Physician, Heal Thy Inner Critic Research Results by Pamela Wible, M.D.
(View all results in video above. Graphs and selected quotes below)
Sneaky ways your inner critic can sabotage your career (and entire life!) The good news? You can take your power back. Interviews with 134 by phone, email, and focus group reveal most common (& shockingly similar) inner critic phrases; when hypercritical voices begin; and how to quiet your inner judge—for good.
Physician Inner Critic Question #1
For qualitative data, view video.
Pick one (1–13) that best describes your most intrusive hypercritical thought during your career as a physician:
1. I’ll never be good enough. 29 (21.6%)
2. Why can’t I keep up? I’m defective. 18 (13.4%)
3. None. I have no inner critic. 17 (12.7%)
4. Other: (please share) ________ 16 (11.9%)
5. I must be perfect. 13 (9.7%)
6. I must know it all. 8 (5.9%)
7. I’m a failure. 7 (5.2%)
8. I’m alone; I can’t trust others. 7 (5.2%)
9. Any mistake means I’m a bad doctor. 6 (4.4%)
10. One error and they’ll see I’m a fraud. 5 (3.7%)
11. My needs are selfish; I please others. 4 (3.7%)
12. Patients deserve better than me. 2 (1.5%)
13. If I’m struggling, I must be weak. 2 (1.5%)
Physician Inner Critic Question #2
For qualitative data, view video.
Most intrusive hypercritical thought during last 12 months (categories ranked by )
1. Not enough 15 (20%)
2. Underperforming 15 (20%)
3. Other (various) 11 (14%)
4. Not perfect 7 (9%)
5. Failure 7 (9%)
6. Worthless/Undeserving 7 (9%)
7. Dissatisfaction 5 (7%)
8. Lazy 5 (7%)
9. Self-Loathing 4 (t5%)
Physician Inner Critic Question #3
For qualitative date, view video.
When did your inner critic start speaking to you this way?
1. Childhood 22 (58%)
2. Premed 8 (21%)
3. Residency 7 (18%)
4. Medical school 1 (3%)
Selected Comments
“An A- according to my mother, wasn’t good enough. If I was struggling with my math class, my dad, who was a math instructor at the community college, would call me stupid. Med School didn’t help. The first day of gross anatomy, the doctor told all four of us at our cadaver table that three of us wouldn’t make it through the first year. Fortunately, he was wrong. Although I barely made it through the first year. I had to retake the biochemistry exam in the summer. That was the year I saw my first psychiatrist. My mental health only worsened from there. I never considered suicide until medical school.”
“After screening thousands of applicants to med school over the years, I’m of the opinion the admissions process tends to select perfectionistic people. Because of the structure of medical school and residency, and the unrealistic expectations of both biomedical science and clinical faculty, this perfectionism often becomes concentrated into a pathological form.”
“I think a lot of the phrases started in med school, especially the feeling of not belonging and having to do perfectly on everything to keep up with my peers. I felt like I was under a microscope both then and now and was the problem student in my class. A couple probably did go back to childhood. Having to do perfectly to keep up with my peers = having to be perfect to keep up with my two cousins who were (and still are) the ‘golden children’ of our extended family, yet no matter how well I (or my sister or our other six cousins) did, those two cousins always did better. . . . My dad had told me “You’ll either be homeless or flipping burgers for the rest of your life” when I was five. What he said stuck with me and I feel like I deserve failure. There’s a lot to unpack here . . . a lot of it probably did stem from childhood.”
“The drive to look/seek for other answers, deeper answers, not accept the conventional explanations or understanding of most everything started as a child. But, hearing it as a critic started with comparison to others, being tested and graded and judged or criticized—then at some level accepting or believing that. Clearly, our profession and maybe society in general does not encourage or celebrate out-of-the-box or non-conventional thinking.”
“Working with my childhood trauma therapist has really helped dull the edge of these comments however, I think the message was there from early childhood. Mostly from my Dad, but a little from mom/her side of family. My maternal grandfather was a factory worker, ww2 vet ‘pull up by bootstraps’ kind of guy, and I internalized that message. Any time I wasn’t keen on doing chores I was ‘lazy’ and it perpetuated itself from there. Never enough.”
