I am Georgia Gibson, I am know for helping people deal with anxiety and perfectionism.

All you perfectionists not seeing the spelling mistake in the title?

I was gonna ask if that was a honeypot.

Me thinks she’s known for enraging perfectionists. Some kind of reverse perfectionism to cancel it out.

No, sorry I did not do that. I am only here to help for a few hours.

No sometime we don't see them. Your mind and fingers may not be as connected as we think. I have that issue at times also.

Was it an intentional trigger?

No, it was not intentional. I am sorry if trigged anyone. Only her to help.

You did it again

I sure did. I promise its not on purpose.

Hi Georgia! I am a therapist who has always had anxiety and still deals with perfectionism! I feel like I manage the anxiety pretty well now, but the perfectionism is still very challenging. Do you have any general suggestions?

There are a few things you can do, but perfection is not a goal. Setting reasonable limits would take the pressure off. As a therapist we want to do all the things so that is a place to start. Seeing a set number of clients and block time out to get notes done. Then rewarding yourself.

Is perfectionism a mental illness, a personality disorder? . . .or are you referring to OCPD? . . . Perfectionism as a personality trait at a clinical level (I thought) was ocpd? - genuinely curious where else clinical level perfectionism in the absence of OCPD, is seen, or is it a separate disorder and/or illness?

Asking for a friend. Thanks.

Perfectionism is personality disorder and it falls under Cluster " C". You are right it is considered a worried state which leads back to anxiety.

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Here is a link that explains it. I hope it helps your friend.

https://www.merckmanuals.com/professional/psychiatric-disorders/personality-disorders/overview-of-personality-disorders

Is perfectionism in the DSM?

Perfectionism is a transdiagnostic process that contributes to several different diagnoses. It is not a diagnosis by itself.

Yes you are right. No, perfectionism does not have its own DSM code but it falls up under OCD.

No it is not as a stand alone diagnosis. Some individuals would say it falls under anxiety, others would say it falls under OCD. I hope this is helpful.

Is it possible to offer guidance when my anxiety is related to everyone else, rather than myself?

In other words, with the upcoming winter, the Cost of Living crisis, and the very real possibility that literally hundreds of thousands of people, if not a few million, are going to be pushed over the line from ‘just about managing’ to literally unable to heat & eat, my fears are for those people.

Yes, anxiety is the fear of the unknown as the upcoming winter living cost crisis most people are worried or anxious. You can start by having the discussion with your family about the impact you maybe facing. Make plans on what you can do to reduce the cost. There are also local organization that offers help for those who need help. Doing some work up front is one of easiest way to help with anxiety. With all the changes in the world helping individuals in your community is helpful across the board.

Thank you for the reply, however… A few points; please forgive me if I sound frustrated or short towards you, it’s not intentional.

This anxiety isn’t related to the impact I or my family will face; it’s towards those in more vulnerable and weak positions. These are real people who I don’t know, in towns I don’t live in. Facing a winter of utter misery as they sit slowly freezing to death waiting for their single meal of the day, terrified by the unpayable bills they have received.

I can stick my fingers in my ears and shut my eyes and pretend they’re not suffering, pretend they don’t exist, but I know they are out there. I can’t help them directly, I can’t offer them tangible support. I’m just an average guy with very limited influence upon the country.

It breaks me to know that so many are going to die this winter, cold, alone, terrified.

And there’s not a single goddamn thing I can do about it.

I do understand you were not referring to yourself and family. The situation of homelessness and food insufficiency is high and during the winter months it can be very difficult. The anxiety you feel is felt by others who see the the disparities you are seeing. Some individuals look for helpful organizations so they can volunteer their time and even donate items of funds to help out others. I was seeing if that was a way you maybe able to reduce some of your symptoms. Sorry for the confusion.

I know what you mean. Switching off the news, not reading what's happening in the world can be hard but it helps with the constant negativity we get from the media. Apart from that, all we can do is help others as much as we can, show kindness and also realise that to do that- we also need to look after ourselves. We can't change the world but we can makes things better around us for a few and if everyone did that- the world would be a better place.

