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Jillian Rigert, an oral medicine specialist and radiation oncology research fellow, discusses her KevinMD article, “Is perfectionism something to strive for or heal from?” Jillian explores the emotional toll of perfectionism, its connection to shame, and her journey toward self-compassion and healing. Drawing insights from Brené Brown’s Atlas of the Heart, she shares how unprocessed shame shaped her perfectionist tendencies and the profound impact of letting go of rigid beliefs about achievement. This conversation offers practical takeaways on recognizing the roots of perfectionism, embracing vulnerability, and cultivating empathy and self-compassion for a more fulfilling life.
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Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome back an old friend, Jillian Rigert. She’s an oral medicine specialist and a radiation oncology research fellow. Today’s KevinMD article is “Is perfectionism something to strive for or heal from?” Jillian, welcome back to the show.
Jillian Rigert: It’s so great to be here, Kevin. Thanks for having me.
Kevin Pho: All right, so tell us what your latest article is about.
Jillian Rigert: My article is a deep exploration into shame. And so I want to present this in the beginning, knowing that shame seems like not that deep of a topic sometimes because not a lot of us allow ourselves to explore just how intense it can be. And that’s by nature—shame thrives in secrecy, in silence, and in judgment. So many of us who need to be talking about shame are hiding in isolation because we’re too ashamed to talk about it.
And so my article is about shame, but also about perfectionism. It includes this quote that I’ll read so people can get an understanding of where we’re going with this. It’s from Brené Brown’s “Atlas of the Heart” book: “Perfectionism is a self-destructive and addictive belief system that fuels this primary thought: If I look perfect, live perfectly, work perfectly, and do everything perfectly, I can avoid or minimize the painful feelings of shame, judgment, and blame.”
Hearing that—after spending a lifetime thinking that being a perfectionist was something to walk proudly around and wear as a badge of honor—I realized just how much perfectionism was maintaining this deep sense of emptiness within me. The emptiness, this never-enough feeling, this unworthiness that I kept seeing in so many high achievers—people on my own show, clients I’ve had—they’ve gone to the Ivy League schools, done surgery, the thing that I thought was going to give me my worth. Yet all of them were just having a very similar feeling: this emptiness of never enough. I really wanted to explore: Where is this coming from rather than just saying, Ah, a lot of people feel that. And what is this role of perfectionism in its relationship with shame?
Thanks to Brené Brown, she helped me put a lot of words and understanding to these two concepts as they’re paired together.
Kevin Pho: So tell us exactly what you were feeling before Brené Brown articulated it so eloquently. In your own life and training, talk to us about how perfectionism made you feel so empty. What exactly happened?
Jillian Rigert: Yeah, if we think about perfectionism—this ideal of who we think we need to be, and then where we perceive we actually are—shame lies in that gap between. I was constantly developing what oftentimes might be heard of as a shame-based or shame-bound identity, this pervasive feeling that I am unworthy, I am unlovable, I am never enough, I don’t matter. That ultimately was the belief system fueling my suicidality. Shame is extraordinarily painful, and I was living with that deep pain. People kept saying, “I wish you could see yourself the way other people do,” and I just kind of shrugged it off—like, maybe it was humility—but really I was empty. Just this pervasive emptiness. I felt this chase to calm or quiet that feeling of emptiness: if I could just do this more perfectly, work harder, do more, be better, then I’d quiet that noise. And it just kept becoming louder and louder, and I was more and more exhausted from continuing to push for more.
Kevin Pho: What happened next once you made that connection between perfectionism and shame? How did you come out of that? What did you do?
Jillian Rigert: It’s really important to recognize that explorations of shame and self-compassion can have a backdraft effect. When I first realized, “Oh my gosh, this is toxic shame,” I dove into a lot of research and resources—books and courses. This was recently, and I spent about a week on the floor, just feeling awful. I was absorbing it all, but I felt terrible.
I want to share that if you’re going to explore shame, at least from my experience, how I explored it during an acute crisis years ago could have pushed me into a very unsafe place. So I think what allowed me to explore shame now and stay safe was that I had developed self-compassion in a way that I could be there for myself and know that these shame-based thoughts were thoughts I was having, not who I was. I could separate myself from the experience and be supportive of myself, giving the love and compassion I needed. I also had a community to lean on who loves me unconditionally and authentically. Back in surgery training, I felt very isolated, and that could have set me up for a lot of problems.
So, yes, when I opened my eyes to how shame was impacting me, I felt a lot worse at first. If you sit with feelings, it can bring up memories of when you felt similarly—both pleasant and unpleasant. I was being flooded with memories of times when I felt shame, when I felt “not enough,” times when I was acutely suicidal and thought I’d never be enough or didn’t matter.
