As a psychologist working in the Sydney CBD, I see many people working in high-performance workplace cultures across various business sectors.
Nicole was one such client referred for therapy by her GP for treatment of anxiety and panic attacks. Aged 33, Nicole worked in the financial industry, where four months previously, she was promoted to a management role. For the first time in her career, Nicole had several people reporting to her and wanted her team to be among the highest performing in the organisation. She was eager to prove herself.
Nicole regularly worked nights and often at weekends as she believed she needed to go above and beyond for her career.
In addition to her daily gym sessions, Nicole was also training for a triathlon in three months.
However, things had not been going well over the past month. There had been problems with a project Nicole and her team were leading, and she was fearful she would have to tell the client she would not meet the deadline. She also felt she couldn’t tell her boss what happened as she was afraid he would judge her to be incompetent.
To try and make up for the lost time, Nicole had been working even longer hours than previously, leaving little time for anything else in her life. She was feeling highly anxious, finding it difficult to sleep, often lying awake going over in her mind conversations or problems from the day or worrying about more things going wrong.
At work, Nicole often found herself just staring at her computer screen, unable to work through the prioritised tasks on her daily long list of things to do. Instead, she spent her time on work that was neither urgent nor particularly important and constantly checked and rechecked work that went out in her name. She felt like she was drowning.
Following a difficult meeting with her boss, Nicole had her first panic attack at work. Finally, Nicole admitted to herself she was not coping and went to see her GP.
At our first session, Nicole expressed that she had found it very difficult to admit that she was struggling, telling me her issues were “first world problems, and I can’t believe I can’t sort this”. Already it was apparent that Nicole was very hard on herself.
I explained to Nicole that from what she had told me about herself, perfectionism appeared to be underlying her current difficulties, including her anxiety and panic attacks.
Nicole seemed perplexed by this. “That doesn’t sound right. So you are saying people shouldn’t have high standards?” She couldn’t imagine her life without constantly monitoring and evaluating her performance and how others perceived her and was initially resistant to the idea of loosening her standards.
Perfectionism and its constant companion, the inner critic, continually dictate requirements such as having to be or appear perfect, never making mistakes, never failing, never disappointing others and never losing control.
We then learn to base our self worth on our ability to continue pursuing and achieving these unrealistically high standards despite the negative consequences to our wellbeing and other important life goals. Perfectionism can also lead us to hold similar unrealistic expectations of others, which can place pressure on work, romantic and personal relationships.
As I pointed out to Nicole, all human behaviours have a function. Perfectionism and all the behaviours associated with it have become strategies we use to avoid negative emotions and feelings such as shame, failure, embarrassment, anxiety and rejection.
Over the subsequent therapy sessions, Nicole began to appreciate how self-critical she was and how fearful she was of making mistakes. She was clear she would never use her own internal dialogue with her team, and when asked why, she responded, “they would feel demotivated and demoralised.”
Ah ha! Understanding this and completing a list of pros and cons around holding these very high standards also helped Nicole acknowledge that being so self-critical was counterproductive and not improving the situation or her wellbeing.
We also discussed that the thoughts and feelings that turn up in our minds are not facts, and we don’t necessarily need to act on them. However, as I explained to Nicole, our inner world is what we know, and we believe what happens in our minds is real.
Learning to step back and observe our thoughts rather than getting caught up in them and fighting them takes practice. I recommended that Nicole participate in an 8-week mindfulness course to give her a good grounding in mindfulness practice, particularly as there is considerable research evidence for the benefits of mindfulness on psychological and emotional wellbeing.
In addition, Nicole also started practising challenging the life rules and unhelpful thinking patterns she had learned over her life, particularly her tendencies to see things in all or nothing terms, catastrophise and jump to conclusions.
She could also see that holding onto these inflexible ways of seeing the world helped her feel safe and in control, which was how she tried, unsuccessfully, to manage anxiety.
Nicole initially struggled to accept that her beliefs about being in control and having certainty about the future were illusions. I pointed out to her that all of us are actually in control of very little.
Our behaviours, beliefs and worries give no guarantee or certainty about how others might perceive us or what will happen in the future, no matter how much we try in our heads to prepare ourselves for all eventualities. Accepting that all we can control are our actions and the values we choose to live our life by is a simpler and more empowering way to live our lives
Nicole worked very hard initially to be the best client she could be, which we both acknowledged with gentle humour – of course she did! She did all the homework and completed the readings and courses – perfectly!
Over time though, her approach became much more balanced and self-accepting as she gained more insight and understanding. Nicole learned to accept and sit with uncomfortable thoughts and feelings until they passed and was much better at stopping herself from going down rabbit holes of worry and rumination.
Nicole now sees me around once a month for what she calls top-ups. She remains very committed to her career but has made space for other valued domains of her life, and as a result, her life feels richer and more fun
She tells me she is now much kinder to herself and doesn’t struggle so much when things go wrong, instead focusing on solving the problem and moving forward.
I asked Nicole to tell me one of the most important things she has gained from therapy, to which she replied, “the courage to be imperfect”.