Perfectionism in Veterinary Medicine, Nervous System Regulation, and Vet Burnout (Ep 25)

[: 00:00:00

Hey friend, and welcome back to the Evolved Vets podcast. I'm Dr. Bethany Weinheimer, and today we're talking about something that almost every veterinarian I've coached, mentored, or worked alongside has struggled with, but. Very few of us want to name it or claim it honestly, and it is perfectionism, not high standards, not the attention to detail.

d it is truly everywhere. So [: 00:01:00

Hello. I'm a recovering perfectionist too. And then I also wanna understand what does the research actually say about burnout and moral stress, and how does that relate back to perfectionism? I want us to deeper understand why your nervous system is wired this way. How do we actually get to this place, and then how do we begin to heal it and work back from that place to really start to live and evolved in an empowered life?

Also, the com other component about about that is that there's usually this fear associated with lowering your standards if you want to fight, uh, perfectionism. But really perfectionism isn't about lowering your standard. It's truly about wanting to rise yourself so that way you can have space for mistakes which do happen because shocker, we're all human.

the story we tell ourselves, [: 00:02:00

And in all honesty, the other reality behind this is. Even if my outcome was totally clinically appropriate and my colleagues reassured me, even if the client was grateful, at the end of the day, I would lie in bed awake and think I should have caught that sooner. I should have explained it better. I don't know why I didn't think of that differential.

voice, it was relentless and [: 00:03:00

But the truth is when it starts to paralyze you and create over anxiety, that's when it becomes harmful, and that's when it leans in from excellence to perfectionism. So when I realized this, I started to realize that voice in my head wasn't actually making me better. It was the thing that was keeping my nervous system in threat mode.

threatened. It actually can [: 00:04:00

And we'll deep dive on this more throughout the episode. I see this story time and time again with veterinarians that I coach, people that I lead. It is a common theme across not only men, but also women in veterinary medicine. And it's something a lot of the people that come to our community desperately want help with and want to do.

Well now, let's just say perfectionism and striving to be great are different, and let's break those down. Healthy striving, right, is saying, I really wanna grow. I wanna do my best or. When I make a mistake, which I will, how can I learn from it? A mantra that I actually developed for myself when I was learning this process of admitting that I was a perfectionist was saying, I'm allowed to make mistakes and I can learn from them.

at will they think about me? [: 00:05:00

Bethany said, I hate you for not doing the right thing or making that choice. There was research published in Frontiers Psychology that found physicians with high levels of maladapted perfectionism were actually significantly more likely to experience emotional exhaustion and depersonalization. These are two core components of burnout.

So let's deep dive what each of these mean and better understand what this research proves. Emotional exhaustion. What is emotional exhaustion? Emotional exhaustion is the feeling of being emotionally overextended and depleted of emotional resources. What's that actually mean? It's that you have nothing left to give.

hysical tiredness in how you [: 00:06:00

We are wired for connections. When we start to avoid that, that's usually a sign feeling irritated by normal client questions, you know, our patients just narrows down a little bit more. Crying in your car. More than usual. It's okay to cry on a normal euthanasia day where you've had multiple, or you know, that really tough case that didn't make it.

means you're on this journey [: 00:07:00

Now, research shows that emotional exhaustion is strongly correlated with stress, chronic stress, actually, and this prolonged activation of our nervous system. When you're constantly on and problem solving and empathizing, or in our case sometimes delivering bad news, making those really high stakes decisions and your emotional reserves just deplete.

It happens. It happens to a lot of us, unfortunately. Emotional exhaustion doesn't mean that you don't care. The reality is it means that you usually care so much about everything, every detail, every system, every process that happens in your hospital, every animal that you have to treat, that sometimes your system gets overloaded and eventually gets to a place of shutting down.

about the other side effect, [: 00:08:00

Maybe it shows up as being cynical around things that happen in our day-to-day lives as veterinarians. In healthcare burnout research refers to developing a detached or impersonal response to those that you serve. In our case, that would be the pets and usually the people that are attached to them too.

