which physicians are expected to be infallible, superhuman, and perfect. However, the reality we must acknowledge, embrace and accept is we are all human, and no one can be perfect.

When we fall short of these unrealistic expectations, it leaves us with shame and guilt, making us feel that there is something intrinsically wrong with us. As Brene Brown has described, shame is the “intensely painful feeling or experience of believing we are flawed and unworthy of love, belonging and connection.”

The shame of feeling inadequate or not belonging (and developing impostor syndrome) spirals into more negative feelings and thoughts. This slowly becomes a quiet source of pain and suffering, hidden and silent, yet continuing a palpable cycle of despair.

Not only do we suffer from shame, but we continue to punish ourselves with judgment once we realize we are not perfect. Our ego comes and demands our perfection and perpetuates false beliefs. However, in a state where our ego drives us, we cannot learn, be open or expansive to understand our common humanity and limitations. The reality is that perfectionism is unattainable.

It is part of the human experience to go through difficult, challenging times which are there to teach us a lesson we may need to learn. However, when the ego drives our thoughts and actions, there is no place to learn and grow, as the ego tells us we have achieved mastery in our field.

Through awareness, we can all collectively realize our common humanity, break free of the shackles of shame, perfectionism and ego, then begin to treat ourselves with love, non-judgment, and self-compassion.

When we begin to have the awareness that if we let shame, perfectionism, and our ego supersede our ability to seek self-care, renewal, and joy, we can change the path we are in health care. We can begin to feel once again fulfillment in medicine because we have achieved a balance of our emotional regulation.

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This is not to diminish that there are real and serious systemic changes that need to be changed and addressed. But we must also take responsibility for our own self-care as well. Being a victim and blaming everyone without deciding that we need to take care of ourselves first will never change the culture of medicine. We need to heal, speak up and be the change in ourselves first, so we can then lead the charge to improve all that needs a serious overhaul.

So, leave shame, perfectionism, and your ego in the memories of yesterday. Begin to feel your humanity, nurture your self-compassion and accept and embrace your inner worth so that we can begin to heal one physician at a time.

Diana Londoño is a urologist and can be reached on Twitter @DianaLondonoMD.

Image credit: Shutterstock.com

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