Cindy Tsai (00:00):
I think it's so important and helpful to reframe that perspective so that you're not just thinking that if you don't get it right or perfect, you're not good enough.
From Spaugh Dameron Tenny, it's the Prosperous Doc podcast. Real stories, real inspiration, real growth. A show for doctors who are ready to improve their overall wellness in every aspect of life. Now, here's your host, Shane Tenny.
Shane Tenny (00:32):
Welcome back to another episode of the Prosperous Doc podcast. I'm Shane Tenny, and glad to have you with us for today's conversation. The Oxford Dictionary defines a perfectionist as someone who refuses to accept any standards short of perfection, and most of us know someone who falls in this category. If you can't think of someone, you may try looking in the mirror and see if the reflection does remind you of someone who may struggle with perfectionism or those tendencies yourself.
In theory, I think a lot of us think that being a perfectionist can be a good thing. Who doesn't want to achieve at a high level and deliver exceptional results? But when you dive deeper into some of the traits, and some of the results of pursuing perfection, what you find is there are symptoms like being highly critical, being pushed by fear, procrastination, fear of failure, defensiveness, isolating relationships, just to name a few. And candidly, I think we'd all agree it doesn't really sound that good anymore.
My guest today is a recovering perfectionist, and here to talk about that journey with us. She was initially motivated by being a really high achiever like most of the people on our show and most of you listening, but she came to realize that instead of helping her stand out, those perfectionist tendencies were holding her back and she was constantly overdoing and overworking to prove herself, and in the end ended up exhausted, missing some of her life and not feeling very present. I'm excited to have Dr. Cindy Tsai with me on the show. She's board-certified internal medicine, trained at Hopkins, trained at Dartmouth. She's a physician, TEDx speaker recently, published author, and life coach. Dr. Tsai, thanks so much for being with us today.
Cindy Tsai (02:36):
Thanks so much for having me. I'm excited to be here.
Shane Tenny (02:39):
I bet you are, and I hope you do a really good job on this podcast. No pressure. Since we're talking about perfectionism, why not start with that? You've thought about this topic a lot longer than most of us have, so maybe you can just level-set our vocabulary based on your journey or what you've come to uncover. What is perfectionism? Can you give us kind of a working definition to start with?
Cindy Tsai (03:08):
Absolutely. So I think about perfectionism as basically when you're unwilling to accept anything less than perfect and you're holding yourself to these extreme levels of performance and really needing to be the best in all areas of your life. Like, anything less is unacceptable.
Shane Tenny (03:36):
Where does this get created in us?
Cindy Tsai (03:39):
Yeah. Well, I see it definitely in all areas. I think for sure, society, our conditioning, culture, background, all of these things have really impacted this idea of perfectionism. I think a lot of times we grow up hearing messages about practice makes perfect and all of these things that make perfectionism seem like a good thing. And I think that, of course, there are times when it is really important to be very precise and be at your very best, but it's important to be mindful and aware of where and how it's impacting you personally to see if it really is serving you in the best way.
Shane Tenny (04:31):
What's the root here behind perfectionism? Is it really that you just want straight A's on everything and all the trophies on the wall, or is there an underlying motivator?
Cindy Tsai (04:42):
Yeah. I really think that perfectionism comes from fear in terms of when you're having this fear of not being enough, when you feel like you're not adequate, your fear of being judged, of being disapproved, disappointing others, fear of failure. It actually, if you think about it, it comes from oftentimes this sense of fear that was instilled in us from a long time ago. And it's unfortunately not the best way to motivate yourself because if you're always driven by fear, there's always going to be that feeling of worry and panic and stress.
And so I think that, on the flip side, when you are grounded and confident and comfortable in who you are, when you know that you can take care of whatever comes your way, you don't have that same level of fear and worry that when you make a mistake, it's the end of the world. Because we're all human and mistakes happen. And I really always say that we're always trying our best in that moment in time with what you have. And so I think it's so important and helpful to reframe that perspective so that you're not just thinking that if you don't get it right or perfect that you're not good enough.
Shane Tenny (06:26):
Back up for a minute and tell me when did this concept of perfectionism start to grow in your mind as something to be aware of and then to want to change?