You're a highly empathetic person- that's a great trait

I too have to keep myself away from the news at times. I will do things like watch home repair shows, listen to music, read a good trashy novel. I love taking walks on the beach it allows me time to reconnect with myself and my feeling.

It’s interesting that she offered no advice for your actual issue. Reading compression fail. I suffer from the same kind of anxiety, not just having to do with what I’m going through, but what I see around me, the misfortune of others, the state of the world, all of that.

With the world being so difficult anxiety diagnosis has increased. We first have to care or ourselves when it come to our health and that includes mental health. Understanding were our anxiety comes from is one of the places a therapist would go to help you understand why you are feeling these emotions. Once you are armed with that information tools to address the symptoms you are feeling and it could include medication but that decisions is made between you and your medical doctor.

Have you decided that it's okay to include errors in your AMA responses?

Is that a conscious decision to avoid 'perfectionism'?

How do you believe these frequent errors impact your credibility?

No, it not I an not a great write, but that is not excuse. I'm trying to be helpful and get excited about that and my spelling goes off. I will adjust my tying speed to see if that helps.

You should have started with this comment. It really is quite funny to read.

Thanks! I should have started with this. I am laughing.

What if any connection to history of anxiety and risk of early risk heart attack?

Your mental health has a direct impact on your physical health. I believe there is a mind body connection and when one is off it affect the whole. The is a history of stomach issues with anxiety and depression. So to answer you question I am not aware but will do some research.

This is the question I want answered the most.

My anxiety attacks are severe and extreme. I already have a genetic disease which affects collagen production in my body. My biggest fear is that my 15yr history of intense anxiety attacks is going to make me predisposed to heart disease and illness as I age (33 now).

There has to be some research out there that links anxiety and heart health.

I am set there is but I have not read anything in the past few months. Here is a links to the topic. I hope it helps.

https://www.verywellhealth.com/anxiety-and-heart-disease-5202217#:~:text=Heart%20disease%20and%20anxiety%20are%20closely%20connected.%20People,develop%20an%20anxiety%20disorder%20after%20a%20heart%20attack.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/anxiety-and-heart-disease

Any advice for a child of a perfectionist parent? Parent doesn't seem aware of the impact it has. But I'm still recovering from never being good enough.

I work with adults with perfectionism, but I will link a website below that may help you with you questions for children.

Katielear.com

One thing I have notice that is diagnosis like perfectionism is not one that is discussed widely enough. I have done some research on how adult mental health affects their children. Thank you so much for being so vulnerable and sharing with us. Have a wonderful day.

Thank you so much for taking the time to respond! I appreciate it.

You are so welcome. Have a wonderful weekend.

I used to deal with a lot of (primarily) social anxiety and some perfectionism. Finally got over my fear and found a therapist. She helped me out so much. Had a lot of life changes around that time as I figured things out. And there was some other stuff like depression but ultimately she helped me get from a place I didn't like to being much better jn my own skin.

For anyone who was raised or who perceives a stigma around seeking mental health, I highly recommend it if you're struggling with something. And if the first therapist you meet doesn't feel right, it's totally fair to tell them and ask for suggestions on other therapists. When I switched therapists after 1 session with new one I told her as we ended that I didn't think her style worked for me. She was gracious and pointed me to another therapist who was a much better fit.

As for AMA. Do you see depression in patients with anxiety and desire for perfectionism often?

I do see some overlap in the diagnosis.

I know you can't diagnose online, but what are some clear signposts that you may need medication to manage your anxiety?

I would add to her response, consider meds if you are in therapy but the anxiety prevents you from engaging in the skills therapy is teaching you. Sometimes being on meds helps reduce some of the distress so with the help of a therapist you can gather new data to challenge the negative automatic thoughts anxiety throws at you, and you can prove to your anxiety "hey that wasn't so bad, see you were wrong" and eventually with enough experience you might not need the meds anymore.

Yes medication is helpful and working backwards to see what lead you to the perfectionism in the first place. Most individuals can connect it to something in their early life.

