St. Louis CBT for Anxiety in Perfectionists.
When you’re an anxious perfectionist and looking for counseling, you may be wondering what type of therapy would be most helpful for you.
And there are a ton of different therapeutic interventions - but one of our favorites to incorporate is Cognitive-Behavioral Therapy, or CBT. CBT is all about the impact of your thoughts, feelings, and behaviors on you as an individual.
What is the cognitive triangle?
One of the foundations of CBT is the cognitive triangle. (You can find a free worksheet for this over on my coaching website, kelseytorgersondunn.com). The cognitive triangle is a visual representation of thoughts, feelings, and behaviors.
To quote myself, from my book When Anxiety Makes You Angry:
“CBT is all about the interactions between what you’re telling yourself and how you’re reacting.
It has a ton of research behind it and is proven to be effective at reducing those overwhelming moments of anger and anxiety. There are three important components that we explore in CBT:
Thoughts:
The voice inside your head. Some people are always aware of their thoughts, and some aren’t. Both are ok!
Not always 100% accurate.
Neither good nor bad. Thoughts just exist.
Feelings:
Your emotional experience.
Always valid, even if someone says you shouldn’t be feeling that way.
Heightened emotions make it harder to keep a clear head.
Behaviors:
Your physical actions and reactions.
Examples: Hitting, kicking, punching; or, avoiding, talking quietly, getting away from the situation. Your behaviors can be big or small.
FYI, all behaviors have consequences, both positive and negative. What you choose to do influences the world around you.
These thoughts, feelings, and behaviors all impact one another.
There’s a relationship between them. This relationship provides a really helpful framework for figuring out what’s going on with you and why. Obviously, when you’re in the middle of a really overwhelming experience, it’s pretty difficult to take a step back in the moment and ask yourself, ‘Hmm, I wonder what thought is going on in my head right now.’ I’d love for you to get to that point, eventually! But for right now, let’s use these three components to explore what’s happening, why, and what you can change.” (Learn more about the book at New Harbinger.com).
Anxious Perfectionism, Therapy for Teens, and the Cognitive Triangle
When you’re an anxious perfectionist, a lot of the thoughts swirling in your head are about your performance. Thoughts like, “If I get less than a B, then I’m on the road to flunking this class,” or, “If I don’t get the lead in the school play, what’s the point of even trying anymore?”
You may also notice thoughts about how your performance is tied to your self-worth, like, “Not only did I get a B, I’m a bad student, and a failure.” Or, “I didn’t get 1st chair for trombone, I’m worthless.”
Or, oftentimes with perfectionists, your appearance is also closely impacted by your thoughts, like, “I don’t like how I look, I’m breaking out… I’m a disgusting human being.”
None of these sound great, huh? But they all probably sound familiar.
Feelings
Let’s look at what feelings these thoughts could bring up. Feelings of depression, anxiety, worry, fear, or even anger are all common.
Behaviors
So you’re telling yourself you’re bad student, you’re feeling really worried and yucky and worthless, what kinds of actions or behaviors are you going to be doing?
Often with perfectionists, I find three common responses, all tied to fight/flight/freeze.
Fight: You tell yourself your terrible, then you snap at your mom or your dad or your little brother with the very next annoying thing they do. Then. you feel ultra guilty about THAT.
Flight: You throw yourself so hard into your work… so you’ll never have to feel this way again! Just kidding, you know it’s going to happen with the next perceived failure. It’s a vicious cycle.
Freeze: You just shut down, give up, and try and take a nap for the rest of the night. What’s the point of trying anymore anyway?
But these fight/flight/freeze responses, while understandable, are not super helpful. Here’s what we’d learn in therapy for perfectionism instead:
Perfectionism Mindset: how to deal with your overwhelming thoughts:
Rather than “I’m a failure” or “I stink,” what’s something more helpful you can tell yourself. Maybe a B isn’t actually a failing grade, right? Maybe you know you can enjoy being part of the ensemble instead of the lead. Maybe this perceived failure actually just makes you stronger in the long term, right?
Notice what those kinds of thoughts could lead to, emotionally. Maybe you still don’t love what happened, but you feel more calmed.
Perfectionism and Anxious Feelings: how to deal with overwhelming emotions:
We can also focus on the behavioral and emotional points of the cognitive triangle, by building in relaxation strategies. What’s neat is, even if you’re unable to think of calming cognitive reframes, you can still cool down your emotional level through coping skills. And that calmer body and brain will allow you to access calmer thoughts with a better perspective.
So, try using a muscle, meditation, or mindfulness exercise (we’ve got a massive relaxation resource list here). Even something as simple as slowly breathing in through your nose and out through your mouth a few times, or tensing all of your muscles and then shaking them out to relax them, or turning on a youtube video with meditation music and closing your eyes for a few beats to really focus on the sound. Give your perfectionism some time to ebb back, and release the stress building up in your body.
Therapy for perfectionism in St. Louis
This is a good starting point, but if you’re noticing perfectionism come up for you more and more and get in your way, more and more, you’re probably ready for some more i depth help.
Our anxiety counselors specialize in working with anxiety, anger, and overwhelm. We teach you strategies to help you get in charge of your anxious perfectionism, rather than your perfectionism being in charge of you.
It can feel really vulnerable to talk to someone about your overwhelm, especially when it seems like it’s kind of not so perfect to need help. But the thing is, basically everyone would benefit from therapy. And having the tools you need to manage your perfectionism, stay calm, and get through challenges with a clear head is going to help you be a better, more successful student and adult in the future, too.
Kelsey Torgerson Dunn is the author of When Anxiety Makes You Angry
She specializes in anxiety therapy for teens and college students, and offers mindset coaching to perfectionist adults.
Compassionate Counseling St. Louis specializes in anxiety therapy for teens, kids, and college students, along with partnering with parents through parent coaching - basically therapy for parents here in St. Louis. We’re located in Clayton and work with clients throughout the St. Louis region. To schedule a free phone consultation, please use our contact page.
