Perfectionism

Perfectionism is a very complicated term, in my opinion. It carries with it this connotation of someone who is very “type A,” who is meticulously clean and organizes everything. This is a very narrow view, however, as it is a general mindset that is much more pervasive. Perfectionists hold impossibly high standards in many areas of their life – that things must be or go “perfectly.”

In some ways, this can be a real strength. Any perfectionist can tell you that they likely had very high standards for themselves when it came to grades, and they can be very detail-oriented, which certainly can be a prized skill. They are likely pretty good friends, having impossibly high standards for themselves as friends to others.

In other ways, these impossibly high standards can cause problems. The core nature of life as a human is imperfection. Waiting for a “perfect” time, or expecting someone to be the “perfect” friend, family member or partner can be a set up for failure, as perfection is not ever a likely outcome. Wanting to be “perfect” is also a personal set-up – you will always fail at that. Perfectionism creates standards that are usually very unlikely to ever be met fully.

How do we start to reverse this rigid way of thinking? Well the first step is always awareness. Often times perfectionists use what is called in CBT “black and white thinking.” This is the idea that the perfectionist is thinking of things in terms of black or white, ignoring all the “gray area” in-between. An example might be – “I screwed up and ate a handful of M&M’s, so I might as well finish the bag.” The person is thinking that the choices are to not eat any M&M’s, or to eat the whole bag, ignoring the “gray area” of being able to eat anything between one handful and the whole bag. They are thinking in terms of perfect or not perfect. Try noticing if you might be using this “cognitive error.”

One way to try to better accept the “gray” between the black and white is to use a skill from DBT‘s distress tolerance skills – “radical acceptance.” This is the idea that you have no power to change what happened before, but you do have the power to change the future. By identifying and naming what is going on, we can  make a plan of attack of how to change it. Say you have a family member who is difficult to get along with, and you struggle to handle they way they are, although they are not likely to ever change. You might choose to accept that they are as they are, and choose to respond in a way that feels good to you. This lessens expectations that they should be perfect.

Maybe you are a perfectionism when it comes to your personal standards – you feel that you should always look or act perfectly. You might do some introspection – what led you to this line of thinking? Do you have a parent that is a perfectionist that may have passed along some of their trait? Do you feel like others in your life have impossibly high standards for you? You might try to do some work around trying to “radically accept” your own unique traits or challenges. Try to be a good friend to yourself by being compassionate and forgiving. You might try to incorporate some more Positive Self-Talk into your life and/or seek out some therapy as an additional support.

One sneaky way that perfectionism creeps into some people’s life is through what I call “passive perfectionism,” or avoiding doing something because you fear not doing it the “right way” or perfectly. This leads to procrastination, which increases stress, and can increase pressure to do things perfectly when you finally get around to doing it, if you do it at all. This can also be related to perfectionists

stopping creative hobbies (i.e. drawing, painting, writing, etc.) because they aren’t “good enough,” even if they never intend to share the products of their art with anyone.

In what ways can you create more appropriate expectations in your life? Can you start to let control go of needing perfection and start being able to accept things as they are? Once you do, you can stopping living in the black and white, and start living in the gray, or as my clients like to call it, the “sparkly rainbow.” Sparkle on my friends.

 

Mindfulness

Mindfulness has become something of a buzzword lately. Although simple at face value – mindfulness is the act of paying attention to the moment in the moment – it is a complex idea to put into action. The problem many of us face is that we are so accustomed to multi-tasking, numbing, and doing things that take our mind out of the moment, that it seems like a huge battle to try to change that. And why is it important? For the long explanation, see this video. Actually paying attention to one thing at a time in the moment that you are doing it can really change the way you think.

In what ways is multitasking built into your life? Do you have a cell phone bothering you while you are working? Is your smart watch buzzing while you are trying to have an in-person conversation? It feels that the more technology becomes a part of our daily reality, the easier it is to multitask. But the problem with multitasking is that by splitting your attention amongst various tasks, you don’t get to give your full attention to anything, and so all the tasks suffer. Are there ways in which you can cut multitasking out of your life?