SOLUTIONS
Physician Success Stories 😍 Taming Your Inner Critic
1. Get therapy
“Therapy therapy therapy. Be curious about why you make choices. Work towards truly enjoying your life. For me, creating a direct primary care practice in my mid 50’s was key. Love what I do and do what I love.”
2. Love your job
“Getting out of mainstream vending machine medicine.”
3. Do meditation & grounding
“I have meditated 15 minutes morning and evening for 12 months and find that now I don’t have inner criticism, just an inner curiosity about what I am feeling.”
“My inner critic has been a lot more quiet and not as chatty. I do a grounding exercise everyday to release any negativity into the earth. I either sit or lay down. I form a thread of light that starts in my heart. I pass it down into my solar plexus, then to my sacral plexus followed by my root chakra. I allow the thread to move into the ground then see it spread down and across the earth. Then i allow all of my anger and frustration to flow into the earth to be transmuted into another form to complete its evolutionary process. I then i state i cut all cords of attachment. I release any aspects that are not mine and return them to their rightful owner. I take back any aspects that were taken from me. For the highest good for all involved.”
4. Enjoy learning from “mistakes”
“I’m an older physician and in my training we were told we were life long learners. I really believe I escaped the inner critic because of that mantra. The voice that told me to strive to learn what was new was not a critical voice and it was more a gentle motivating reminder.”
“Now in the ‘wisdom’ of retirement and older age, I think what ‘saved’ me in medicine was having low expectations because I was not a science major (degrees in writing, anthropology, minor in biology). I applied to medical school to say I’d tried and because the humanitarian aspect appealed to me, but never expected to get accepted, as only 1 in 10 students were female at the time. I anticipated going into a medical librarian career. And I admit I still wonder if I would have been happy with that! So I never expected to be a top student or, more importantly, to know everything. I approached medical questions expecting to have to search and dredge for answers all my career, to always seek help. I also quickly saw that many “top” students and attendings had flaws in empathy and relationships, and that they were not as happy as one would expect with their status. Long story short, I think being less ego-invested in the physician role was key to my sanity.”
5. Be human
“I have never been hypercritical. I do admit mistakes, errors whether related to my work or in my relationships but I do not berate myself on an ongoing basis. I have never thought I was a fraud. Generally my perception entailed being a human, a physician who is doing her best and I know that it is never perfect and it is unlikely to ever be perfect. Even if you believe you did a perfect job on anything one can look at is with a magnifying glass and find defects. Not worth belaboring the matter. As I will be 90 years in a couple of weeks I feel that I did my best in my life and practice, helped a lot of my patients and enjoyed my career, as stated in my memoirs: A Journey through Medicine. This does include errors, mistakes, wrong decisions, flawed behavior and all that is also part of me.”
“Surprisingly, and a blessing that I was never hypercritical of myself as a practicing physician. Somehow I always knew that I was human, not perfect, not a superhero. I set unapologetic boundaries early in my career and I know that is how I survived.”
“I am doing a good enough job. This I apply to all my areas of life. I am good enough wife, mother etc. Being a Buddhist I do practice middle pathway and ‘good enough is good enough.’ Always there will be a better person than you and a worse person than you. Middle path in everything.”
6. Practice self-compassion
“In my 50s I learned greater compassion for myself and mostly learned to shut that voice down.”
7. Find your true self
“No inner critic any more. Years of correcting thoughts, convincing myself that I am fine the way I am, that I make moral decisions, and that society brainwashes us to all believe we are pieces of crap and it’s a lie. Then the subconscious starts operating from this faulty programming. Started a meditation practice in 2019, lots of agonizing thoughts about the past and current state came up when my thoughts calmed down. Had to deal with each as it came up, digging deep to find my true self under the lies. Took 5 years for this to stop. I don’t remember the last time I had a self-critical thought.”
8. Explore self-inquiry
Reflect on the day’s events by asking four questions: 1) What brought me joy today? 2) What brought me desolation? 3) What was my role (if any) related to this joy and/or desolation? 4) What can I do to increase the joy and decrease any desolation tomorrow?
Become aware of your critical self-talk, perfectionism, approval-seeking & self-sacrifice–patterns from childhood, reinforced by medicine’s demands. Identify core dysfunctional beliefs limiting your success & begin healing in our.4-week course with 6-hour CME. Contact Dr. Wible.