So in VetMed, the ways that I see depersonalization coming up is. Referring to patients by diagnosis or their cage number instead of saying, you know, oh, Robert over there, I gave him a human name. But Robert over there, I just had a patient named Robert last week. So Robert over there, um, you know, is here for laceration repair, like using the name of our patients.

we start feeling numb during [: 00:09:00

Emotionally detaching from clients. This is gonna be huge. Um, usually for me, one of the indicators that I find with depersonalization. Is when somebody asks, what if it was your dog? And I don't have an emotional response. That's usually a sign that like, I need to take a break or take a step back from work to go heal or do something for me.

handle this, if this is too [: 00:10:00

This is, this is the moment that I have to pause for me, and when this emotional exhaustion remains unchecked. It continues on and goes on longer. That detachment becomes the way that your system knows how to cope. And so that's when we really get into this depersonalization step. Now, there was a research study back in 2022, um, from Frontiers Vet Science that found a large majority of US veterinarian.

Actually report moderate tie burnout with emotional exhaustion being the most common component. And there's other research studies that say 86% of veterinarians actually hit this point of burnout through some of these clinical signs that we're seeing here when emotional exhaustion increases and depersonalization tends to follow.

and that's kind of the steps [: 00:11:00

You never really have that peace or that time to actually get personal with the clients and the pets that you help or reconnect with the ones that you're at work with. These are the moments that matter the most. Let's think about a reframe. If you're experiencing emotional exhaustion, you're not weak.

issue and it's warranted for [: 00:12:00

And usually this is what around the time where I start to have clients come to me for code blue coaching. Because with Code Blue Coaching, they're sensing this, fear, this, this shutdown. They notice that they need help and they come to me for advice and we start to work through these things together because the truth is, it's about protecting your emotional bandwidth so you don't have to numb yourself to survive.

y Crane Phillips and Karen in: 2015

The ethical dilemmas that they experience hit harder and they linger for longer. I definitely have experienced this throughout my journey as a [00:13:00] veterinarian, and learning to cope and process this journey differently is truly helpful. So what does this mean? The very trait that helped you succeed academically actually makes you more vulnerable emotionally and more susceptible to compassion, fatigue and burnout.

Ouch. Perfectionism ties performance to your identity. Been there. And if the case goes well, you're competent, right? You did it. You're a good person, you're a good girl. You did it. You're the best doctor. But then if the case goes poorly, you're the problem. You're not smart enough. How dare you not triple check that dose.

his goes back to conditional [: 00:14:00

We're praised for performance, being in charge of things, taking more on, that's very common throughout all of veterinary medicine. And now let's actually think about how perfectionism shows up in veterinary medicine. And let's get really specific, I wanna talk real examples of what it looks like in Bat Med and continue to share more openly about my story with.

Perfectionism and how I've begun to overcome it, but it is an active process that I work through every day. Perfectionism in VetMed looks like this, staying two hours late, rewriting medical records, I used to do this one all the time. I was functioning out of lack mindset, fear. I was terrified that I'd be sued by a client.

ld actually spend like eight [: 00:15:00

Another example can be overexplaining to clients because you're afraid of complaints or that bad Google Review. We wanna be liked. We have people pleasing tendencies in veterinary medicine, and I have those too, and it is really hard. Here's another one. Not delegating because you're the only one who can do it that way.

Yeah, everyone raise your hand even if you're in the car by yourself. That one is tough because your plate ends up getting full. You're overextending. You're not actually taking time to prioritize you taking PTO, right? Do you actually unplug from your phone, from your email? When you're on PTO, you're up late at night 2:00 AM and you're replaying that case you're, it's like a video replay, replay.

t off to be with your family [: 00:16:00

Uh, this perfectionism creates hustle culture. You have to perform, you have to show up, you have to do the right thing. And we're all trained in this vigilance. I think the other thing that we'll see in VetMed is like being fearful of like what the specialist would think or that referring veterinarian or the person that takes my case over next time, like what other people think influences how we show up and kind of reinforces this perfectionism.

