Perfectionism – Is It Pushing You Into Adrenal Overdrive?

I have a confession to make. I’m healing from the lifelong condition of being a Perfectionist. That's not subtle self-praise or a brag. It’s an admission of a problem that I have come to understand as having had a real impact on my health, my life, and my relationships. And one that I now know is also impacting millions of women.

Don’t get me wrong, I have no intention of packing up my ambition and drive and sending them walking – they’re a natural aspect of who I am. But I do I have some new takes on Perfectionism – and a happier way of living – that have been major game changers for me, and I think might be for you if you’re being dogged by a relentless sense of never quite doing – or being – enough and are struggling to find more inner peace.

Perfectionism with a ‘Capital P’

When I use the word Perfectionist, notice it’s with a capital P. As in the Persistent Painful Pressure to be Perfect. It’s the never-ending angsty feeling that you always have to do better, do more, be better, be more, prove yourself, to be fitter, smarter, or more successful – or however Perfectionism shows up for you – that’s causing you chronic internal unrest.

Perfectionism is also not the same as excellence. It keeps us from true excellence because anxiety keeps us from unleashing our Inner Wise Woman and truest, deepest, fiercest, strongest, most fun, juicy, exciting creative powers on the world. Instead we play it safe so we get that approval we’re looking for. Nor does it bring us satisfaction. Quite the contrary. We almost never feel satisfied or say to ourselves, “Job well done, woman,” even if the rest of the world is telling us that.

Here are some of the symptoms that suggest you may be struggling with Perfectionism:

  • You’re frequently or chronically stressed out or overwhelmed because of a lengthy to-do list.
  • You pretty much always feel that you could or should be doing more.
  • “Should,” while we’re at it, is an oft-repeated word in your vocabulary.
  • You frequently compare yourself to others as in “Is she accomplishing more than I am?” “Is she just fundamentally better than I am? I mean maybe even genetically?”
  • You generally feel that you haven’t accomplished enough in your life and should be further along at something – or everything.
  • You have black and white thinking – you’re either successful or you’re a failure, and your happiness and inner peace go up and down based on external validation and successes.
  • You often experience frustration at yourself for not meeting your own standards.
  • You worry a lot, or struggle with anxiety.
  • You pretty much always feel you could have “done it better.”
  • You hold yourself back from something you dream of doing because you’re afraid to fail; you have analysis paralysis – everything has to be perfect before you do it/show it/release it.
  • You’re on a perpetual quest for self-improvement (i.e. physically, emotionally, spiritually, professionally, financially).
  • You communicate with others based on your accomplishments; you feel you have to present yourself to others as perfect.
  • You have unrealistic expectations of others and get irritable, critical, or easily frustrated when others aren’t living up to your standards or expectations.

Let’s take a look at why you probably feel this way.

It’s Not Your Fault, It’s Your Default

Very early on in life I learned that being high achieving kept me safe, secure, praised, and loved. The more science fairs and spelling bees I won, the more obvious it became. By age 14, demonstrating my smarts got me out of a less-than-healthy childhood home situation and into college. Being in high achievement mode quite possibly saved my life. Seriously.

Here’s how that equation looked to my primitive brain:

Achievement = Approval/Praise/”Love”/Valued = Safety/Survival

Simple, right? Yeah, actually, it is. And since this same formula just kept on working, being in constant overdrive to achieve and accomplish became my survival default.

We all have default modes – patterns we develop early on that keep us safe, loved, fed, part of the tribe, alive, and that either drive us, or that we fall into during times of stress. They have names you’re probably familiar with like Perfectionism, Good Girlism, Helper-ism (as in helping others at the expense of your own well-being or even playing the martyr), Comedian, Peacemaker, and others.

