Dr Catriona Bradley wonders if as pharmacists, we take our perfectionism home with us and what problems that may cause
Last week, I met with three separate groups of friends… all pharmacists. We caught
up on different aspects of life, bemoaning the challenges of work, the joys of parenting, and the ups and downs of relationships. One described the frustration of working with colleagues who didn’t seem to understand the importance of accuracy, another lamented the fact that her partner, whilst helpful around the house, didn’t share her standards for cleanliness, and a third (me!) fretted about finding the best Irish college for her son. Despite very different characters and conversation topics, we identified one common thread — our tendencies, as pharmacists, to be perfectionists. We realised that sometimes we expect exceedingly high standards of colleagues, family and ourselves, which can create stress for all involved.
These conversations got me thinking. As pharmacists, we are trained to work with accuracy in college and are aware of the potentially fatal consequences of mistakes. The seeds of perfectionism were probably planted well before the pharmacy degree, when we learned the value of regurgitating perfect responses during State examinations. There were no points for creativity in maths, physics, chemistry, biology; perfect answers were required to accumulate the precious points needed to secure a coveted place on a pharmacy degree. As a result, perfection was cultivated during formative stages of our development, and it is likely, for some of us at least, that it shaped our personalities. It is likely that some of us unconsciously carry this approach to life outside of study and pharmacy.
From a psychological perspective, perfectionism is generally viewed as an aspect of personality. In the Big 5 Model of personality, perfectionism sits at the higher end of the conscientiousness continuum. People at the lower end of the spectrum tend to be more impulsive and more likely to engage in risky behaviours, whilst those with high levels of conscientiousness demonstrate high levels of self-control, responsibility and reliability.
Whatever the origins, when over-expressed, conscientiousness can lead to perfectionism
It is not surprising that people with high levels of conscientiousness do well in jobs that require attention
to detail, and research indicates that pharmacists generally exhibit high levels of conscientiousness.
Is this because conscientious people are drawn to pharmacy, or because pharmacy training creates conscientious people? Does the wand choose the wizard, or the wizard choose the wand?
In truth, conscientiousness most likely emerges from the blend of inherent traits, conditioning, environmental influences, and learned behaviours, a product of both nature and nurture. Whatever the origins, when over- expressed, conscientiousness can lead to perfectionism, and this is where we can sometimes run into problems. A study of 1,744 students studying veterinary medicine, dentistry, medicine, pharmacy and law in the UK found that pharmacy students are more prone to perfectionism than students of other healthcare professions. It is not unreasonable to anticipate that the results of the student study would be similar among qualified pharmacists.
On a positive note, perfectionism is an ideal character trait when undertaking high-risk tasks that require accuracy. It is a wonderful trait to find in pharmacists, as long as it is primarily reserved for such tasks. This important qualifier is usually omitted. Perfectionism is perfect when answering exam questions or during dispensing. It is not so perfect when navigating this imperfect life. In life, high standards need to be balanced with managing workloads, preserving relationships, and maintaining sanity. If not managed, perfectionism can lead to negative self-evaluation, concerns over mistakes, and conflict with those around us. It can lead us to procrastinate and it is a proven risk-factor for stress and burnout. Therefore, it is worth taking a moment to reflect on whether we sometimes carry our perfectionism out of the dispensary and into our lives, where it has the potential to cause problems.
I must admit, I do not consider myself a perfectionist. As a practicing pharmacist, it took focused effort for me to ensure accuracy in my work, and I did not bring this accuracy into my life outside the dispensary. However, there were two incidents in the past few weeks that caused me to revise this view of myself.
The first was a lecture by Prof Keith Gaynor, a psychologist working in UCD, titled ‘Why perfectionists are more likely to become depressed’ (Available on YouTube). He proposes that when we are presented with a task, there are three possible outcomes… a completed task, a partially-completed task, or a task that was never started. Prof Gaynor describes the perfectionist’s tendency to procrastinate when faced with some tasks. This is usually driven by fear that they won’t be able to complete the task to their own excessively high standard. This results in avoidance of the task, generating associated feelings of guilt and self-recrimination.