Let me speak directly to the woman who feels like she's barely holding it all together. You are still competent. You are still high functioning. Your team probably thinks you're fine. Your family probably just thinks you're a little disconnected, but inside you're exhausted, irritable, disconnected, and wondering if you chose the wrong path.

ary medicine. You've already [: 00:17:00

Rebuild yourself, trust in your self-worth. Create boundaries. You can actually hold. And you have your accountability from yours truly don't forget, we also get a one-on-one personalized recovery protocol just for you that will help you for years beyond our coaching time together. So what you get is accountability, nervous system tools, and a true handholding pattern that will help you through with a white glove experience.

. Now is the time. Make that [: 00:18:00

I hope to see you in there and that we can stop this code blue moment. This hypervigilance will keep your nervous system at a chronic state. Of activation in this fight or flight that we've talked about. And there have been many that I've coached that are absolutely terrified by their perfectionism that they can't even go into surgery.

So anxious that they literally can't go into the surgery suite because there's a fear. A fear of making a mistake, a fear of not cutting the right thing, of not doing. Now, a healthy amount of fear is good. I always tell the story. I used to work at the Winnie Carter Wildlife Center with Dr. Um, Alice Blue.

rience was like I would work [: 00:19:00

It only takes one click for them to take you down. Or one kick not click. Um, so in those moments you have to pay attention. It's important to pay attention, and it's important to be focused, but it's also important. Not to really take on this concept of fear equals safety because that's not the truth. And so for these veterinarians that I coach in, that we have in our community, this severe anxiety for surgery comes from this extreme amount of perfectionism and we, we give them space to make mistakes.

That actually helps so much. And it's a process, right? It's not just like, oh, I'm gonna decide not to be a perfectionist and then everything's magically healed. That's not how this works. It's a journey. And so I just really appreciate everyone who's messaged and dmd and actually shared some of these vulnerabilities.

'cause it is everywhere. [: 00:20:00

So the truth is, here's the part that we don't talk about enough. Perfectionism is considered a survival strategy. Many high achieving women in vet men find this perfectionism. These are the people that are in our community that are getting coached. They do it because they earned praise. They avoided criticism.

erfect, I'm loved. The truth [: 00:21:00

So when you do make a mistake, your brain doesn't register. Huh? Okay. That's a learning opportunity. It registers a threat. Your heart races, your stomach drops, it wakes you up at 3:00 AM with anxiety and you replay it for days. It's almost like a, I like to think of like an old school movie reel. In these moments when I wake up at night with these situations, your body truly believes you're in danger.

going to actually focus on. [: 00:22:00

We talk a lot about burnout in veterinary medicine. It is a common thing, but there's a reason we talk a lot about it because it, it consumes 86% of veterinarians, which is huge. This was from a frontier study in veterinary science. Um, and it just blows my mind how much. Of that is workload and how much of that is actually the internal work that we need to focus on?

How much of that is self-criticism, self-hate, or over analyzing every little detail? 'cause the truth is, our itty bitty shitty committee, or our inner critic doesn't clock out. They don't take PTO even when you're on vacation. They probably still come out a little bit. Mine sure does. And for me, acknowledging that I've had five critical cases in a row and I did it with Grace is not the natural go-to, right?

It [: 00:23:00

Guilty. Me too. I've been there. The gossip. The criticism and the negativity also have an impact here. It's not just the perfectionism, but why does perfectionism exist? One, like we said, inner child, we grew up that way. We were taught that it was safe. Our whole undergrad experience we're trying to make great grades, honestly, before that too.

your face, maybe in a group [: 00:24:00

Maybe it's in rounds or a Facebook post about another veterinarian or a DM, or that Google Review from a client. You know, it's that subtle shift in tone when someone says, interesting choice. Even if it's not directed at you, we all feel it. Even if you've heard another veterinarian or veterinary staff.