In our pop-a-pill culture where we are so intensely medicated by both medical professionals and through legal and illicit drug use that is has become the norm to just numb through difficult emotions or pain instead of figuring out how to cope with them. One drug we don’t talk about as much is food – people who compulsively overeat often turn to food when they are not hungry, but rather to numb them from their negative emotions. This provides a temporary fix until the guilt sets in about overeating, and can be especially difficult, as you can’t cut food out of your life like you can with drugs. Seeking therapy can be one way to unload all of the emotions that you might have been “stuffing down” or “numbing” over time so that you can release the pressure that builds.

Sometimes people are driven not to be mindful, because when they are quiet and alone, thoughts related to depression (that usually brings unhappy memories from the past), and anxiety (which usually makes us worry about the future) or other mental health concerns. If you find it is difficult to be alone with your thoughts, then it is time to find someone safe to share them with. You might start with a friend or family member, but may find someone outside your social life, such as a therapist, helpful with this. If you have any thoughts of harming yourself or others, please seek help immediately by contacting emergency services/911 or a local crisis resource.

Part of mindfulness is being in your body in the moment. For some people, this may be somewhat of a foreign concept. We, especially as women, tend to take a position of desiring to change our bodies, never accepting them as they are, the only body we will ever have. By getting back “in” your body and getting in touch with its signals and feelings, often acceptance starts to build, and the body becomes reintegrated with the mind, which are really two halves of our whole selves. To start, you might try a body scan. This involves sitting quietly in a comfortable spot with your eyes closed, focusing on relaxing different parts of your body. This falls into the category of “guided meditation,” and can be a great way to get started with mindfulness. Try a search on YouTube or download an app – Calm and Simple Habit are some of my favorites.

If you’ve already explored some meditation, and thought “I’m no good at this,” or “I just can’t sit quietly for that long,” consider that your mindfulness skills are like a muscle to be built up over time. In the video above, Ron Siegel describes your mind as a puppy that you need to be patient with and train by being patient and bringing it back to the task at hand each time it strays. He also describes trying to think of your thoughts as clouds in the sky, just letting them float on by without getting stuck on them or judging your thoughts. During guided meditations, such as the one linked above, it can be easier to keep your mind on task, because there is a voice to focus on and to go back to. After a while you may prefer “open meditation” or just sitting quietly without any guidance, usually for a set period of time.

Once you start to be in touch with your body, you will start to realize what an amazing machine it is – it is smart enough to tell you when it is hungry, what it is hungry for, when it is full, and when it is tired or in pain. If we can listen to these signals and respond appropriately, our bodies have the opportunity to find balance and calm. For more information about how to find peace with eating through honoring your body’s signals, check out intuitive eating.  If you struggle to be able to identify when you are hungry and when you are full, or feel that you eat for reasons other than being hungry, you may consider seeking out an eating disorder assessment. Work with an eating-disorder-informed therapist and/or dietitian may be helpful in reestablishing those cues.

Challenge yourself to integrate mindfulness into your life one bit at a time – such as setting an alarm to do a 5-minute meditation during your break at work, or finding a meditation that helps you fall asleep. See what sort of calm and peace you can bring to your life by being mindful in this moment, using all your senses, and observing all that is going on inside and outside of you without judgment. Be your body’s own best friend and figure out how to receive all the communication it is sending you, and how to take care of yourself best.

Goal setting

So many of us have lofty goals that we hope to achieve some day in the future, but may struggle with how to get there. Large goals can seem overwhelming, and it can be hard to know where to start.

From my frame as a therapist, I would approach this from sort of a “treatment plan” perspective. A treatment plan is a set of specialized goals, objectives and interventions with a set time frame for re-evaluation. This means that a larger goal is stated, and broken down into smaller goals, or objectives, that lead up to a goal. An intervention is the action taken to move towards your goal. If planning and organization are helpful to your mental health, this can be a really concrete way of setting your course.