Thank you for this! I am in therapy but the changes, if any, are very slow and the past year has been challenging, to say the least. Trying to be open to all options.

For some individuals a combination of mediation and therapy works well for them. Have you spoken to your therapist about your feelings. That may help them in adjusting how they are working with you.

All or nothing thinking,

Being highly critical,

Feeling pushed by shame,

Having unrealistic standards

I’m in the middle of a truly crippling episode, feeling completely overwhelmed by my workload at school and all the associated fears of not achieving things to the best possible standard. I feel myself shutting down. Preferring to not face anything at all than tackling things one by one. I just feel so incapable. It gets so bad that I feel like punishing myself for being this way.

I’m sorry, I know this is a lot. I just saw your post and felt like I should say something because it feels very relevant to what I’m experiencing.

I guess I just want to know what the best and most realistic way is to pull myself out of this? It’s so much self-sabotage but I don’t know how to change its course. I’d appreciate any advice at all.

I am glad you felt like this was a safe place for you. It sounds very overwhelming. You can start by looking for a local therapist, if your are in college the school offers service to you for free. if not check out your state mental health office they will be able to point you in the direction of where you can go next. If that does not yield the result you want you can look for therapist on the site Psychology Today. I hope this helps.

I can second what the therapist said—accessing my Uni’s counseling services was a huge turning point for me. I also got help pretty quickly and easily. Also talk to your doctor—you may need medication in the short or long term to help you out.

Some CBT tips that have helped me personally in the meantime (what works with CBT methods is fairly individual though): -Writing out my fears can take them out of my head and make them seem more manageable -Ensure you are always challenging your negative thoughts: But what if that doesn’t happen? What if the people around me support and love me no matter what? What would I say to a friend who has this thought? -Recognize bad cycles and try to break them (not easy): We do lots of things to try to easy our anxiety. Avoidance, which is clearly affecting you, is a big one. All of these things create a bad cycle where we feel a little better in the short run but keep feeding the cycle in the long run. Write out what you are doing to self-smooth and try to come up with a plan to slowly and purposefully move away from that. For example, you can choose one thing to do each day and then push yourself to do it. -Accept that your mental health is really important and that you might need to make changes to prioritize it: sometimes we can’t get out of the hole with the same parameters/requirements as before. You may have to set new boundaries, lower your course load, ask for help from your family, or other changes. This is okay! You will find it’s always less bad than you imagine and that we can keep living and thriving without pushing ourselves to the limit all the time.

Thank you so much for this incredibly thoughtful response. I’m going to comb through all your suggestions and see what I can manage. Living in Japan as an international student (where mental health resources are close to non-existent) makes accessing mental health professionals a little more challenging. My university doesn’t have counselling services. I can get in touch with my therapist from back home remotely.

Otherwise, your CBT suggestions are all incredibly helpful. Thank you. When I struggle this much, a reminder that kind strangers are willing to take time to offer advice is of great help. ♥️

There are therapist who work overseas, but it a challenge with insurance for many. Hopefully you can get access to a great therapist to relieve some of your symptoms.

So happy you were able to get the help you needed. Help is available, but getting the right help can be very difficult for some. Thanks for listing some of the things that worked well for you. Information should be shared. Have a wonderful weekend.

Are you treating OCPD in particular? Can you discuss what it is?

No, I don't I do generalized anxiety, but your local mental health office can point you in the right direction. Psychology Today may be another resource to finding someone who does specialize with OCPD.

I have been treated for it for more than a decade with therapy and clomipramine, which has been life changing. I did not know it existed separate and different from OCD until I was diagnosed with it. Anxiety & perfectionism seems a good description of it, though clearly not a full one.

I am so glad to hear you have gotten relief. We don't often hear about the good outcomes.

hello, what are the most common causes of perfectionism and what is the most common barrier to overcoming it?

Having high standards or expectations, Feeling pressured to live up to expectations, Exaggerated negative reaction to mistakes, fears and high levels of self-doubt to name a few.

