Katrina Ubell: You are listening to the Weight Loss for Busy Physicians Podcast with Katrina Ubell, M.D. episode number 43.

Introduction:       This is Weight Loss for Busy Physicians, the podcast where busy doctors like you get the practical solutions and support you need to permanently lose the weight and feel better, so that you can have the life you want. This is the resource you've been looking for to guide you on the journey to overcome your stress eating and exhaustion and move into freedom around food. Here's your host, Dr. Katrina Ubell.

Katrina Ubell:      Hey, friends. How is it going? How are you today? So excited to talk to you. My kids are going to be coming home from school here in a few minutes. They're getting a ride home today, and I thought let me just sneak this podcast recording in quickly. I'm hoping they don't get here faster than I expect and then we have some little kid voices on the tail end. If we do, that is okay because guess what? Today we're talking about perfectionism. Maybe this podcast just won't be perfect. In fact, every podcast I have ever created has not been perfect and I can't wait to talk to you about why that is a good thing. First, I want to talk to you a little bit about iTunes reviews.

As you know, I have been asking you to please, please, please, pretty please fill out that iTunes review little area on your podcast app if you would be so kind to do that. Now if you have an Android phone, you're not going to be able to do that. You could do it on the Stitcher app, which would also be helpful, but iTunes is really more helpful. If you even have iTunes on your computer, you can also just search for Weight Loss For Busy Physicians and do your review right there. Super, super easy. If you haven't done it and you found this podcast to be helpful in any way, I would super, super, super appreciate it if you could do that. This is the thing with podcast reviews. I know it seems like it's not that big of a deal.

Like why does she keep asking? It kind of reminds me of how on NPR when they're doing their monetary drives, right? You're like, “I gave already. Stop interrupting every show asking for more money. Can I just hit the pause on that?” For those of you who've already left me a review, I'm so grateful. Thank you so much and thank you for being patient while I ask for more. Listen, there are so many of you who listen who for sure have not left me a review. If you could please be so kind as to do that, I would really appreciate it. It really, really helps the podcast. It helps the podcast to be more easily found within iTunes for other listeners and other physicians. As we all know, we all need this help, right?

If you could please, please, please do that. Guess what? You don't have to be a doctor in order to leave me a review. If you're one of the many people who have contacted me and let me know that you're not a physician, but that this podcast has been so helpful for you, I would also love and appreciate your review if you could please leave it for me. What I wanted to offer you today is actually an email that I got a little while back from a lovely woman whose initials are K.H. She sent me this email and said, “Try to do from instructions you gave in episode 34. I'm pretty tech savvy. Not sure why it wouldn't send,” but she wanted to send it to me anyways and that's so sweet. She's like, “I just want you to know what my review is even though I can't post it.”

She said it was titled great info and perspective. This is what she wrote, “I happen to be a psychiatrist and the model that is being used in this podcast gets me right in my wheelhouse. I have found so much support and great tools within my time listening. I usually listen while working out and often find myself laughing out loud and sometimes crying from the truths that are being laid out. I often feel like I have been talking with a best friend afterwards.” It makes me feel so happy. “It has changed my relationship with my mom, my spouse, my boss, coworkers, and most importantly with myself. Oh yeah, and by the way, I've lost 10 pounds so far.” Amazing. Thanks, Katrina. “Keep up the great work.

Sorry it took me so long to do this review. However, I have shared the podcast with many.” I'm sure so many of you can totally relate that it's going so well for you. You're really enjoying it and you just haven't done the review. If you could please do that, I would really appreciate it. Hey, K.H. Thanks so much for the review. I really, really appreciate it. Let's talk about perfectionism. I coach my clients on this topic all the time and lots and lots of doctors and other people have trouble with perfectionism big time. We kind of talk about it like it's a good thing. When I decided to become a doctor, I was ortho all the way. Believe it or not. My undergrad degree is in biomedical engineering with a mechanical engineering focus.

I had done research as an undergrad on artificial limbs. I thought this would just be so great. I used to shadow ortho clinic when they had the amputees come in. I thought this would just be so great. I could do ortho. I would love it. I was all ortho all the way. All the way until I did my ortho rotation third year of residency. This is the thing, it really wasn't even ortho. It was all of surgery. It wasn't like I was against surgery. I totally could have done it. It was fine. It was totally interesting. I just didn't love it. I just didn't have the passion for it that I think you need to have when you're taking something like that on. What I used to say is that I wasn't enough of a perfectionist to be a surgeon.

