Psychologists Should Strive for Excellence, Not Perfection

The practice of psychology can be difficult, given the many work-related stressors and the high stakes involved. Therefore, psychologists must show a high level of competence and dedication and avoid making mistakes. After all, mistakes can lead to a treatment failure, patients dropping out of treatment, or, in extreme cases, the death of a patient by suicide. Consequently, psychologists tend to be highly motivated and conscientious, and to set high standards for themselves.

However, those high standards can morph into perfectionism, a pernicious state in which people set impossibly high standards, rigidly pursue them even when this causes harm to themselves and leads to the neglect of legitimate personal needs, and engage in harsh self-disapproval when they fail to meet them (Lenton-Brym & Antony, 2020). Perfectionism is a transdiagnostic trait, although it commonly occurs in anxiety and depressive disorders and can lead to shame insofar as one believes that they must hide mistakes and flaws from others.

These perfectionist ideas can manifest themselves in what Albert Ellis called musturbations, or self-imposed, irrational demands that people place on themselves (Wolfe, 2000). Norcross and VandenBos (2018) identified some of the ways that these irrational assumptions can develop among professional psychologists. Psychologists may believe, for example, that they must succeed with every patient, be liked by every patient, or be one of the world’s best psychotherapists. In addition, they may adopt an all-or-nothing attitude toward mistakes, wherein they think that one mistake has made a project a complete failure. One cannot sustain a rewarding career while in a state of hypervigilance and continual self-condemnation.

Perfectionism can predispose psychologists (Keading et al., 2018) to burnout, which is a problem for several reasons. First, psychologists, like everyone else, deserve the opportunity to pursue a career they find rewarding. Second, it raises quality-of-care issues. Psychologists with good mental health tend to achieve better patient outcomes than those who report burnout symptoms (Delgadillo et al., 2018). Finally, if psychologists are unhappy with their work and leave the field prematurely, it would exacerbate the existing shortage of healthcare professionals.

As a younger psychologist, I struggled with perfectionism but had rationalized these beliefs as evidence of being a person of high moral purpose. Only with the assistance of some cherished colleagues was I able to recognize and name my feelings, redefine what it means to engage in ethical conduct, and gain a new perspective on what it means to be an effective professional. However, I still need to self-monitor because those perfectionistic tendencies can still seep through from time to time.

Psychologists can find resources to help them understand and deal with perfectionism and promote self-compassion by accessing articles found at the Greater Good Science Center (https://greatergood.berkeley.edu/topic/compassion), workshops from the Self-Compassion Institute (https://self-compassion.org/short-course-in-mindful-self-compassion/), or worksheets and handouts from the Social Worker Toolbox (https://www.socialworkerstoolbox.com/free-perfectionism-cbt-worksheets-and-handouts-collection/).

The challenge to psychologists is to maintain high standards without succumbing to perfectionism. The answer is that, rather than striving for perfection, the goal should be to pursue excellence or what some researchers might call adaptive perfectionism, or high standards combined with self-compassion, and without excessive concern over mistakes (Lenton-Brym & Antony, 2020).

Psychologists have several options for curbing their perfectionist tendencies. Because perfectionism may vary somewhat from individual to individual, not all of these interventions would be appropriate for everyone.

First, psychologists should focus assiduously on self-care in all aspects, including getting enough sleep, exercising, eating well, and minimizing external stressors, because high levels of stress appear to exacerbate perfectionism (Lenton-Brym & Antony, 2020). Psychologists’ well-being is also associated with developing strong social supports, learning how to regulate one’s emotions, and setting limits on the responsibilities one is willing to undertake (Yang & Hayes, 2020).

Second, psychologists can conscientiously strive to focus on realistic, attainable, and sustainable goals, which may require directly challenging the musturbations associated with perfectionism. Cognitive behavior therapy is often used to treat perfectionism with success (Suh et al., 2019). This cognitive restructuring could also involve cultivating self-compassion to counteract the harsh, often unrelenting self-criticism that accompanies perfectionism. Perfectionists may condition their self-worth on perfect behavior—an impossible standard to meet. Programs to promote self-compassion (e.g., Neff et al., 2020) may be indicated to help them accept and love themselves despite their all-too-human propensity to make mistakes.

Finally, psychologists may strive to cultivate humility, which is “self-knowledge and an openness to the perspectives of others” (DuBois et al., 2013, p. 925). With humility, one tries to see oneself accurately, which can include actively seeking out honest, sometimes negative, information about one’s performance, while doing so with self-compassion. Instead of avoiding all mistakes, a psychologist would try to identify those mistakes and learn from them. As stated in the title of an article by Nissen-Lie et al. (2017), one should “love oneself as a person, doubt oneself as a therapist.” This productive self-doubt is one of the four factors that distinguish highly effective psychotherapists from the rest of us (Wampold et al., 2017).

Although the above recommendations could be pursued by anyone already licensed, it is also desirable for graduate school instructors to address perfectionism as a threat to professional competence and to recommend strategies to help students become aware of it and curb its pernicious influence. The training program could also emphasize self-awareness, humility, the importance of feedback and how to benefit from it, and the value of avoiding catastrophizing one’s mistakes.