For years, mine worked out great for me. As long as I kept accomplishing more and more, I was okay. I felt safe. And eventually accomplishment became connected to money, lack of which was one of the primal fear triggers from my childhood, so I started saying yes to, and taking on more and more. Life became all about accomplishment. Eventually, though, I had too much on my plate and though I was handling it well on the outside, I started to notice that my work was too often accompanied by anxiety and pressure. Sometimes I was working so hard that I was losing sleep, skipping a meal, or favoring a project over exercise. This also started to happen along with the age of the Internet, so I found it increasingly easy – and tempting – to compare myself to others, compounding my stress and worry.

I might have just kept going that way, and perhaps it all would have been fine. More likely though, I would, like so many women, eventually develop worsening anxiety, burnout, or other symptoms. My fate changed when I met my patient, Marni, who at age 62 was a firecracker of a woman, but now in the early stages of ‘crash and burn.’

As it had become for me, Perfectionism had been her best friend. It had gotten her out of poverty. It got her a highly successful career. It got her a great life with a happy marriage and successful kids. But Perfectionism was also an ever-present unquenchable beast always demanding more of her.

Right then and there, sitting with my patient, on the day she shared her symptoms – fatigue, trouble gaining weight, poor sleep, anxiety – and on top of it, a diagnosis of Hashimoto’s, I saw exactly what was driving her so hard and what was leading to her symptoms. She was feeding Hungry Ghosts from her past that weren’t chasing her anymore. She was so afraid of returning into the poverty that she came from, that she just couldn’t stop pushing herself. And for her, the ticket out of poverty, like for me, was high achievement.

I showed her the evidence in her life that she was already safe and successful but that her primitive brain just hadn’t registered the message. She was still living with a pattern that continued to trigger her survival mode and led to exhaustion. She looked at me, exhaled with an enormous sigh, her shoulders dropped, she teared up, and she said, “I never thought of it that way, but you’re exactly right. I’m running away from something that I overcame long ago – my brain just hasn’t realized it yet!”

I then gave her a prescription that I’ve since given to tens of thousands of women: Permission to Pause.

That night, sitting at my dining table typing up Marni’s medical recommendations, I had an epiphany – I was doing the same thing! I was feeding Hungry Ghosts that were no longer chasing me. After a lot of years in overdrive, and being in the ‘power club’ of medical training which only amplified my Perfectionist tendencies, I heard an inner voice say, “Baby girl,” (my Inner Wise Woman was clearly channeling the voice of my dear friend, Tieraona Low Dog, M.D., who calls me baby girl in the most loving big sisterly fashion), Give yourself permission to pause, too, starting now. ”

I soon after learned that in Buddhist philosophy the term Hungry Ghosts represents an addiction that, no matter how much we feed it, is never satisfied. The words I’d heard long ago in a Tracy Chapman song had a meaning far more relevant to my own than I'd realized at the time.

My patient’s symptoms and life story turned out to be a wake-up call for me. Since then I’ve made tremendous shifts in my mindset that have led not only to the satisfying work I’m now doing, but as importantly, to the much more relaxed way I’m living my life.

A Symptom of SOS

Enter the adrenals, thyroid, and the world of neuroscience. Perfectionism, I discovered from my research, is a symptom of being in Survival Overdrive Syndrome (or SOS) – a term I coined that refers to the phenomenon technically known as allostatic load – or getting “stuck in survival mode.”

Survival mode is a series of responses that begin in the part of your brain (your amygdala) that monitor your inner and outer world for any evidence of danger, and when danger is sensed, set off a cascade of chemical and neurological reactions, including the production and release of adrenaline and cortisol by your adrenal glands, to get you ready to fight or flee the danger – that’s why it’s called the fight or flight response. .

Somewhere along the trajectory of our lives, usually early on, Perfectionists got the message that achievement was connected to safety or security in the form of being loved, accepted, appreciated, seen, heard, or maybe not rejected, hit, or abused. The behaviors that protected you and helped you feel safe got wired together – and while these behaviors were initially adaptive, they can eventually become maladaptive causing us more stress than good.

Perfectionism can lead to imbalances in our cortisol production due to us being under so much stress, and can ultimately lead to anxiety, overwhelm, and fatigue from taking on too much and not sleeping enough, burnout, digestive problems, blood sugar and insulin problems, hormonal imbalances, depression, and immune system problems, including autoimmune diseases.

