National Suicide Prevention:
 Dial 988  •


About three years into recovery, I began to look at my need to be a perfectionist in my dental practice.  I had always thought that it was good to try to achieve perfection in my work, but I wondered why I wasn’t as happy or economically fit in my profession as others who were not quite so devoted to as high a degree of technical excellence.

When in treatment for chemical dependency, I relearned some phrases I grew up with:  “anything worth doing is worth doing poorly” and “strive to be average”.  Balance seemed to be the key.  I volunteered to buy a coloring book and crayon outside the lines.  I found it extremely hard to do.  One slight lapse in my concentration and oops, there I was, coloring inside the lines again.  Where did this need to be perfect come from?

I asked a recovering dentist who was a counselor at the treatment center to help me with this question and he asked me to define my perfectionism to him.  I always thought my perfectionism in dentistry was a good thing, like the Olympic athlete training for years to be the best in the world at something.  He shocked me with his definition.  He called it “self-hatred” and told me it comes from a position of low self-esteem, an extreme need to people-please, a sign of never measuring up to others’ expectations.  It’s a way of hiding who we really are from others.  The perfectionistic thought is  “If I do this job well enough, you will love me, and you will not find fault with me.”

Working for praise is one thing.  I think that’s part of the good stuff in life.  We perfectionists, however, work to avoid shame.  An example can be found in my waiting room.  It still has the same furniture purchased twenty years ago.  The upholstery still looks good!  The furniture holds up so well because I never let the patients sit in it.  I fear their disapproval of waiting for me, so I have a habit of seating them in the operatory immediately upon their arrival, even if they’re early.  This is shame avoidance.

Another example of perfectionism is in housekeeping.  When I’m done with the dishes, I have to wash the sink.  Then, of course, I have to dry the sink to avoid the water spots on the stainless steel.  Then I find that last dirty cup and I am confronted with the problem of leaving the job incomplete or rewashing and redrying the sink.  What energy this takes!

Procrastination becomes an issue.  “If I can’t do it my way, I won’t do it at all, (until I find the time).”  The sink is spotless one day a week, but the rest of the time it looks like a war zone.  Half-baked projects are scattered thoughout the house and spill over to the garage…

I have come to learn that perfectionism is a sign of my codependency, which is a set of behaviors developed during childhood and adolescence as a reaction to never quite measuring up to expectations from others.  Dental school honed this need to perform to a fine edge.  Instructors in clinic taught us to seek approval for every little step of filling a tooth.  Miniscule deviations from the standard practice were strongly disfavored.  I did well with this, however, and was rewarded with a degree and a license.  Early in my own unsupervised practice, I remember feeling like I needed to show my tooth preparations to my assistant to make sure it was good enough!

I want to make a distinction between precision and perfectionism.  There needs to be a precision in the working length of a root canal, which is significantly different from the precision in the thickness of the palate in a full denture.  Here’s one of my keys to recovery from perfectionism:  when the additional effort to achieve a higher level of precision becomes insignificant to the outcome of the task, stop and move on to the next task.

I think perfectionism is the symptom, not the disease.  Overcoming it means looking at my past fear-based behaviors and trying different healthy actions in similar situations.  I need to look at the motivation for the old behavior instead of the behavior itselfI need to realize that I don’t need my patients to love me.  I don’t even need them to like me!  It’s a job, not a popularity contest.  I am responsible for doing a good job at a fair price in a fairly convenient manner, but that’s all.  The funny thing is that when I can show my patients that I don’t need their approval, and am only willing just to be a good dentist, they like me even more!  That’s all they wanted in the first place.

A Perfectly Imperfect Recovering Dentist