Say something negative about a colleague, even if it's not about you, you feel it. You hear how other doctors are talked about. You might see how somebody made a mistake and it became a story that everyone shared. I'll tell you an example from one of my clients. There was a incident where. A pet that they had had surgery on, they did surgery on, was transferred, um, or seen by another veterinarian for follow-up care 'cause the dog wasn't doing well and it was after hours.

n had, um, accidentally left [: 00:25:00

That saw how somebody would treat them if they made a mistake. You see how someone's mistakes become a story about how they're a bad doctor in this case, just is one of many I've seen ruptured urethras where people wanna make comments or, um, you know, their x-rays weren't taken 'cause they were declined.

t wanna be in this position. [: 00:26:00

That's how it gets reinforced. Not because you wanna be perfect, but because you don't wanna be the topic of conversation. None of us wanna be misunderstood, judged, criticized, or be labeled as a bad veterinarian. That's not what we want. But perfectionism leads us to this place where we're constantly afraid of that and we don't give ourselves the space to make mistakes.

And we're human. We all will. So the first call to action is how do we support other veterinarians and veterinary professionals when those mistakes are made? Right? Because the truth is when that happens and you hear somebody talking about another vet or vet professional, you tighten, you double check you over, prepare, you over explain.

in meetings. Maybe you avoid [: 00:27:00

And the truth is, research on psychological safety is so huge. There was a Doctor Amy Edmondson's work out of Harvard. That shows that teams with higher psychological safety have fewer medical errors, better communication, and stronger performance. Not because they're softer, right? The job that they do is the exact same, but it's because they're safer.

can report medical errors in [: 00:28:00

But for ourselves too, because we're able to take away some of that criticism and judgment that we fear, so remove that fear. Humiliation, your performance will naturally improve. And I found the same thing in my life as I started to decompose and pull back the layers to what perfectionism looked like in my life.

The downside is when gossip criticism are normalized, the amygdala stays on, and that's the part that fight or flights in our brain. When it's activated, your brain is gonna always prioritize protection, not growth. And that's why you replay conversations. You scan for tone. You're over aware of how people are reacting to the things you say and the things you do.

at feedback equals a threat. [: 00:29:00

Oh, maybe they didn't like the way that that landed or overanalyzing that feedback conversation 'cause it was hard for you to give. Your nervous system doesn't know the difference between actual criticism and the feeling of criticism. So every time we replay that, what if scenario we are reinforcing. To be in fight or flight.

So let's start to name it. How does perfectionism feel in the body? I'm gonna speak from personal experience, but others of you might have had different experiences. I'm also gonna speak to things that my clients have described. It's a feeling of being small, being isolated. Walking on eggshells, terrified to speak up.

ke you can't fully exhale at [: 00:30:00

And honestly, the reality is oftentimes we feel like we have to prove ourselves and. It happens like over and over and over and over and over again. It's not like we prove ourselves one time. We've earned our reputation and now we're a good person and we can make mistakes every once in a while. But it's a relentless hustle of proving and showing up and doing our best and never making mistake, never making mistake, and that's why we get completely destroyed when we make a mistake or we do have that challenge or that conflict shows up, perfectionism becomes protection.

truth is, no one's flawless. [: 00:31:00

You can't control how other people project. You can't control someone else's insecurities or shame. What you can control is how you grip to perfectionism. Step one. You need to claim it to change it, and this is something I say at the evolve ts all the time. So step one is claiming it. If you, if any of this sounds like you just say, okay, I'm a perfectionist, and let me be honest, this took me like a solid year of journaling before I was able to admit this to myself.

is so important. Step three [: 00:32:00

So in those moments where you're starting to notice, I'm replaying this conversation, I'm stressed about what somebody else is saying, notice it. And then the fourth step is gonna be practice release. So when I first started to uncover and unravel my perfectionism, there was this thing that I understood that really stood out to me.

As I was peeling back these layers to my perfectionism, I started to notice that I was replaying conversation at 3:00 AM every night, and I wasn't getting a full night's rest. And as a manager for the last six years, I do a lot of feedback conversations. I have to give people good news sometimes, and sometimes it's not great news.

And as a people pleaser, it was really hard for me to go into these conversations and give that honest, direct feedback, but I knew that that's what my team needed. And so after these conversations, I would go home. I would replay, analyze everything in my, like laying in bed, analyze it. Did I say the right thing?