What I mean by that and what I meant by that was that I'd be the student retracting or doing whatever menial task with my back on fire or whatever, so sore. What I would get so frustrated with was the surgeon or the fellow, the attending or fellow or resident just going after every little bleeder, every little minor thing and I would just think, “Oh my god. They're such perfectionists. Can we just close up and move on? I'm hungry. I'm thirsty. I have to pee. I'm sweating.” I just was so uncomfortable. I thought that meant that in order to be a good surgeon, you needed to be a perfectionist. You needed to be totally in there, meaning until the very last minor detail is done. You are not going to do anything else, but finish that up.

We kind of look at perfectionism kind of like a badge of honor, right? Because it means that we're doing good job if we're aiming for perfection. I think some of us have even been told that we were perfectionists from way back when we were children. Maybe we took it on kind of as part of our identities without questioning whether that belief was even useful or not. Somebody, maybe some teacher or parent or family member said, “Oh, you're such a perfectionist,” so we're thinking, “Okay. Yeah. I'm a perfectionist,” but we really have to look at what that really means. Often we think it means that we are performing at a high level or we have a lot of success or we put out very high quality work.

It's always so interesting to me when I talk about doing B minus work, how a lot of people really get kind of freaked out because they really want their work to be excellent. They want it to be perfect. This is the thing, perfectionism doesn't mean that. The definition of perfectionism is a personal standard, attitude or philosophy that demands perfection and rejects anything else. Let me repeat that. A personal standard, attitude or philosophy that demands perfection and rejects anything else. Not demands high quality work or demands success, it demands perfection and rejects anything else. Here's the problem, who decides if something or someone is perfect? Exactly. It's totally open to interpretation.

This is where we get stuck. It's a completely unattainable ideal. If you're a perfectionist, then you'll by default never be good enough. There's always going to be something else that can make what we do or who we are better. Then when you never measure up, you feel terrible. Then many people start to feel like an imposter. Like you're just really good at pulling the wool over everyone's eyes so that they think you're better than you really know you are. You have the secret. You know you're not that good. They all have been tricked into thinking that you're better than you are. Then your self-confidence and self-worth go through the floor. Then if you put your work out there, people will find out about the real you.

That you're not that smart, you're not pulling your weight, you don't deserve your job or your position or your title and then what? Then life's over. The house of cards comes tumbling down. Perfectionists will spend so much time and energy trying to keep up this persona that doesn't even exist. This false representation of themselves. This is what this looks like for most perfectionists. They get a task. Say they need to write a chapter for a book. The perfectionist believes that it must be perfect. She doesn't believe that she can do perfect work, so she procrastinates and procrastinates and procrastinates.

Waiting for the perfect idea or the perfect time to write it or the perfect stroke of genius that's going to make this the best chapter on gastroenterology, renal failure or whatever it is that's ever been written. Then she overeats and maybe over drinks to put off the task or to feel better about not doing it. Then she scrambles at the last minute to put the work together. She writes the chapter, but frantically after hours or at the expense of other things like her relationships or her self-care like sleep and rest and things like that. Then she turns in B minus, but feels terrible about herself and beats herself up. She totally feels like a failure because it's not perfect.

Then if she listens to this podcast, she overeats and maybe over drinks to feel better about the subpar work she just turned in and then the cycle continues with the next task. Perfectionists waste so much time and energy in putting off the task just to end up submitting work that isn't their best. They're so worried that their best isn't good enough that they don't even give themselves the opportunity to turn in their best. This is the thing, right? Here's the issue, they don't even really want to be their best. They want to be the best or at least as good or better than someone else that they look up to or idealize as perfect. The best is totally subjective.

Perfectionists would never decide that they're the best, so they by default will never measure up and never be good enough. Those with weight issues eat to feel better and to distract themselves from this emotional pain that they're inflicting on themselves. Some might say, I feel like I can hear some of you thinking or saying out loud, “Well, hold on a second. I won't settle for mediocre. Are you asking me to just put out junk into the world? I have high standards and there's nothing wrong with that.” Here's the thing, I completely agree. You don't need to settle for mediocrity. In fact, I would not recommend it, but you do need to settle for done being better than incomplete.

I'm not asking you to put out junk into the world. I'm asking you to put out anything into the world, to not hide by procrastinating. There's absolutely nothing wrong with having high standards, but then you have to make sure that your high standards are realistic and attainable because a perfectionist's high standards are not if they really look at them closely. Perfectionists won't ever not feel like failures because of this well meaning thought loop they've created for themselves. Here's the loop, if you aim for perfection, then you'll finally be good enough for worthy, right? You decide to do that, to do something perfectly. Then you never measure up to this ideal and then you always feel like a failure.