Cindy Tsai (06:40):
Yeah. So I would say that I had actually always been very proud to call myself a perfectionist for most of my life. And I was even voted biggest perfectionist in my high school yearbooks in pro team. And I'm also a Virgo, perfectionism came extra naturally to me. So I think that for me, I always thought that, yeah, who doesn't want to be the best? And I think what it led me to doing was constantly striving and pushing, and all of that. And it wasn't until in the later years, especially going through medical training and seeing how grueling the whole process is, and when I personally had various health issues and you experienced burnout to some degree, that it really prompted me to slow down, to really recognize that, hey, this wasn't sustainable and it's really not working out for me.
Shane Tenny (07:54):
Talk a little bit about what health issues showed up in your life, and I totally track with your point about just medical training and residency and fellowship are intense. And so I think this message is probably appropriate for our listeners. What did you start experiencing that made you, I guess, start paying attention?
Cindy Tsai (08:17):
Yeah. So I want you to imagine waking up one day and not being able to see, that's what happened to me. So to wake up and go from healthy to sick overnight was a total wake-up call. And I remember waking up opening my eyes and rubbing my eyes, being like, what's going on? Putting my glasses on, all the things. And it just looked like a veil was came over my eyes, the room was dark and blurry and I just... It was terrifying. And I think for me as a physician, of course, the first thing I want to do was to diagnose myself. Ran through a whole list, what could this be, and all the things. And went to see doctors and they had no idea. They were like, "This is interesting, the tests were normal." My prescription increased threefold overnight. And they were like, "This is interesting." And as physicians, we know that you don't want to be interesting to a doctor, right? It's code 4, I don't have any idea what's going on, good luck with that.
But after a couple days, more symptoms came up and eye pain and stuff like that, and so I was diagnosed with an autoimmune uveitis, an inflammatory condition impacting my eyes that could have led to full vision loss. And so started the medications promptly, steroids, immunosuppressants, all the things. And as I shared in my TEDx talk, it's really about learning that our body has its own intelligence and that it talks to us, so we need to pay attention to these messages.
I think a lot of times when we have to work all these late hours, long shifts, we're exhausted and one of the first things we do is reach for caffeine. And instead of doing that, that third cup of coffee, what if you just took a moment and asked yourself, what does my body need and what would feel energizing to me? Maybe it's taking a few breaths. Maybe it's going to the window or going outdoors, get some sunshine, all of these other things that can actually make a huge difference. But we don't because we're so disconnected, we're so trained in this idea that we just have to keep going and going and going, and that we can't stop that it really takes a toll on you over time, especially.
Shane Tenny (11:02):
What helped you make the connection between what your body was telling you and the stress from your perfectionistic tendencies?
Cindy Tsai (11:14):
Yeah. Well, I think in my own journey, really learning to explore other options, really leaning into integrative medicine, assembling a team of different practitioners who were really focused on looking at the root cause and not just prescribing medications as a bandaid or something like that. I mean, there's absolutely a time and place, and it's not like I'm against medications. But I think for me, especially at that point in time when I was towards the end of medical training, I didn't want to have to take medications for the rest of my life. And I think it's really when I gave myself permission to slow down, really to think about, huh, it has been very stressful. It's not sustainable to be flying all around doing all these interviews and then going straight into a night call and working in the CCU and all these other things.
And so I think that when you actually give yourself permission to slow down and to recognize, hey, this is my pattern, this is my tendency that it's like when people ask me something because I want to be helpful, I say yes without even really checking to see if I have the bandwidth, to see if I'm okay. And I find that especially a lot of physicians, healthcare practitioners because we're so altruistic and we want to help and serve others, we really have put our own needs to the wayside.
And I think that a lot of times, I see this in patients too, where they come in for their routine exam and whatever, and it's almost like just to check off a box on their to-do list. And they're like, oh, I can't talk about that. I got to go to my meeting. I got to do this. And then it's only when you have some type of health diagnoses or some type of crisis and then that really forces you to slow down, right? Pause. But my intention is to really encourage people to pay attention right now. You don't have to wait until you're sick to do something to take better care of yourself. It starts right now. It's time to redefine self-care.