Further, Perfectionism can be a form of addiction but unlike more obviously harmful addictions, for example to drugs, sex, or gambling, Perfectionists get praised for ours. The more we achieve, the more opportunities, job promotions, money, and recognition we might receive. So it becomes a vicious cycle of achievement, approval, and exhaustion.

From Perfectionism to Peace

Your survival default modes aren’t a bad thing. They are the shadow side of your innate, beautiful powerful traits. It’s just that your naturally high level of inner drive and determination, curiosity, capacity to ‘multitask,’ sense of responsibility, and your intelligence got co-opted and amplified for a specific purpose – to keep you safe.

The awesome news is that due to something called neuroplasticity, which means you can literally change how your brain is physically and chemically wired, you don’t have to keep living out that old pattern if it isn’t working for you anymore. You can keep the upside of your traits while thanking the downside and kissing it goodbye. You get to give yourself permission to turn off the pressure, replenish yourself, relax, and know that you’re still safe and loved – and now you get to love yourself, too! In doing so, you’ll also start to reverse the physical symptoms that may have resulted from Perfectionism running the show.

Going from Perfectionism to inner peace is simply a matter of time, mindfulness, and practice. Here are seven simple practices I used to heal my own Perfectionism, and which still continue to help me live my live with more ease and enjoyment. And the amazing thing is that in becoming more laid back, my productivity and effectiveness have gone up, not down! Pick a couple of the practices that resonate most with you.

#1 Listen In

Rather than lean in and try to be all things to all people, I suggest listening in. I believe we all have an Inner Wise Woman that gives us information in the form of physical sensations (i.e. a tight feeling in your throat or belly, or a feeling of lightness and ease), and insightful thoughts that if we listen, reveal our deeper intuitive knowing and our desires. This can help us be more honest with ourselves about our motivations, and stay in alignment with our needs, rather than be driven willy nilly by Perfectionism. In other words, if your Inner Wise Woman is screaming “No, way,” don't’ do it, and if she’s saying “Hell yeah,” trust that and go for it. Notice feelings of overwhelm, anxiety, and distress and take these as signs you've crossed over from healthy stress and hard work into adrenal overdrive.

#2 Give Yourself Permission to Pause

High-performance athletes and business people know this and make time for recharging and rejuvenating, getting massages, hitting the spa, or getting outdoors to unwind, clear their heads, and decompress. So why do we women – and especially moms – find it so hard to make time for ourselves? Why are we riddled with guilt? Because somewhere along the line we got the idea that it’s self-indulgent to practice self care, we’ve convinced ourselves that we don’t have enough time, or most likely, both. But self-care is health care! Hitting the pause button puts us more in touch with our inner knowing, and gives us important time to replenish and rest – super important if you naturally are a high octane woman, and also important if you’re someone who needs more down time to have energy for that big world out there.

#3 Quiet Your Inner Critic

Automatic Negative Thoughts (ANTs) are like that old song, “You’re no good, you’re no good, baby, you’re no good, I’m gonna say it again…” playing over (and over) in your head. When you hear the chatter of negative self-talk telling you you’re not good enough, you have permission to interrupt with a new message! Here’s a quick trick I use: I imagine my badass best friend telling those thoughts to stick it, and then telling me something awesome about myself. Try it – it’s a super fast mindset shift that really works.

#4 Quit Comparing

When you compare, you’re defining your own self-worth in relationship to someone else, rather than honoring your own beautiful uniqueness. Comparing can lead you to feel isolated (you’re not good enough to belong), exhausted (trying to keep up or win), and judgmental (not usually a good feeling). As a perfectionist-in-recovery I am quite familiar with comparing. I conquered my habit of it in a strange way. Every time I found myself comparing myself to someone else (invariably, someone in my professional field who I felt was “running circles around me”), I’d go to their website or social media page and drop a “Like.” By giving a shout-out, I was reminding myself that there’s room for all of us, and honoring, rather than diminishing that person. In retrospect, I was also doing a “good deed” which our brains reward by dialing down the Stress Response so it was a win-win. Interestingly, over the years, I’ve learned that there really is room for us all, and we’re all needed. So comparing just wastes your precious time from bringing your gifts to the world while you’re distracted by someone else’s.