How did [: 00:33:00

And so I started to create this meditation and it is available in the Evolve Vets membership and through Code Blue Coaching. But essentially at night I would listen to it and. It would teach me to stop the replaying. It would teach me to stop the video that just kept going over and over again in my mind and truly stop beating myself up over wanting to do it better next time.

ctive and then practice that [: 00:34:00

How do I let go of the things I'm experiencing? Because when you're not in self-worth, it's tough. It's tough to go out there and fight criticism, losses and stinks. But when you're confident and you're living aligned to your values and you can say, Hey, I'm so sorry I fucked up there, and then move on. Do better next time.

That is the thing that matters. And so as you start to do these things and pull back these layers and uncover perfectionism, you'll start to notice the most, your most evolved self is coming out of this, or that's what I noticed when I went through the journey and that's what people on code blue coaching also experience.

It's not tearing down. It's not that leadership's never gonna be criticized in impacts. As you grow more as a leader, you're probably gonna be criticized more. It's being able to stay authentic to who you are despite the criticism, being confident in the decision that you made, while also being able to look forward and say, I can do it differently next time.

e your nervous system really [: 00:35:00

It's my online home and community for women in veterinary medicine who are done surviving and ready to start evolving inside the membership, you're gonna find race approved. Masterclasses vet reset meditations, live monthly coaching with yours truly, and a community of women who actually get it. It's not toxic positivity.

It's not just another membership you sign up for. It's learning how to manage your energy, protect your boundaries, and build a sustainable career in veterinary medicine, it's your choice to move from self abandonment to self devotion. And the truth is you don't have to do it alone, my friend. Come evolve with us.

realized I was excellent. I [: 00:36:00

I overanalyzed every sentence, every word spoken every moment inside and outside the hospital, and it all added up the shift in the de shedding of the perfectionism. Wasn't lowering my standards, it was showing up for myself in a way that I love for myself. So I can be an authentic leader, a driven person, and someone who also allows space for mistakes, space for difficult conversation space for others to make mistakes too.

perfectionism, not have the [: 00:37:00

My nervous system began to calm, my leadership improved. My relationship softened. My joy returned. I began to love medicine again, and the reality is this is happening for my clients too. As we go through this journey and we start to discuss situations and shed these layers of perfectionism, shed this.

Emotional separation that we've experienced in veterinary medicine. This is what matters. It doesn't change your job title or the work that you do, but it shows up how you allow yourself to make mistakes. It gives yourself compassion and grace in order to show up as authentic and confident. Calm as possible.

that actually work create a [: 00:38:00

There was a Dr. James Pennebaker from University of Texas, and he did a study where 15 minutes for three to four days consecutively, and you just journal out your deepest fears, no grammar, corrections, no judging of what you put in there, but really just not censoring yourself and just laying it all out there, get it out.

What that found was they had improved immune function, lower stress hormone levels, fewer doctor visits. Um, it improved their memory and really just increased their emotional regulation because they were able to get those fears out on paper. Now students who did, uh, they also had another study who showed that students who did expressive writing before an exam.

So imagine yourself in vet [: 00:39:00

It reduced what researchers called as cognitive load or what our brain can process, and it also made them show up more ready for these exams in a more clear way. So think about this. When you write things out, your brain will organize, metabolize, and often let them go. Now, it's not the only solution, but it is something that works.

nto our rational processing. [: 00:40:00

Fight, freeze and fawn the four Fs. And so as we turn the dial down on our amygdala, our fear center, and then we can turn up our rational processing. Now what we might find is more coherence. You might see a decrease in annoyance behavior. Remember how earlier we discussed the cynicism, the shame, the judgements that are coming out that can actually reduce some of that, um, that behavior as well as like avoidance.

udy that was done back in the: 1980

So European school systems actually [00:41:00] incorporate emotional liter literacy journaling, which is quite interesting because they, for 15 minutes will just write about their fear-based writing. And so this. Study is now being replicated internationally, and I also saw a TikTok earlier this week that discussed, like in Switzerland, there's this practice of, before 15 minutes before your kids go to bed, they just release their anxiety and fear onto a journal.