If the perfectionist does overcome procrastination and attempts the task but doesn’t reach the standard that they have set for themselves, this is often perceived as evidence supporting the original thought that they weren’t good enough, prompting further guilt and self-recrimination.
Interestingly, if the perfectionist does undertake the task and does indeed do a good job, even by their own evaluation, they tend not to congratulate themselves but, rather, perceive this as evidence that the task wasn’t as difficult as they originally thought. Perfectionists tend to undermine their own efforts, rather than celebrate achievements. Therefore, whatever the outcome, whether they avoid, complete or partially complete the task, the perfectionist will inevitably engage in self-criticism, which ultimately impacts on self- esteem and perpetuates perfectionistic tendencies. Whilst I don’t consider myself a perfectionist, the description of procrastination and self-recrimination sounds uncomfortably familiar.
The second incident that nudged self-reflection was a conversation with a non-pharmacist colleague who pointed out that, when evaluating my own performance, I was probably comparing myself to other pharmacists. She suggested that this could be leading to a somewhat skewed perspective, because pharmacists tend to be a pretty perfect lot! On reflection, I realised she was correct. Whilst I don’t feel like a perfectionist compared to other pharmacists, I probably do have some perfectionistic tendencies when compared with the ‘normal population’. Perhaps I had set the bar for being a perfectionist unreasonably high. A classic perfectionist move! My perfectionism isn’t good enough to qualify!
Prof Gaynor advocates several strategies to deal with perfectionism. The first is recognising when we have perfectionistic tendencies. Awareness is half the battle. The second is to avoid having unrealistic expectations, instead cultivating acceptance for more flexible and realistic standards. The third is to recognise when we are procrastinating or avoiding issues, and to develop strategies for gradually and incrementally managing tasks through steps. The fourth is to avoid self-criticism and to focus on building core confidence. The fifth is recognising the law of diminishing returns and accepting when our work
is good enough and when further investment of effort leads to ever- decreasing yields. Finally, he advocates that we recognise when we’ve done a good enough job.
If we use these strategies, we may more easily overcome the obstacles that life throws at us and be happy with what we achieve, avoiding the pitfalls of perfectionism.
As I reflect on the conversations with my various groups of friends last week, I recognise and appreciate the high standards to which my pharmacy friends and colleagues hold themselves in their work. It is vital that we maintain such standards in the production and dispensing of medicines. However, I also recognise that so many of us hold ourselves, and others, to high standards outside of these areas, possibly without even realising that we are doing so.
Work colleagues can produce good work even if it doesn’t always meet our standards, spouses can be trusted to do the housework, even if it doesn’t meet our exacting standards, and the world will not fall apart if I don’t make the optimal choice of Irish college!
For me, the conversations and reflections in the past week or two have prompted me to acknowledge that maybe I do have some perfectionistic tendencies. This suspicion is supported by the level
of procrastination that preceded the writing of this column! So, as I put pen to paper, I reminded myself that this writing doesn’t need to be perfect. It just needs to represent a decent effort to communicate with colleagues about an issue that I think is relevant. It doesn’t need to be earth- shatteringly insightful. It doesn’t need to be award-winningly eloquent. It just needs to be good enough.
So here it is… the result of a decent effort, which will hopefully prompt one or two of you to take a step back and see if, perhaps, you might be able to go a bit easier on yourself, and keep your perfectionism in its rightful place: The dispensary.
Dr Catriona Bradley is a pharmacist and psychologist and currently works as the Executive Director of the Irish Institute of Pharmacy. She’s particularly interested in exploring psychology in pharmacy and always welcomes pharmacists’ views & comments in this area at catriona1.bradley@gmail.com.