You just can't ever win. It's a complete loop. You don't think it's a choice to feel like a failure, but it totally is. I was recently coaching one of my amazing clients about this. In some areas, she was thinking that perfectionism seemed like it served her. She was telling me that with her weight, if she didn't follow her plan perfectly, whatever that means, then she would feel like a failure because she would not be losing weight yet again. Then in other times, she talked about how she had setbacks and that was fine and she moved past them and moved through that, but she felt like the perfectionism had been helpful.

She had really been a really high achiever most of her life and for pretty much everything in her life she was able to accomplish what she set her mind to do, but with weight she was really struggling. I know so many of us can relate to that, but this is what's so interesting, right? What determines if something is a setback or a failure? Isn't it the same thing? It's totally the same thing. It's completely only how you decide to look at it. If not losing weight on a plan equals failure, that usually means completely go off the rails, eat and drink whatever you want, gain all the weight back and then some, and then feel even worse about yourself, right?

If you are following a diet plan and it wasn't working, you decided to look at it as though it were a setback, what would that mean? That would mean you need to reevaluate. You need to look what's working for me and what isn't. Who could I ask for help? Maybe I should hire a coach who can help me. You should definitely do that, right? It's completely looking at the same information from a different place, from a place of looking at it just like it's an obstacle and it just needs a solution. It just needs some problem solving. I'm having a setback here. What can I adjust? What can I do differently to move pass the setback and achieve what I want? That might have been in school.

Maybe you didn't do very well in a class or you got a bad grade or you just weren't understanding some topics and you needed to go get extra help, right? You might decide yeah, that was just a setback. You didn't look at it like, “I'm failing college. I'm done. I'm out of here. I'm just going to go work at McDonald's.” Right? Of course, not. You took that setback for what it was and you got help and you moved forward. It's so interesting how it's just this automatic way of thinking about weight loss that if this doesn't work, then I'll feel like a failure. I'm feeling like such a failure. I'm following my plan and the weights not coming off. I feel like I'm failing this. Why would you choose that?

It's completely a choice to think about it that way. Why would you choose to think about it in a way that makes you feel terrible? What I was helping her to really understand is that she was thinking that perfectionism had served her at times in her life, but it never ever serves you. She was talking about maybe really having high expectations for herself with her grades, with school, but that's not perfectionism because she always could have done better. If she were really a perfectionist, then she would have to get every single test question correct, 100% on every single paper, problem set, essay, test, all of it, right? Everything would have to be 100%.

Always getting the top marks and probably a perfectionist would also think that she shouldn't need any help, right? She should never go to the TA for any extra help. She should never ask a question. She should be able to figure it all out on her own. That's not at all what this client's schooling had been like, right? Of course, she had not always gotten every point correct. Maybe she always got A's, but that doesn't mean that she always got every single question correct. She had high expectations and she worked as hard as she could to meet them and she did, which is why she was thinking that that was perfectionism serving her. No. That was her high expectations serving her. If you have high expectations for yourself with your weight loss, what does that look like?

That looks like you expect yourself to follow your plan 100% all the time. That you're never cheating on yourself. You're never doing little things that are out of plan. You're never having a little bite or lick or taste here or there, right? That's a high expectation. I'm somebody who does what she says she's going to do. I'm going to plan my food the night before and then guess what? The next day I'm going to eat it not matter what. I'm not going to make excuses. I'm not going to think that this is an exception. I'm just going to do what I'm supposed to do. That's high expectations. Perfectionism is when you look at it like no matter what I do, I can't ever do it right.

I can follow this whole thing, but if I don't lose five pounds every eight minutes, this isn't working. Obviously I'm exaggerating, but you know what I mean. I hear this from my clients. It's not coming off fast enough. Then I go back and I'm like, “You lost five pounds in the last two weeks.” They're like, “Oh, really? Oh, okay. That's good?” Yes, that's good. That's amazing. It's amazing. When you're looking at it from this place of perfectionism, you will never be satisfied. You will always feel like a failure. This is a great example that I want to go through with you because it was actually an area I had to work through when I was first learning this difference in how we kind of think about perfectionism and what it really is.

I was thinking about whether I … If I had a brain tumor and I needed to hire a neurosurgeon to take it out, wouldn't I want the brain surgeon who's the perfectionist or would I really want a brain surgeon who does B minus work? I really had to really work through this a little bit. Here's the deal, this is what the perfectionist brain surgeon does. She puts off doing the surgery. She wants all the labs to be perfect before she operates. She tries to avoid doing the surgery. She's really worried that it won't go perfectly. Finally, she does it and in the OR she goes really slowly trying to perfectly resect the tumor. In doing so, actually messes something up because she overthinks it.