Ways to overcome is first noticing the emotions that come along with perfectionism setting realistic goals, and rewarding yourself when the task is completed. I have also made suggestion to have post it notes reminding yourself of pass accomplishments. I hope this helps.

The most common barrier to overcoming perfectionism is that you have to stop being a perfectionist. If being a perfectionist is a compulsion, and it is, well, then you have a problem.

Yes it can be. Problems have roots and if we dig to the root we can then find answers and work forward and reduce the symptoms of anxiety, OCD. The process to know yourself and showing up as the person you want can take time, but its so worth it.

How do anti anxiety meds work? What do they actually do?

It increases the activity of chemicals called neuronstansmitters to the brain. They work for some individuals really well when they are prescribe the right medication for them.

I do know of many that work, but that is a decision you will have to discuss with your physician. It may take a few tries to get the one that is best for you. With the license I hold I do prescribe medication.

I hope more than one question is ok.

1. Do you find a difference between how patients interact (level of openness, for example) in online therapy versus in-person therapy, and if so, what are the most notable impacts to treatment?
2. When starting therapy for the first time, where should a patient begin when there isn't immediate trauma or event that needs to be addressed? For example, should someone with lifelong depression/anxiety with no recent triggering event try to unpack their history/past first or what?

Thanks! These are weird questions, I know, but I am considering returning to therapy but am unsure given that I had mixed results previously.

No they are not weird questions. They are great because not everyone is familiar with how therapy works. You may have helped someone else with the same questions who was not brave enough to ask.

I provided only online therapy at this time and have notice a big uptick in the number of request for services. When individuals are at home in their personal space it likely for them to be more open. Online therapy also allows it to take place in may different locations with is good for the clients.

Someone does not have to be in active trauma to seek services. Some individuals notice a change in themselves and seek out service. Others are referred to services by physicians, work, school and family members.

I believe my 10 year old has anxiety (seems to be mostly health anxiety and a bit of perfectionism too) what are things I should watch for as warning signs that she should seek further help? Any useful tips I can pass on to her when she's in the middle of panicking about something?

I do adults but I will link a website you can check out that maybe helpful. If you have anymore questions please come back and ask.

Katielear.com

How can one help a spouse who deals with a hoarding problem? I ask because they also have anxiety.

Anxiety is a very large umbrella that covers a great deal so sub categories. If he is seeing someone for anxiety has he mentioned the hoarding? If he is not seeing someone that might be a place to start. Having a third party that is objective may help with both the hoarding and the anxiety, The therapist may help him find out why he is hoarding and the feelings that accompany the hoarding. Which could reduce his anxiety symptoms.

How do you know what a realistic expectation or goal is, especially for something you don’t have much experience in? I find myself frustrated when I don’t improve as much as I think I should at certain skills or activities.

If you are doing this alone you may need someone to talk to. It could be a therapist, counselor, coach or a trusted friend who has your best interest at heart.

You may want to take to someone who has experience in this area.

Hey Georgia!

Where do you practice? And what is the best method for referrals? Thank you!

I practice in SC, NC, WV, IN, NJ, ME and FL. You can contact me through Psychology Today. Just type in my name in the search box.

Did you purposely put a type-o in the title to identify potential clients?

No, I think faster than I type. Especially when its something I am excited about. Thanks for the heads up I will go back and fix it when I have a break. You have a wonderful day.

what are your thoughts on using cannabis to manage anxiety?

I can't give advice on whether to use it or not, but I have done some readings on it reducing the feelings of anxiety. With the laws changing in the US it may become a treatment in all 50 states.

At what point should someone seek therapy if they suspect that they have problems with anxiety and perfectionism?

Therapy is a wonderful tool for most individuals, but for those with anxiety it could be beneficial in many way. An individual can learn skills to reduce the symptoms, learn where the feeling come from and learn ways to show up different when the anxiety and perfectionism.

Is it totally wrong to think of ocd as a rebranded "anxiety+"?

I am hoping that individuals are not thinking that OCD is a rebrand for anxiety. Perfectionism falls under OCD.

