The Fourth Reason

Make more mistakes

When I ask most people about what gets us into therapy, the usual responses are; stress, depression, anxiety, relationship problems, drugs or alcohol, and a few others. In a more general way, I’d suggest there are three primary “issues” that get people into therapy; grief and loss, abandonment and neglect, and abuse of all kinds. There are certainly more reasons people cite in wanting to see a therapist, but in my experience, there is a fourth thing that prompts people to come in: perfectionism.

For many of us and many cultures, at first there seems to be little downside to perfectionism. In truth, some of the character assets that come with it drive many of the personal and cultural improvements we’ve made in all kinds of areas. Like many things though, it behooves us to look at the fine print. There is definitely a price for this way of behaving. It is sort of a softball to point at the usual and sundry – loss of time at home and in recreation, medical problems like heart attack and stroke, the aforementioned mental health treatment. These things are certainly caused by a constellation of problems, but if looked at a little differently, by looking at the symptoms of perfectionism and their subtlety, it might shed some light on perfectionism and its consequences.

Clients who self-identify perfectionism being a problem for them report a host of symptoms that are pretty easy to see are related to this issue. Here’s a few:

  1. Rumination/obsessive thinking, replaying or imagining how we think some experiences should go
  2. Hypervigilance
  3. Imposition of high expectations on self or others
  4. Sacrificing parts of ourselves/lives that we can’t afford to lose (time, sleep/rest/breaks, exercise, money . . .)
  5. Saying “yes” when “no” might be better for us
  6. Being critical of self or others in ways that have negative consequences
  7. An “incongruent affect” (a clinical term) – the way we “look”, our facial expressions and the like, don’t match how we feel on the inside
  8. “People-pleasing” – similar to #4 above, but subtly different
  9. Lack of compassion/kindness for mistakes/foibles made by self and/or others
  10. “Social engineering” or “the Jedi Mind Trick” – managing other people’s perceptions, thoughts, and feelings about us
  11. Different types of negative “self-talk” – “How could I be so _____ (stupid, fat, ugly etc.)?”, “I should have/could have done more/better…” (there are TONS of examples)
  12. “Punishing” oneself (staying later at work or activity, working more, sacrificing more, putting off things we’ve earned or deserve, sometimes physical or “verbal” self-talk punishment . . . ) for “not doing enough”, “not measuring up” and etc.

There are many more examples of symptoms of perfectionism. There are also more examples of the consequences than the ones listed above. Strange as it may seem, perfectionism can also show up as an unhealthy relationship with food, alcohol, drugs, sex, how we treat our partners and children (having high expectations, for instance), picking or staying with unhealthy friends/partners, depression, low self-worth, anxiety and more.

So, what to do? Many of the typical suggestions from therapists are helpful, but sometimes insufficient. Lots of these are intuitive, and can be done without paying somebody – there are plenty of resources available on the internet. They usually are ideas like:

  1. Trying to remove the word “should” or “could” from discussion (including self-talk) about our abilities/behavior
  2. “Being gentle with ourselves” (a strangely vague direction, I’d argue)
  3. Changing/lowering expectations
  4. “Having healthier boundaries” (often ill-defined)
  5. Using “positive affirmations”

There’s certainly more. What I would offer might be more concrete suggestions. This is an incomplete list due to the medium, and per usual, many of these are better utilized with the direction of a therapist on an ongoing basis. Here are some other ideas:

  1. Learn to have (and survive) a “congruent affect” – how to gracefully and appropriately have your outsides match your insides
  2. Get “peer review” – ask trusted friends to help with an objective sense of whether we are asking too much of ourselves, and the like
  3. Make a list of the perfectionistic behaviors we engage in, and stop engaging in them. If that is difficult, would suggest using some of these ideas to help stop them. This is a great example of the kinds of things that might need more ongoing therapy to come up with specific strategies, as is the next item . . .
  4. List quotes of our negative self-talk. These can be replaced with more “right size” ideas/statements, or counter ideas that both keep us from adding to the pile, but a way of starting to counter this self-criticism and other similar behavior.
  5. Yet another really important method that would be better done with ongoing therapy, identification and processing of the issues/experiences that might have prompted us to suffer with this in the first place.
  6. Learning what healthy boundaries are, and how to employ them
  7. Replacing “punishing” ourselves, being hard on ourselves and the like with more compassionate/loving kinds of ideas. Every therapist on the planet (almost) suggests self-care/self love as a solution, but we are terrible at being specific about it. Will offer a quick “thought experiment”. Think of a person or thing you are pretty sure you are good at being compassionate/loving towards. Think about the principle that is involved in these ideas. Attention? Providing basic needs? Verbal affection/appreciation? Consistency/responsibility? There’s tons of examples, but whatever we come up with, if we add a little critical thinking skills/objectivity/guidance from a therapist, we can readily come up with some great ideas that we do for others, and learn how to apply those ideas to ourselves.
  8. Learning how to handle the consequences of saying “no”, and methods of communicating it clearly/assertively
  9. Learning “thought-stopping” techniques
  10. Consider making __ (insert your age here) year-old mistakes

As I noted, while there are clearly more ideas that might be employed, I think this is a pretty good list. In some cases, this behavior might point to the ill-defined issue of “codependency”, but that is an idea better tackled for a blog (or book) of its own. It is hard for me to write about this and not make at least a mention of the idea of “humility”, another misunderstood and ill-defined term in some ways. However, humility, what I would suggest is a principle that helps us consider our awareness and relationship with our own individual human-ness, the quality of our human-ness, can also really help us have a “right-size” relationship with who/what we are. This seems to be a method too of diminishing perfectionism in a healthy way, but is beyond the scope of this blog as well.

It seems to me that our society, certainly here in the US, is fraught with nudges for us to behave in a perfectionistic way. Though we all agree that our expectations of ourselves tends to be unhealthy, how it shows up in our lives is even more subtle than the messages we get this from in the first place – comparing our insides with the outsides of others, trauma, poverty, advertising blaring one-way communications with us about who we should be/what we need, and the like. The pain, shame, and anxiety this produces is intense, being a therapist in the room with many of my clients (and having struggled with this myself many times in my life).

One of my heroes, Sheldon Kopp has admonished, “Why be perfect, when you can be good enough?” in many of his books. My hope too, is to get us to consider that the only thing wrong with us is that we think there is something wrong with us, and give us more practical methods of changing our relationship with this on a daily basis.

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