Shane Tenny (13:39):
Well, and you mentioned even in sharing your story, I think you made the comment about you went from healthy to sick overnight, but I think probably in retrospect, you would say you weren't healthy the day before and sick the day after, there was a chronic culmination of stress and toxins and fatigues that you were ignoring.
Cindy Tsai (14:02):
Exactly, yes. I think that we are actually always getting messages from our bodies, from surroundings, all these things, and it's just a matter of whether or not we're paying attention, and also whether or not we choose to pay attention. I think that's also important to make note of. Because a lot of times I think people say, I'll take care of it when I finish this. I will take a vacation when I get this promotion. I will do this. And it's like I'll do it later, but later is already too late. And so I really appreciate that you brought that up because it's true. It may seem like it's a sudden shift and change, but absolutely, all of these things have been accumulating over time, and it's like just... It's not sustainable, we all have a threshold. It's slightly different for everyone, and that's why I think some people they feel like they can keep going and some people not as much, and it just depends. It really comes down to being aware.
Shane Tenny (15:19):
We've got to take a quick break, and when we come back, I want to ask a little bit about the book that you recently published this year and some of the myths that you highlight about perfectionism. So we'll be right back.
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All right. So, Dr. Cindy Tsai, we're talking about perfectionism. You were sharing your story of just hitting a wall and your body telling you, stop, this is unsustainable, when you were in your training. You published a book called So Much Better earlier this year. We'll link to it in the show notes below. But tell me a little bit, what prompted you to put your learnings into writing? What are you hoping that people take away from reading So Much Better?
Cindy Tsai (17:25):
Sure. So I wrote this book because I kept seeing the same things come up again and again through my work with clients on their journeys. So basically, So Much Better is a self-help book that's based in mindfulness, and I share a lot of different tools and techniques to help you develop and master the three key pillars of calm, confidence, and curiosity to become your own inspiring success story. And it's a resource and guide that I wish I had years ago because in my own journey, I realized that there were so many other modalities and techniques, and practices that can be very helpful and transformative. And these are skills that anyone can learn and master. And so that's really the intention behind it.
When I kept seeing those same things come up again and again and I was like, "Well, it would make sense to just put it in a very simple guide and resource." And it's been so wonderful. I think when I saw that the book became a bestseller, and just being able to do these book signings and hearing from people, it's been really gratifying to see that. A lot of times people do want to change, people do want a better life, but it can be really overwhelming when you don't have a clear blueprint or process to follow. And so for me, I break it down into these three pillars where basically the first one calm is about regulating your nervous system. And so a lot of times when we're under stress, it stimulates the sympathetic nervous system, we're in the state of survival, our heart rate's beating, racing, palms get sweaty, all the things. And so calm is about having tools and techniques to really change that, to change from that sympathetic overdrive to a state of relaxation and parasympathetic calmness.
And then confidence is about rewiring your brain and beliefs and really developing that strong sense of self-belief and trust in yourself. And I find that this is really important, especially when people are going through different phases in life. We oftentimes create an identity from many years ago. For example, for me, I was holding onto this identity of being a perfectionist, and then when I realized that it wasn't working for me, I had to really look at these components. Where did this belief come from? What were the stories I was telling myself? These are beliefs and stories that we hold onto.
And then the third part is curiosity, which is about tapping into your creativity and the fun, and also reconnecting with your inner wisdom so that you can be really fully grounded and aligned and be able to connect with your gifts and share that with others to really help make our world a better place. I was going to just quickly say that if you're paying attention that the three components are actually tied to our body, mind, and soul or spirit. Calm is about the body, confidence is about the mind, and curiosity is about spirit or soul. And it really takes that integrated holistic approach, really being aligned in all parts of you for you to finally really feel so much better.
Shane Tenny (21:15):
I think it's a great story. How does it connect with, or how do you use that when you are speaking with or coaching people to address some of the myths that you hear about perfectionism?
Cindy Tsai (21:31):
Yeah, absolutely. I think a lot of them relate to the confidence piece in terms of our mindset, and the beliefs and stories that we've been told and accumulated over time. So oftentimes I think we have a sense that perfectionism equates success, and you want to do it right because then everything will be good. And yes, perfectionists, many of them experience a lot of success, but it often comes at the expense of their mental and physical well-being. And so I think it's really getting into the deeper underlying roots of where do these beliefs come from. And you can imagine if growing up maybe you had a teacher in third grade who told you that you were never going to be good at math. And then you take that story with you and then you try extra hard in all your math classes and you just for some reason don't get that A and it's just reinforcing that pattern and belief, and so you're essentially going to just push yourself when it's not really in your best interest.