What suggestions would you give to a parent who sees the anxiety and perfectionism cycle in his tween son?

We have him in counseling and on an anxiety medication. But if there is something I can do to help, I haven't been told and I struggled with it myself for decades before I started getting counseling and medication. I want to help him break the cycle.

You are doing a great job. Noticing the issues and looking for ways to help is important. I work with adults and would not want to give you inaccurate answers, so I will send you to a wonderful website. If you have more questions please come back.

Katielear.com

I work with adults, bit have a website that may help you. I hope this helps. Katielear.commmm m p oe h I .

What was the process to get your Masters like? Do you think becoming a therapist is a good career path for perfectionists?

I have always loved human behavior and wanted to be a psychologist, but found my people in social work. It allows me to do so much more than is could have as a psychologist. That is my personal preference, I love what I do and don't see me stopping anytime soon. As a perfectionist it was a great choice for me.

Not for me, but what is your recommendation for severe OCPD with perfectionism when meds and therapy don’t work? We were told the Mcclean clinic wouldn’t be able to help.

Have you or the person looked into anyone who may work well with this diagnosis in the area they are located? If not try Psychology Today and filter by state and diagnosis.

He is seeing a well known ocd specialist in ny. Nothing seems to help.

What about asking the therapist if there is something else that could be added to assistance with his current treatment plan.

I have long questions I know, and I bet you are shaking your head. I get it. But please hear me out and please have mercy on me & try to answer to the best of your ability. I would be more grateful than you know!

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1. Have you heard of the vagus nerve stimulator for people who have treatment resistant depression? I have it by the way.
2. I feel like I need such specialized care because I have so many complex issues but I don't have most of the resources for it. Extreme trauma for being abused growing up, BPD, issues with failing in the University because I mentally check out when I'm doing badly, extreme grief, loneliness, c- PTSD, suicidal feelings almost 100% of the time, and the list goes on and on. I feel like I need intense twice a week therapy and different types of therapy like EMDR Therapy, talk therapy, etc. DBT didn't work for me, but I wasn't able to stick with it because insurance did not pay. I know you can't diagnose, but what types of therapies if I was able to do them all, would you recommend? Can you recommend at least some of them? And do you agree with me about tackling it very intensely. I've been battling these things for soooo long and the vagus nerve thing proves I'm willing to do anything.
   
3. I read a lot of self help and even psychology/healing books at home, I try to stay on a decent routine, I meditate, and I journal almost every day. Do you have any other "poor man/woman's" ways to help with these intense problems at home without therapy. I do watch a lot of youtube videos too, and btw, every condition I said was a formal diagnosis.

I'm so embarrassed that I'm putting all of this out on here, but I am working SO hard to get better and I'm looking for resources pretty much everyday. If I can get something out of this, it would just be the best thing ever!

You are very brave, does your college offer mental health services? The reason I am asking is because it is free. They are also a good referral source for the kinds of treatment you may need. You can also check with your local mental health department they offer a sliding scale and referrals to local therapist. Some therapist also do pro bono work as a way to give back. It will take some work on your end to and I know it just feels like too much. If you have done these things let me know.

I have done all those things and currently I'm not in school. I was and lived on campus and everything. (This was a long time ago) but when things get really bad, and things are bad pretty much all the time, I just shut down. Some people can hyper-focus when they are upset, but I'm the complete opposite. Right now I work a dead end job and I WANT to go to school, but I need to heal first so I don't fail again.

This might be a graphic thing to say, but I think it makes sense. here me out with this euphemism/comparison please. I see my extreme trauma & issues like a massive/won't go away, boil or under-the-skin painful cyst. Reading books, educating myself, small town therapy when insurance would pay, etc. don't HURT anything. It's like using a generic cleanser on the boil. But does it help? Does it make much of a difference? No way! Not even close! The only way since it's gotten this bad, (in my opinion) using the boil/cyst thing to symbolize, is to have a professional go in, cut in deeply and take out all the infection, pus, bad stuff. It's gruesome, gross, takes time, and a little painful, but necessary! And the specialist needs to remove the gross cystic sack (root/cause/etc. of trauma) take it out and kill it because if the cystic sack is not removed, it WILL grow back.