For example – say your goal is to get a job in a field that is new to you. While this sounds simple, it is not an action that can be taken in one step. You might break down the actions needed to get to your big goal. Objectives might be to re-do your resume, talk with those already in the field, and to search and apply for positions. Within each of those objectives, there are many smaller goals that can be underneath each. For example, to re-do your resume you may need to write a draft, have it edited, and then finalize a copy. You may write out your goals and objectives in a way that flows from the first action you take to the final one. You may also choose to set goals as far as when you would like to complete each task. Then, you would decide what sort of interventions would help you achieve each objective or part of an objective. An example would be that, to have your resume edited, you may need to reach out to someone willing to lend you some time and expertise. You may set an end date of when you would like to re-evaluate your plan.

Maybe after three months or so, you could check to see – what objectives have you completed? What objectives were you unsuccessful at completing or did you not get to yet? Then you can update your plan to reflect what goals you are working on now. You might need to re-evaluate some objectives – sometimes objectives you don’t complete are objectives that just aren’t right for you, and they need to be re-written or scrapped altogether.

Another aspect of change and goal setting for many is a sense of accountability. I’m sure each of us can think of a time when we had a great plan in place, but it just faded away because there was no one there to keep us on track. If this feels familiar to you, you might want to find a friend or family member who is also looking to make positive change in their life, and see if they want to be an accountability partner with you. Perhaps you meet for coffee every month to check in, or just have a phone call now and then to see how goals are going.

I do not recommend doing weight loss challenges. I feel that they encourage disordered eating and negative body image, and also push others to further compare their bodies with others, with can be very troublesome. If you would like to change your eating behaviors, I would recommend moving towards variety, balance and moderation, and just comparing yourself to your own progress.

In our clinic we would say “Stay on your own place mat,” because comparing yourself to others isn’t fair. You don’t have their body, their food preferences, their family, their job or their life. You do what works for you, and that is all you can do. Please read my article on Relationships with food for more reflections from working with clients with eating disorders.

Making changes in our lives can feel daunting and difficult to approach. However, if we break down big goals into more “digestible bites” then it seems much more doable. It is never too late to to follow your authentic self and have the life you dreamed of.

What is a disorder and how do I know if I have one?

people-office-group-team.jpgA large part of my professional career has been doing assessments. As part of this process, I always encounter clients who are of two minds – they are convinced enough that they need help to schedule an assessment, but who think that they really aren’t sick enough to need serious help. How does one know if they need help?

As a clinician, a set of symptoms becomes a disorder when it is significantly impacting the functioning of one’s life. When you think back about the course of an average day, what percentage of your day is impacted by your symptoms? What areas of your life are significantly impacted by your symptoms? Often times people end up coming for assessments when they feel out of control, and unable to contain the effects of their symptoms anymore.

Mental health is unique in this respect. If someone was diagnosed with a serious medical condition, such as cancer, there would likely be little to no consideration made about following the suggested treatment of the physician, whether or not it impacted our lives otherwise. When it comes to mental health diagnoses, however, the attitude tends to be much different. People feel the stigma of the label, and don’t always want to share with others the burdens they bear. They also struggle to consider taking time off from work or family commitments, minimizing the need for the intervention that drove them to assessment in the first place. So many struggle alone, feeling ashamed that they cannot pull themselves up by their bootstraps, as they have been told they should.

My general advice is to follow your gut and be your own best advocate. Start with your primary care doctor, they can usually point you in the right direction of what help would be best. Another resource that can be used is your insurance company. They have staff that can find resources within your insurance network so that it can have the least financial impact.

Someone once told me that the hardest part of running is putting on your shoes. It takes great courage to admit that you need help. Reach out and get the help that you need, and that you deserve.