And I think the other thing I want to touch on is that perfectionism wastes a lot of time and can really block productivity, because if you think about wanting to be perfect, you have to be very detail-oriented, you want to spend just a lot of time triple checking. I'll read emails like three, four times, check everything and then send and then be like, oh my gosh, I missed that spelling. Typo.
I think it's really important to recognize that when you're doing these things, it impacts all of you. It's like when you're pressed for time when you have a deadline, but then you're like, oh no, I have to get this out perfectly, that's causing stress on your system. That's when we need these techniques like breathing and all these other things to help you stay calm and grounded so that you're not in that state of survival constantly.
Shane Tenny (23:57):
You have begun working as a coach to other physicians around the country who want someone to guide them through the confusion, the fog, the stress they're dealing with. What are some of the ways that you approach people who are struggling with perfectionism or high achievement or whatever label they might put on it?
Cindy Tsai (24:24):
Yeah. I think it's so important to create and hold a safe and supportive space when you are doing this kind of work. Because yes, you can learn different tools and techniques, you can try to do different things. You can book massages and vacations and be like, hey, yes, I'm doing my self-care. But a lot of times that's all external, and in order to have true transformation and sustainable change, you have to look within, you have to look at who you're being, your identity, your beliefs and values, and all of these things.
And so in my work, especially, coaching other physicians, physician leaders, I think it's so important for us to really have this collaborative space and to really look at, hey, what are the things that are working for you and what are the things that are not working for you. And being very mindful and intentional about crafting something that works. Because it's not about me, it's about you. Everyone is different so the things you need are different
And what I really love is just getting to know my clients, meeting them where they are. If you have four kids and you have to go run off and pick them up one after another, I'm not going to tell you to do something at 4:00 PM in the afternoon. We have to figure out what works for you because that's the most important. And I think what I love doing is just sharing all these different tools and techniques and resources so they actually learn how to fish and that they can really learn to advocate and take care of themselves moving forward.
Shane Tenny (26:11):
This has been a great conversation. One of the questions that I often like to end conversations with is really an opportunity for you to shout-out to someone that has been really impactful on your lives. We all arrive where we are based on what others have poured into us, and so I'm curious if there's someone or a couple of people that come to your mind as just being really instrumental in your growth and development where you are today.
Cindy Tsai (26:41):
Oh my gosh, so many. I've always been interested in self-help and self-development. So I think ever since I was young I would read a lot of different books and things like that. I think for me, definitely having different mentors, coaches, and guides, especially as I transitioned into entrepreneurship and business, coaching, all these things have been great. But I think that two thought leaders come to mind, Brené Brown being one of them. Love her work on vulnerability. And she does have a book about perfectionism which I highly recommend also, Gifts of Imperfection. And then another person is Kristin Neff. She wrote a book on self-compassion.
And I really think that learning and embracing self-compassion has been so helpful for me as a perfectionist because we mentioned that a lot of times when you have this idea of perfectionism, it's like anything less is unacceptable. And then we get into a lot of self-criticism, self-judgment, and all of that, and then the shame and the spiral, and it's all this very negative energy.
And so with self-compassion and this skill and technique and really learning to extend that to yourself, it really opens up more space and an opportunity to look at what's going on and really offer a tangible way to transform and help you reframe so that you can actually be more open to looking at what's going on. It's like if you make a mistake, it's not the end of the world, happens to everybody. You're having a hard time and that's okay. How can you be kind to yourself in that moment so that you can really learn and grow and evolve? So I would say those are definitely a couple of my top influences.
Shane Tenny (28:52):
Yeah, those are great shout-outs, and certainly prolific authors and speakers themselves. So you're in good company there. Well, Cindy, thanks so much for your time today. Thanks for your work, your thought. As I mentioned, we'll put links to the book in the show notes below. And I wish you all the best, thanks for being with us today on the Prosperous Doc podcast.
Cindy Tsai (29:15):
Thank you so much, Shane.
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