But it was important for me to sit with that because, like burnout—which is sometimes a misused term and might actually be moral injury, spiritual or existential crisis, or PTSD-type responses—if we’re naming the wrong thing, then our solutions aren’t pointing us toward the right healing modalities. Because I was able to sit and figure out it was toxic shame at the core, I could then find resources and ask, “What is the antidote to shame?” Because it’s not perfectionism. So what is it?
I realized medicine is very shame-based: it perpetuates shame by stigmatizing struggles, by putting us in places where we isolate, we’re in secrecy, we judge ourselves, and that all fuels shame. The antidote, then, is connection. And a huge shout-out to your platform, because it reminded me of the times I was able to release shame, like when I wrote the “I risked my career to save my life” article. That article literally saved my life just by sharing it, because it released so much shame. It brought so many people into my life who gave me empathy and could see me. They shared their stories, and the antidote to shame is people who respond with empathy. Internally, it’s self-compassion, but shame is very much a social feeling. Evolutionarily, it came from fear of being rejected by the group, and now it’s often weaponized against us.
Kevin Pho: I love that framing—how you said medicine is almost a shame-based profession. If doctors, trainees, or physicians are anything less than perfect, they often get a shame-based response. They’re not encouraged to show vulnerability or seek help, and a lot of that is leading to moral injury and burnout, and it’s driving some physicians out of medicine altogether. Like you said, platforms like yours and ours can be a safe space to connect with others who are going through the same thing.
Jillian Rigert: Exactly. Even something like workaholism can be an antidote to shame because it’s an addiction that’s actually normalized. And in leadership, the more emotionally immature or even narcissistic qualities we see can be very shame-based identities, where those individuals aren’t willing to face their shame, so they shame others. For someone who is shame-based, that’s very painful because it’s easy for others to manipulate you emotionally—leveraging your own shame.
Once I recognized my vulnerabilities, I could protect myself better. I could see when a person was going to project their shame onto me, and I could note, “That’s not true.” In the article, I shared that the words that brought up my shame were when my therapist asked me how I was doing, really, and I said, “I am struggling.” I went straight into shame because I’m not used to admitting that.
Kevin Pho: Now, as we know, the culture of medicine is notoriously slow to change. In that context, how do you advise the physicians you coach and the ones who are listening on this podcast to let go of their perfectionism, knowing the culture still values it? How do you counsel them?
Jillian Rigert: First, it’s important to observe perfectionism’s real impact. Over and over, we see it’s not truly leading to fulfillment or well-being. Many times, shame has been passed down within family systems. So, to break that cycle, the best thing we can do is heal the toxic shame within ourselves. We have to be the change.
For me, I also had to recognize which parts of medicine I could stay in. Many find themselves in roles that are causing moral or existential crises—where their deepest values don’t align with the values of the institution. This leads them to devastating mind, body, and spirit illnesses. I want them to know they matter enough to reclaim the narrative in their own mind, body, and soul, and heal the toxic shame within. Rejecting the shame-based narratives is powerful. We can’t change all of medicine overnight, but we can reclaim our lives in the meantime.
I almost died from anorexia—I’ve talked about that before on your channel. I was on my hospital bed, completely alone, and that moment made me realize none of my achievements or credentials mattered at that point. The people I had from work didn’t provide the support I needed. Shame makes us not love ourselves, so we start with loving ourselves enough to do the internal work, release the toxic shame, and go from there.
Kevin Pho: We’re talking to Jillian Rigert. She’s an oral medicine specialist and a radiation oncology research fellow. Today’s KevinMD article is “Is perfectionism something to strive for or heal from?” Jillian, as always, let’s end with some take-home messages that you want to leave with the KevinMD audience.
Jillian Rigert: First, if you’re going to explore shame, know that it often stems from trauma. Also recognize it can get worse before it gets better, so make sure you have adequate resources: self-compassion, plus a community that loves you unconditionally for who you are, without needing to see your CV to assign worthiness.
Shame thrives in secrecy, silence, and judgment. The antidote to shame is connecting with people who respond with empathy and support, and internally cultivating self-compassion. Remember shame is social in origin—it stems from fear of rejection by the group, but now it’s weaponized in so many ways.
We’re led to believe that more achievements and more perfection will quiet that never-enough feeling of unworthiness and not being loved. Often, that comes from childhood experiences where certain needs weren’t met. It helps to look at that with compassion, curiosity, and no judgment, seeing how shame might have been passed down. Our parents and grandparents probably didn’t get everything they needed, so many of us inherited some degree of toxic shame.
In short, ask yourself: What need wasn’t met when you were younger, and how can you give that to yourself now so you can feel whole—enough, worthy, loved, and lovable—without requiring achievements to prove it? We believed that accomplishments would fix us for so long, so it may take time and patience to unlearn. As you go along, try not to perpetuate your own shame. Shame begets shame. Show yourself kindness and curiosity throughout the process.
Kevin Pho: Jillian, as always, thank you so much for sharing your story, time, and insight. Thanks again for coming back on the show.
Jillian Rigert: Thanks for having me, Kevin.