And what it's actually been doing is lowering their depression and anxiety rates in children in that country. And it is so interesting to me that this is now work that's simple. It's 10 to 15 minutes. Um, if you wanna be very formal with it. The original research did say 20 minutes, but just write out your fears, like uncensored.

uch better just because I've [: 00:42:00

That's probably never gonna happen, and it makes me feel so much better. So I really enjoy that one. Okay, so step two, begin to separate your identity from the outcome. Brene Brown talks about this all the time. Instead of saying, I'm a bad doctor, or I'm not good enough, say like, okay, I'm human. I'm allowed to make mistakes.

I made a bad decision. So it's not owning who you are, it's not your identity. It's just something that happened, and that's part of life, and that's part of the human experience. Number three, ask the diagnostic question. Is this excellence or is this fear, right? Because if you're noticing the root of it is based on fear, then it's probably an underlying component of perfectionism and control that we can work on releasing.

es burnout and improves your [: 00:43:00

Um, and long-term, honestly, jobs in veterinary medicine, it's gonna be key to that piece. Number four is gonna be practicing self-compassion. Research shows consistently that if you have self-compassion, it will reduce your likelihood of burnout and improve resiliency in healthcare professionals. So interesting.

Right? Some of the things that we stay here at the MAL vets are like the internal work is actually the thing that matters the most, but it's the thing that's so hard to make time for because it means we're putting ourselves in high self-worth and making ourselves a priority. But the truth is self-compassion.

an and in this profession so [: 00:44:00

And the great thing about self-compassion is it usually spreads to compassion to others too, right? So the more grace we give ourselves, the more likely we are going to assume innocent intent to the person across the room. And then five, let's redefine what gold standard is in a whole person model. Gold standard is not just making every right decision, making, every right prescription, making no clinical mistakes, but uh, also can.

Include like sustainability and teamwork, and it also includes your mental health. Think about it this way, the Evolve vets, we describe the whole person model as mind, body, emotions, and spirit. And when all those are balanced in a way that is authentic to you, you can shed some of that perfectionism and actually show up authentically you and that gold standard can look like.

whatever it is for you. Find [: 00:45:00

You choose to be you. You choose to not self abandon, and you choose to let go of this perfectionism so you can show up authentically. Now we've talked a little bit about living aligned with your authentic values, right? That is essentially the whole concept of the whole person model. Balance isn't about scheduling things perfectly or having more time, or adding more to the do list.

st at the same time. Balance [: 00:46:00

Shame, shame, shame. Like I also struggle with shame, and I know many of our veterinarian friends do too. It is okay to let go of that shame and show up. Authentically as yourself because you deserve a lifelong career in veterinary medicine. So the truth of all of this topic, which is really deep one perfectionism, probably helped you get here.

That's why you're a veterinarian. That's why you're a veterinary professional, and you got it through organic chemistry surgery rounds. But really, it also kind of created this one high expectation, and it also kind of created this imposter syndrome, right? So you made all A's you did it. Good job. You've arrived, but now what you also have on the other side of that is something that's not sustainable long term.

ctionism, and it affects the [: 00:47:00

Of course, like when you don't know something, admit it, learn from others, get a mentor, get a coach. But over time, you're gonna start to see your skills grow. And when you do grow, start to trust in those skills because you're smart and you're capable. And you're worthy. And if there is a mistake, it's not about the person, it is about the process.

So when the next mistake happens in your hospital. And your perfectionistic switch turns on and there's a thought maybe of judgment about the other person or how it was done, or how they didn't double check or how they need more training. Think back to yourself. Is there a process that we could improve here?

reality is the more you can [: 00:48:00

And my friend, you deserve to be in VetMed. For as long as possible, and you deserve to show up without that self-criticism, without that anxiety that exists in the world that we created for ourselves. So sending you off with love and hugs and together let's stop revolving and start evolving. Thanks guys.

Thank you so much for listening to the Evolve Vets Podcast. It truly means the world to me. If this episode supported you or spark something new in you, please go to evolve vets.com to become a member or join our coaching program and truly continue this work beyond the podcast. Let's evolve together.