The Imperfect Aspects of Perfectionism

One of the most common causes of emotional suffering is perfectionistic tendencies.

We fall for, and get mesmerized by, the sound of voices in our head that point out our vulnerabilities, convincing us that we will sustain extreme humiliation or even death if we didn’t protect our egos in a defined way. This wisdom is not particularly apparent to most of us. The mesmerizing quality of these threatening voices fool our solid self. We often don’t realize that the thought is nothing but an over-generalization, or mind reading, or fortune-telling.

In the following scenario, I have developed a hypothetical situation where a person experiences anxiety, anger and depression over the observation that they have a medical problem that makes it hard for them to work. The following sentences are those that this person might say about their circumstance:

  1. If I go to work with this migraine, I’ll make a bunch of mistakes and that’ll be super embarrassing.

  2. People might think I’m loosing my grip.

  3. Then I won’t be a candidate for that promotion.

  4. And if I don’t get promoted, it’d mean I was just being mediocre all along.

  5. And that would mean I’ve wasted all these years at school, the training and all the hard work would mean nothing.

  6. And that would mean I’m a loser, someone that is unworthy of even being alive.

Now, imagine a friend of yours has just approached you with the problems mentioned in the above scenario. This friend is quite dear to you and has come to ask for some help, wishing to feel better. The conversation between you and your friend might go something like this:

Friend: If I go to work with this migraine, I’ll make a bunch of mistakes and that’ll be super embarrassing.

You: Oh dear, well you do sound like you are in a great deal of pain and yes people aren’t usually at their best when in pain. But is there anyone at work that might understand your situation and be a little helpful? Or perhaps you could just call-in sick today, or maybe just do some basics that would not be too tedious, making it less likely to make mistakes.

Friend: But then I won’t be a candidate for that promotion.

You: Well, I suspect they make those decisions based on your overall qualifications, not just your need to mind your health one day. I see that in general you have such a high work ethic and do the job in the most amazing way. In fact, you worry about making mistakes if you went in with this migraine, which suggests your high work ethic–isn’t that what they factor in when looking to promote someone?

Friend: But if I don’t get promoted it’d mean I was just being mediocre all along.

You: Well, to my way of thinking, someone being mediocre might not really care much for the quality of work they offer, whereas your job performance has seemingly been amazing so far.

Friend: And that would mean I’ve wasted all these years at school, the training and all the hard work would mean nothing.

You: Well, yes sometimes people wake to realize that they don’t really care for their work and feel they have wasted years of training and hard work. You on the other hand seem to love this work since you put such high value into doing it to the best of your capability.

Friend: And that would mean I’m a loser, someone that is unworthy of even being alive.

You: Oh dear, I can see that being sad and disappointed over having this migraine has taken a toll on you. But all I see in front of me is a carrying and responsible worker who puts lots of heart into the work they do. To me that is quite worthwhile.

And, the kicker is, this is a Double Standard that we play against ourselves. We are so likely to speak with compassion for a friend. My question for you is: Wouldn’t you choose to offer the same level of compassion for yourself?

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Why Are Patients With Body Dysmorphic Disorder So Self-critical?

Anxiety or Eating Disorder?

Body dysmorphic disorder (BDD) is actually a type of anxiety disorder, not a type of eating disorder. The affected individual focuses on physical flaws that other people may not notice. The cause of BDD is still unknown. But most likely it results from an inborn biology plus environmental factors.

Brain studies have confirmed that brain imaging results differ between subjects diagnosed with BDD and others who have not been diagnosed with this disorder. For example, BDD individuals are more likely to report feelings of disgust or repulsed when viewing images of their own faces versus control groups. Similarly, brain-imaging studies show alterations in two areas of the brain of persons with BDD: the visual processing center in the orbitofrontal cortex, and the frontostriatal system, which affects emotional reactions and behaviors. Theses studies suggest that brains of people with BDD are processing visual information differently in their brain, and this finding might explain why their perceptions differ from those of other people.

Exposure Therapy

A good majority of persons affected by this type of anxiety disorder might mistakenly resort to restricting their caloric intake in an effort to lose weight and therefore look better (in their own eyes). Clinicians might even mistakenly look at this issue as an eating disorder. Unfortunately, no amount of weight loss, or plastic surgery, or covering the body with make up, clothes, jewelry, etc. will present relief.

Just like many other anxiety disorders, the most effective treatment is exposure therapy (read more). The idea is to desensitize the brain at the site or image or thought of the dreaded object, in this case the part(s) of the body that brings out the most disgust in the mind of the person until such time that the brain will no longer react by the same emotional intensity as it did before. It is as if we have over charged the circuitry to the point of disconnecting the relationship between emotional disgust and the site of the dreaded body part.

I am Dr. Dashtban and in my practice I treat anxiety and depressive disorders associated with medical conditions. If you have any questions regarding successful treatment of BDD, give me a call at 408-458-8222, 831-621-1150 or write to me at drdashtban@medicalpsychologyservice.com.

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