Then the patient has extra anesthesia time because she's trying to get every little minor oozy area instead of just closing up and getting out of there. She spends extra time making sure every staple is perfect and the tape is lined up just right on the dressing. Then she puts off doing her OP note until a few weeks because she's back logged from trying to always have perfectly written and formatted notes. Then by the time she gets to the OP note, she omits some information about the patient or the surgery that actually is important. Okay? You see how she ends up doing subpar work, worse work than she could do because she has such a perfectionistic viewpoint. Now the B minus work brain surgeon thinks clearly.

She knows there's never a perfect scenario to operate on someone's brain. She knows her limits and the risks she's willing to take and not take. She takes action. She operates to the best of her abilities. She doesn't get bogged down by minor details that don't matter, but she does pay attention to the important details that do matter. She finishes up and minimizes the patient's anesthesia exposure. She lets the resident close and the nurse do the dressing so she can get the opt note before the patient goes to the PACU. She is efficient. She's effective and she gets things done. That is who I want operating on my brain for sure. Perfectionists are paralyzed by fear and doubt.

Instead of moving forward immediately with B minus work and then refining it if there's extra time on the back end, they live in fear and doubt and procrastination until all they can ick out last minute is B minus without any time to refine. They are by default putting out less optimal work than if they just did it. First, I want you to notice where you're a perfectionist in your life. Some of you might find that you're like this in lots of places. Some of you might find that it's really just this one little element that you need to work on. This is the thing though, you might be like, “I don't know. What part of my life is perfect?” If you're a perfectionist in that area of your life, that does not mean that it looks perfect.

In fact, that area is usually incomplete and probably a bit of a disaster. If you're thinking that you should have the perfectly decluttered closet, your closet is probably a mess because what makes the closet perfect? It'll never be perfect. The other way you may notice it is that you're putting forth tons of effort to make it look like what other people think is perfect, but you still think you could or should do more. Other people think maybe your house looks amazing and it's so perfect and they couldn't think of anything else that you could do, but you know that there's things that aren't perfect. Here's some examples of places where you might have some perfectionism going on, your notes or results or letters or phone calls.

This is a big one that comes up with my clients all the time. So behind. Taking all this time procrastinating doing that work. You just get it done with B minus work. Don't forget, B minus work notes means that all of the important information is there and you don't worry about the rest. You're not spending a bunch of time on minor details that nobody cares about. You're not rereading and proofing again to make sure the formatting is good and that there's not any typos. In this day and age with people typing, there's going to be typos. End of story. It's how it is. Another area, all the topics you cover in a check up. I sometimes would get like this.

There's so many things that they want us to cover and I always felt like I was never measuring up because it's unattainable. There's no way you can cover every topic that the experts in pediatrics think you should cover in a check up. You just can't. How about academic work like creating talks or writing grants or writing educational materials? How you think your house should look? For sure many of us have this ideal of how we think our house should look. What kind of mother you think you should be, right? This is the total Pinterest thing where you see what other people are doing, also Facebook, Instagram, things like that, and then you make a decision, “Oh, I should be doing that too.

Their life looks perfect. My life should look like that.” Then when it doesn't, you get to feel really bad about yourself. Also, what kind of eating plan to follow. Which is the perfect one, right? You can spend your whole life researching eating plans and how do you know if it's ever the perfect one. Then also what your body should look like. So many of us think our bodies will never be good enough, right? You can never love your body because it's never perfect. It's never good enough. That is just failure in advance, right? You're not happy now. You're not happy when you're thin. You do plastic surgery. You're still not happy. You're totally setting yourself up to feel like a failure, to never be happy.

I am a big fan ultimately of the sentence “good enough is good enough” because it really is. Really in every area of our lives. Good enough is good enough. You know why? Because it's done. Don't confuse high expectations with perfectionism. If you have high expectations with your house and what it should look like in terms of being tidy and clean and you can't do it all yourself or you're killing yourself doing it all yourself or you're not interacting with your kids, you're yelling at them all the time because you're constantly working on that, you can hire someone to help you, but it's still never going to be perfect. If you think the perfect house looks a certain way, you're going to be very, very disappointed.

