36 CLINICAL FOCUS
36 CLINICAL FOCUS
20 MARCH 2026 ausdoc. com. au
Therapy Update
Perfectionism and health professionals
NEED TO KNOW
Perfectionism is self-worth based on high standards despite negative effects.
It is common in doctors and other health professionals.
Perfectionism is linked to burnout, anxiety and depression.
CBT for perfectionism has been widely studied and is effective.
Psychology
Professor Sarah Egan is an academic clinical psychologist at the school of population health and the enAble Institute, Curtin University, Perth, WA.
Reflecting on your own experience of perfectionism, and potential strategies to ameliorate its adverse effects, can be helpful not only for your own wellbeing but also for your care of others.
Free online programs based on CBT for perfectionism are available.
Helpful strategies include aiming to increase relaxation time away from work and recognising and reducing self-criticism.
PERFECTIONISM is a commonly used term, but what does it mean as a doctor or health professional? Striving for high standards and excellence are not inherently negative.
Perfectionism is different from simply aiming for excellence. It becomes a problem when self-worth is based on meeting standards, despite negative effects. 1 Unchecked perfectionism can become maladaptive, characterised by unrealistic standards, self-criticism and an inability to accept one’ s own best efforts. This can have a range of adverse mental health consequences, increasing the risk of anxiety, depression and burnout in medical professionals. 2
The three key elements of perfectionism are illustrated in figure 1.
Perfectionism
How does perfectionism impact doctors?
When striving for high standards is also accompanied by self-criticism, ruminating over mistakes, and all-or-nothing thinking, it can be linked to burnout, poorer mental health and mental illness. 2
Examples of all-or-nothing thinking include statements such as“ I only got 75 % in the exam, it was not a high distinction, therefore I am a complete failure” or“ I should never miss anything my patients say about their symptoms, I am a failure if I do.”
Perfectionism is linked to burnout, anxiety, depression and eating disorders. 3, 4, 5 This is as true for health professionals as it is for the general population. Self-critical aspects of perfectionism predict burnout in doctors. 6, 7 In a review of perfectionism
1. Setting very demanding standards for yourself and mental health in medicine, higher perfectionism was found to be associated with a greater risk of burnout, anxiety and depression. 8
Treatment options
There are a range of evidence-based psychological therapies to help overcome perfectionism. The most widely studied and effective is CBT for perfectionism. 9-11 Most studies on CBT for perfectionism have evaluated it as a self-help program, including delivery online and as a traditional hard copy self-help book. 11
CBT for perfectionism has been evaluated in over 15 randomised controlled trials. It is effective in preventing the onset and symptoms of anxiety, depression and eating disorders associated with perfectionism. 9-11
It involves teaching the participant that they are worth more as a person than just their achievements at work( or other valued areas of their life). 12 CBT for perfectionism involves learning strategies to decrease self-criticism and rumination over mistakes and challenging all-or-nothing or thinking. 12 CBT techniques include behavioural experiments to challenge unhelpful thinking, fostering self-compassion, and increasing rest time and enjoyable activities. 12
How to overcome perfectionism?
Reflect on your own perfectionism to reduce standards or stop striving to achieve. Instead, it is about trying strategies to test what happens when striving is approached in a different way. It is about learning you are good enough as a person, and that self-worth is about more than just achievement of goals.
Balancing striving with rest and enjoyment It is tempting and easy, especially when
3. Basing your selfworth on how well you meet these standards
Figure 1. The three elements of perfectionism.
2. Trying to meet these standards even when there are negative effects
Higher perfectionism was found to be associated with greater risk of burnout, anxiety and depression.
Think about whether you feel bad about yourself when you do not meet a goal. Are you continually setting high standards for yourself that are hard to reach? Reflect on whether you are procrastinating over some tasks, even though you feel bad about this later. Are you spending a lot of time ruminating over mistakes you have made? Another key aspect of perfectionism is downplaying your successes. For example, when you achieve your goals, are you likely to think‘ that was no big deal, others in my cohort also achieved this endpoint’? Or continue to set your goals higher?
Online tools can help clinicians do a quick check of their own levels of perfectionism( see online resources).
It is not about lower standards CBT for perfectionism is not about trying busy, to let go of recommendations you would give to patients to promote their wellbeing. It is important to have downtime, sleep, spend time doing enjoyable activities, and spend time with family and friends. A recent study which assessed treatment approaches delivered to medical trainees for managing perfectionism suggested doing a cost – benefit analysis of perfectionism. This involves weighing the pros and cons and reflecting on how a lack of exercise or sleep( as examples) affects the participants’ work, wellbeing and family. 2 Consider whether you include enough enjoyable activities in your week to reduce burnout and achieve more balance.