How Do You Feel? by Jessi Gold

Author:Jessi Gold
Language: eng
Format: epub
Publisher: S&S/Simon Element
Published: 2024-10-08T00:00:00+00:00

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Not all perfectionism is the same. In 1971, the human dynamics scholar D. E. Hamachek suggested there were two types: normal (or adaptive) perfectionism and maladaptive (or neurotic) perfectionism.8 Normal perfectionists strive for perfection without compromising their self-esteem; their efforts can even enhance how they feel about themselves because they derive pleasure from their desire to achieve and reach their goals. They also seem to be able to sometimes ease up a bit, allowing for the occasional mistake. In contrast, maladaptive perfectionists set unrealistic goals and feel dissatisfied when they don’t reach them. They regularly have thoughts about not being “good enough” or they “should” or “could” have done better. And while the adaptive type of perfectionism might help a doctor achieve good results in medicine, the maladaptive type is related to mental health issues and burnout. In one study of 169 first-year medical students,9 for instance, those with maladaptive perfectionism were more likely to experience feelings of shame, embarrassment, and inadequacy than did their peers who did not meet the criteria for maladaptive perfectionism. They were also more apt to report moderate and severe levels of depression and anxiety. Perhaps the desire for perfection can help explain why people in the medical field tend to experience such high rates of emotional distress.

Knowing this is important to understanding the best way to support people in medicine and those who want to go into medicine. One meta-analysis found that the overall prevalence of depression in medical students was 27.2 percent,10 compared with 8.4 percent in the United States as a whole.11 As a practitioner who sees students like Naya on a regular basis, while I know medical school makes students much more depressed, I also know that the mental health effects of this training process start earlier, impacting whether students choose to stay in the field, or even pursue it in the first place. Premed students who experience greater burnout report a decrease in their interest in pursuing a career in medicine over time, with steeper declines in women.12 That, and the fact that I want Naya to get better for her own sake, is why I’m glad she came to see me when she did.

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