Printed on: February 5th, 2025

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Strengths and vulnerabilities in clinicians

Strengths and vulnerabilities in clinicians

As clinicians, working to our strengths can allow us to realise our full potential in all aspects of our lives.

This is about being your best self, making the best of your life, and finding ways to both survive and thrive in the face of stress and challenge. It’s about living in line with your values, and being the person you really want to be.

This is not about living up to impossible standards. Recognising any of our own personality traits that might make us more vulnerable to stress can help us find ways to boost our personal resilience and cope better under pressure.

This article looks at some personality traits you might recognise in yourself or in colleagues, and explores how these can affect how we work and relate to others. We also explore how we can learn to look after ourselves if we recognise any of these characteristics.

Being perfectionist involves relentlessly pursuing personally-demanding standards and basing your self-worth on achieving them, which can result in a huge cost to your personal wellbeing. It is possible to have perfectionist traits in one or more different areas of life, including relationships, home life and work. 

Unhealthy perfectionism can be distinguished from simply having high standards because of the negative impact it has on your life and self-esteem.

It is important for health professionals to have high standards, including having attention to detail and a healthy desire to get things right. Pursuing excellence, learning new skills and achieving good results are all important and valuable traits, helping build our sense of achievement and self-esteem:

Having healthy high standards involves being able to relax or adapt standards when appropriate to meet the changing demands of complex situations, and being able to recognise that ‘good enough’ is sometimes good enough.

The problem arises when these ideals slip into becoming rigid rules, demands or expectations.

Unhealthy perfectionism can arise when these internal rules start to get in the way of our happiness and wellbeing. The paradox of perfectionism is that having extreme high standards can actually get in the way of achieving goals. As we place ourselves under enormous pressure, this leads to stress, tension and anxiety as we constantly strive to meet these self-imposed demanding standards.

Perfectionists tend to judge their self-worth on their ability to achieve. So, if things go wrong, even for reasons outside our control, we will often blame ourselves; we may start to view ourselves as ‘a failure’, or even as being worthless, leading to feelings of sadness, shame and low mood.

We may feel a short-lived sense of relief when we do meet our perfectionist standards. But there is often a tendency to re-evaluate the original standard as ‘not high enough’ so we continue to view ourselves critically, with nothing ever quite being ‘good enough’.

Pursuing these demanding standards can have a significant impact on our wellbeing, and may contribute to burnout, insomnia, anxiety and depression. Perfectionism is often linked to overworking: we may over-plan or over-organise, take longer than needed, find it impossible to delegate to others, and constantly check or correct ourselves while seeking an impossibly high standard of achievement.

We may also become overwhelmed by our inner perfectionist demands, leading to procrastination, slowness and avoidance, difficulty making decisions and giving up in the face of challenges. We may lose confidence and find ourselves constantly seeking reassurance from others that our work is an acceptable standard.

The following beliefs are commonly held by people with perfectionist traits. (NOTE: This is an informal checklist for personal use, NOT a validated diagnostic criteria!)

How many of these can you relate to?

A printable PDF version of the table is available here: Spotting unhealthy perfectionism – could this be a problem for you?

Most health professionals are compassionate and caring people who take great pride in their work. Yet, many excellent, responsible, caring doctors also struggle with large amounts of inappropriate, irrational guilt and an exaggerated sense of responsibility.

This may create a ‘chronic hero’ who has an overwhelming desire to fix every problem they see, and who may hold an underlying belief that they are somehow responsible for things that are beyond their control.

A healthy level of guilt can be advantageous in some ways for clinicians, encouraging qualities such as respect for others, empathy, professionalism and dedication; it may even contribute to a career choice within a helping profession. However, too much guilt takes a huge toll, and we may start to place undue pressure on ourselves, become self-critical and constantly worry that we have not quite done as much as we ‘should.’

Constant striving to be a hero in the workplace can lead to overwork, perfectionism and tremendous guilt over every problem and issue that arises. A constant sense of pressure to help everyone all the time can be draining and exhausting, and may put a strain on the hero’s personal life. 

Chronic heroes are usually motivated by helping others, but their actions may not always benefit others. Some heroes may jump in without getting the whole picture, making things worse for the person in need of support.