You might have high expectations to go, “Look, I don't want a cluttered, messy house, so I have someone come in three times a week to clean it.” More power to you. Fantastic. That sounds great. It sounds like it serves you, but don't ever expect your house to be perfect. I want to give you an example. A couple of years ago we did a big home renovation. Our house I think I've talked about it before is built in the '30s. We actually moved out because there was only one room that was untouched. Every bathroom was touched. The kitchen was totally moved to another area of the house. It was unlivable. We couldn't live in the house, so we moved out and we had really just an amazing designer and contractor and amazing workers come through.

They did a phenomenal task, but at the end, we were back in and we were noticing some things that needed improvement as they do, right? There's little areas that need paint touch ups and the stain on the floor needs a little help here and there. Little things like that. No big deal. Then we started noticing some little nail pops. Nail pops are when the nails in the studs that hold the drywall on move either because it gets colder or warmer and the walls expand or contract. When they do that, sometimes it pushes the nail out a teeny bit. You either get this little like dimple like where it goes in on the wall or it pooches out a teeny bit. We started getting those and I knew those would happen.

No big deal. After a year, we get those all repaired and then another six months, 12 months goes by and we're getting more of them. I had been told that it takes a year for them all to happen. Then you fix them. You're done. Yeah, well, that's not how it goes. We still got new ones all the time and apparently that's what happens when you have a smooth finish on your walls, which is what is popular right now. It was so interesting. I remember one time noticing a new nail pop and thinking to myself, “Does Kim Kardashian put up with this kind of stuff?” I was asking myself about her in particular because while we were doing our house, she and Kanye were apparently doing some huge remodel of their home as well.

Like $10 million remodel or whatever it was. I just thought to myself, “Does she put up with this? Does she settle with these imperfections or is her house literally perfect and they just don't move in until there's not one thing wrong with it.” That thought, this line of thinking, surprisingly, right, made me feel terrible. Why does she get to have the perfect house and I don't? You know what ended up happening? Our kitchen is a pretty big kitchen and has a large ceiling. It's been repaired I believe two times. Every time it gets repaired, it has to be repainted. Every time it has to be repainted, it cost a thousand dollars. I'm certainly not doing it myself. We have the painter back in and I was showing, “Look, now there's this.

Now there's that. Now there's the other thing.” I'll spare you the whole story, but basically we had a nice conversation, he's a great guy, about perfection and what are things we're willing to live with and what are things we're not willing to live with. By this point, I think I even had gone through my coach training. I realized that every time I looked at that ceiling, the lens I had created for myself was what's wrong with the ceiling. All I could see were the imperfections. All I could see were the things that had gone wrong, that didn't look good, that needed to fixed and had already been fixed a couple times and you could still notice them. I remember thinking if someone comes in here, they would look up and they would go, “Oh my gosh.

Look at all these things wrong with the ceiling.” You know what I thought? Who comes in and looks at the ceiling? I don't ever look at anybody's ceiling. What am I doing? I'm creating so much agony for myself over this dumb ceiling that nobody even looks at. You know what I decided? I decided not to look at the ceiling anymore because nobody else is and it doesn't make any sense. I could have spent another thousand plus dollars and gotten it fixed again, but I really didn't want to. I decided to just not look at the imperfections anymore because even when the house is new, it's not going to be perfect because perfect doesn't exist even for Kim Kardashian I'm going to guess. Even if you have a gazillion dollars, it's still not going to be perfect.

I can have high expectations. I can not want the ceiling caving in clearly, right, but I don't have to make such a big deal out of all these tiny little issues that just aren't important. When it comes to a task for those of you who really procrastinate and are perfectionists when it comes to getting some tasks done, you must break the task down into all the different small parts including the things that you need to learn how to do or where you need more information. Time to research that. Then you put all of those parts onto your calendar and when that day comes, you do it. You won't want to do it, but you will do it because you said you would, right? You're somebody who does what they say they'll do, right?

Nod your head yes. Yes, you do. Then you get the B minus work done well in advance. You put all of the work down onto your calendar early. If you have eight weeks to write a book chapter, then you write it in four weeks and then you spend the last four weeks revising or asking trusted colleagues to edit it for you. Decide ahead of time that it will be a good book chapter, but it will not be perfect and it shouldn't be because that does not exist. Okay? I hear the kids coming. They will be opening the door in a second. Please leave me an iTunes review and Android listeners on iTunes on your computer please. I would really appreciate it and in Stitcher as well. Thank you so much. Have an excellent week and I'll talk to you next week. Take care. Bye, bye.

Outro:                 Thanks for joining us on Weight Loss for Busy Physicians. Now take the next step and go to katrinaubellmd.com to download just what you need, the Busy Doctors Quick Start Guide to Effective Weight Loss. Join us again next week for more support to keep you in control and own the path to freedom around food.