Perfectionism and the Tyranny of Expectations

A growing number of media outlets have begun highlighting a concerning rise in adolescents’ and young adults’ feelings of emptiness and despair. Some articles have bemoaned the rise of “teacup kids.” Many others have pointed toward a growing suicide rate as evidence of a troubling trajectory.

This recent piece in the New York Times is a knockout, relaying the story of one young woman’s struggles with suicidal ideation, as a touchpoint to explore deeper issues of perfectionism, high expectations and the various pressures of social media. As the author notes:

Nationally, the suicide rate among 15- to 24-year-olds has increased modestly but steadily since 2007: from 9.6 deaths per 100,000 to 11.1, in 2013 (the latest year available from the Centers for Disease Control and Prevention). But a survey of college counseling centers has found that more than half their clients have severe psychological problems, an increase of 13 percent in just two years. Anxiety and depression, in that order, are now the most common mental health diagnoses among college students, according to the Center for Collegiate Mental Health at Penn State.

Many scholars have emphasized the winner-take-all culture of today’s college admissions as a precipitating factor in this trend, but it’s likely that the problem starts earlier, within families and school systems that prize achievement over fulfillment:

These observations echo those made by the psychologist Alice Miller in her seminal book for therapists, “The Drama of the Gifted Child: The Search for the True Self.” In the book, published in 1979 and translated into 30 languages, Ms. Miller documents how some especially intelligent and sensitive children can become so attuned to parents’ expectations that they do whatever it takes to fulfill those expectations — at the expense of their own feelings and needs. This can lead to emotional emptiness and isolation. “In what is described as depression and experienced as emptiness, futility, fear of impoverishment, and loneliness,” she wrote, “can usually be recognized as the tragic loss of the self in childhood.”

One of the bedrock missions of my Philadelphia psychotherapy practice is to help address the issue of pressure and its injuries, and to help performers, artists and professionals resolve the strong feelings that can result. Over the coming months, I’ll be writing more about the psychology of resentment that can bloom within “gifted” individuals, and how psychodynamic therapy can help to resolve many of the burdens that come with high expectations.

Depression Therapy: Is There an App for That?

Depression and anxiety hold us back, diminish our horizons, and in extreme cases, can end our lives. Since these are two of the most common issues in our culture, patients are constantly on the lookout for better ways to manage the overwhelming feelings they precipitate.

Conventional therapy remains the best-known treatment for depression and anxiety, of course, but now technology has begun to make some inroads. Consider MoodGYM, an online cognitive behavioral therapy program that seeks to help people manage some of the destructive thoughts associated with both disorders:

[S]tudies have found that online C.B.T. works as well as conventional face-to-face cognitive behavioral therapy – as long as there is occasional human support.

Of course that part about human support is crucial, not least because there are many dimensions of psychology that computers cannot address. Although the simplest, most standardized parts of CBT may easily be offloaded to software, the conversations that surround this work are essential for true healing.  Therapists typically supplement CBT with deeper inquiry about the emotional components of depression and anxiety – where the symptoms come from, and what underlying factors may be fueling their power.

In addition, the relationship itself between the patient and the therapist can be one of the most transformative elements of therapy, leading to lasting improvement and going beyond workbook therapy to resolve some of the deepest issues we face. Working with a warm, compassionate therapist who is trained to truly hear and understand you, in a nuanced way that an app cannot do, can help you learn to relate more effectively and authentically with the people in your life.

To learn more about how you can find relief through depression therapy and anxiety therapy, please contact a Philadelphia therapist who integrates cognitive-behavior therapy and insight-oriented therapy today.