Hero-type behaviour may also create a sense of dependency and disempowerment in patients and colleagues, undermining the other person’s belief in their own ability to cope. Heroes are also at greater risk of becoming drawn into manipulative relationships.

Chronic heroes are particularly vulnerable when faced by a problem, mistake or complaint. The inflated sense of responsibility leads to a huge sense of guilt and shame when things go wrong, seeing themselves as having ‘failed’ to save the day. In a similar way, heroes may also be more vulnerable to experiencing distress in the face of moral injury – profound psychological distress which results from situations or actions which violate your moral or ethical code. 

So, for example, being unable to see patients face to face during the COVID pandemic might lead to powerful feelings of guilt and personal responsibility for being unable to do ‘more’ to help.

The following beliefs are commonly held by people with chronic hero traits. How many of these can you relate to? (NOTE: This is an informal checklist for personal use, NOT a validated diagnostic criteria!)

A printable PDF version of the table is available here: Could you be a chronic hero?

Surprisingly common among high achievers, people with imposter syndrome experience persistent self-doubt and fear of being exposed as a fraud. Many are outwardly highly successful yet continue to doubt their own ability and talent, attributing their achievements to error or luck rather than to personal qualities such as intelligence, skills or experience. 

Imposter syndrome is not currently a recognised psychological disorder or illness, and is better viewed as a personality trait. But, when present, it can have a marked negative impact on many areas of daily life, creating a chronic sense of stress which negatively affects job performance, job satisfaction and wellbeing, and leads to an increased risk of burnout in health professionals. 

People with imposter syndrome tend to hold beliefs about not being good enough, or not measuring up to the standards of others. So, when faced by challenges such as such as making a mistake, receiving a small criticism, being asked to present at work, taking an exam or applying for a new role, an individual with imposter syndrome may experience a barrage of negative thoughts and fears.

Even when things go well, impostor beliefs can interfere with our ability to accept and enjoy our achievements. We minimise our successes and use our hard work as evidence that we really are an imposter:

Imposter syndrome tends to become apparent when we face an achievement-based task that feels outside our comfort zone, such as taking on a new role or responsibilities. One coping strategy is to avoid these kinds of threatening or challenging situations. So, we might avoid taking on a leadership role, not go for that promotion or shy away from giving a presentation at work. This may reduce anxiety in the short term but it reinforces self-doubting beliefs, limits opportunities for professional development and impacts negatively on wellbeing.

Feeling like an imposter can also make us think we need to ‘prove ourselves’ by overworking, and we avoid asking for help or sharing our feelings for fear of revealing our flaws to others. You might find yourself overpreparing, working gruelling hours or putting excessive time or effort into projects, getting in the way of your other needs and priorities in life.

The following beliefs are commonly held by people with imposter syndrome. How many of these can you relate to? (NOTE: This is an informal checklist for personal use, NOT a validated diagnostic criteria!)

A printable PDF version of the table is available here: Do you struggle with feeling like an imposter?

Strengths and vulnerabilities in clinicians Working to our strengths can allow us to realise our full potential as professionals, make the best of our lives, and find ways to survive and thrive in the face of stress and challenge. Unhealthy perfectionism, chronic heroes and imposter syndrome are all commonly seen in clinicians, and present a cost to personal wellbeing. Recognising these in ourselves and our colleagues can help us identify strategies we can use to counter-balance these tendencies.

Useful resources: Websites (all resources are hyperlinked for ease of use in Red Whale Knowledge) BMJ – perfectionism in doctors BMJ – Clare Gerada: unhealthy perfectionism Journals Blum LD. Physicians’ Goodness and Guilt – Emotional Challenges of Practicing Medicine. JAMA Intern Med. 2019;179(5):607–608. doi:10.1001/jamainternmed.2019.0428 Books Dweck, C. 2007. Mindset: The New Psychology of Success. Ballentine Books. Gilbert, P. 2009. The Compassionate Mind: Compassion-focussed therapy. Robinson. Hibberd, J. 2019. The Imposter Cure: How to stop feeling like a fraud and escape the mind-trap of imposter syndrome. Aster. Shafran, R. 2018. Overcoming Perfectionism: A self-help guide using scientifically supported cognitive behavioural techniques. Robinson.