Once all the gruesome, hard work and heavy stuff is over, then I can do lighter things like add products and self care to make sure my skin never gets that bad again. The "lighter things" and "products" refer to tele-health type therapy or regular therapy that most people get once the issue is gone and it can be controlled. Does my symbolism and my euphemism make sense?

By the way, I appreciate it so much that you are communicating with me and are willing to talk about this in your reply!

This makes sense to me. You have to get to the root of the problem and without the right access to therapy is difficult. Please don't give up the thing that will help will come your way.

I have periods(months) of anxeity and periods without them. I am not sure if it has to do with perfectionism but i am a tech entrepreneur and write software with huge code bases.

I have been thinking that is what has been causing my anxeity, as i work in 3 different projects each with 10-50k lines of code and sometimes i am the only one who remembers it all and if i have switch projects then it causes more problems.

Do you think that might be what is causing my anxeity?

I feel better after taking clonazpam but i feel sometimes it slows my brain down. I still choose it over not being able to sleep the entire night or wanting to hide under the table.

It could be, but there is so much going on around us that we don't know is affecting how we feel. Work is always a big one along with family and finances.

If you work from home that really affects our mental health. You may need to go and see someone just to process your feelings.

Your proof is blury. What accreditation do you have?

LISW-CP, LCSW

Licensed Independent Social Worker in Clinical Practice

Licensed Clinical Social Worker

.. does that mean one of those pieces of paper is a masters degree?

Those are my license I have a masters in Social Work. The licenses dedicate what kind of services I can offer. I hope this helps.

Whats your take on the over prescribing of Adhd, Anxiety, and Anti-depressant medication?

Do you believe that Doctors use medical dependency to ensure steady income streams?

How do pharmaceutical companies promote their drugs?

Thank you for asking these questions. I am not licensed to prescribe medication, but I do know in some cases of they are necessary. So individual only need the medication for sever cases, others only time them for a limited period of time. The there are those who need it for long periods of time. I would like to believe that doctors are not using medical dependency to ensure steady income streams, but if I am honest I know it happens. Pharmaceutical companies use ads on television, social media and pharmaceutical reps who target doctor's offices. I am sure there are other ways but those are the one I can remember now.

Have you ever done DMT?

I only have experience with working with ETC clients.

I don't expect an answer, but I thought I'd try. I have crippling anxiety, to the point of losing my thoughts if I'm asked a simple question. I notice small changes in people's tones and fixate on their reactions to me. I lost my family a few years ago, and I don't really have many supportive friendships. I do not live in an area with good mental health & therapy options. Are there any coping strategies that you can provide for managing anxiety?

Your local area dose not have to be you only choice for therapy or support. Most therapist are licensed in the entire state. So lets look beyond your local area, maybe the next big city. With tele-health you now have access to others you would have never been able to see. Anxiety is one of our most primitive alarm system it allow us to know when something is not right/good. We then to override it and see what will happen. I have been a person that encourages individuals to follow your gut. Once you do that you then test to see if it something that will bring you harm. From there we make an informed decision.

This is something not with me but for my wife. It is association of 8 yrs now and post her first delivery sometimes she gets furious on very small thing. She grown up in an environment where no one pointed out her mistakes, so now after when she does anything wrong and even small words of caution trigger anger mode. In 8 yrs she never accepted her mistake. This behaviour cause issues in relationship we have. Can you please suggest as what can be done in such situations?

Has she ever seen anyone for therapy, counseling or coaching? A third party person maybe able to open her eyes to some of her issues. Many couples struggle with discussing short comings of the other person.

Many of our responses in adulthood comes from our childhood. Let me start by saying there are no perfect parents or children just people who choose to show up in a different way when things are pointed out to us.

Way to own it. I can't really think of a better introduction. Can you?

That is the first thing we discuss in therapy what are you responsible for, and what can you do differently?

Thanks