#5 Stop “Should-ing” On Yourself

Should-ing on yourself thoughts sound like this: I should be thinner, more successful, married (with two kids) by now, in better shape, healthier, own my own house, have more money in the bank, have a better job…the list goes on. In my early 20s a much older woman (I think she was at least 40) who mentored me in my midwifery career said “Honey, take the word should right out of your vocabulary. You’ll have a much happier life.” Only then did I begin to notice how often I “should-ed” on myself. Taking out the should is a tough exercise, especially if you say it as often as I did, but how we talk to ourselves really does influence how we feel. If you want to get out of the “should” pressure cooker, 86 the word completely for 3 weeks. You’ll see what I mean.

#6 Release the idea that you’re a Continual Self-Improvement Project

The “self-health movement,” always seems to be pushing us to be more spiritual, healthier, cleaner, better, and thinner, adding to the problem for so many women. Not only is it exhausting to be in a constant quest for self-improvement, it’s harmful. It keeps us in overdrive and overwhelm. We feel we’re never able to do enough, do it all, or take downtime, yet we say yes to doing more, we exercise harder, stay up later to get more done, all in compensation for feeling we’re not enough just with who we are and where we are and what we’re doing right now. Next time you ‘should on yourself’ about your yoga class, a detox, or something else you have to do or give up, ask yourself if it’s actually in your best interest, or whether it’s your perfectionist driving you!

#7 Count Your Wins

Perfectionists tend to think of all the things we didn’t get done, rather than giving ourselves credit for the things we have – small or big. To shift that, make it a practice each evening before dinner or before you go to bed to recount at least one thing you did that day that made you feel good about yourself – whether that was holding a door open for an elderly person at a grocery store, saying something kind to someone, or checking some things off of your to-do list that have been nagging at you. We all deserve praise, and who better to get it from than your own best friend (you). Plus, optimism and gratitude release hormones that counteract the Stress Response and rewire your brain so you don’t get stuck in SOS, and weirdly, there’s scientific evidence that optimism can help you to attract more wealth and success into your life.

These days I’m really proud of myself. After that appointment with Marni, I realized my Inner Wise Woman was there all along, quietly whispering to me that it’s safe to relax. I was just too busy pushing to hear her. I practiced letting myself stop pushing so hard and I stopped beating myself up for not being Perfect. I stopped wanting to be! I realized that I could live a whole new way – enjoying my creative process, which yes, is sometimes hard and requires a lot of work, but without cracking an inner whip on myself. I’ve learned to have compassion for myself and understanding of the reasons I became a Perfectionist, honoring my powerful, wild, deep survival instinct that got me here today. I welcome and embrace a softer, decidedly more feminine approach to my life along with my love of learning, writing, creating, and sometimes even being so far into the ‘zone’ that I do occasionally forget to eat or sleep. This is all me and who I am. I’ve learned to see the Universe as a safe and friendly place. And I’ve learn to let myself rest when I need to. I hope you will, too. You deserve it.

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Read or leave comments 11 Comment

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I was having this conversation with my husband last night! That I never feel settled. This speaks to me. Thank you! Going to jot these down and put them on my wall. I desperately need to PAUSE.

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Tamara Whitehead

Thank you Aviva! It's so true I really identify with this and I think more women need to read this, understand their root cause and realise its more than OK to stop and relax it's really needed.

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You write for/about women but I see a lot of this in my husband. I assume this can just as well be applied to men right?

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    Aviva Romm

    Absolutely! :)

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Christine Hatfield

Thank you Aviva, for sharing so openly. I am also female MD navigating my way through motherhood and functional medicine. Your story rang true with me - acceptance through achievement. "Should have" has been my driving force. I know full well that I have been in SOS for years, but I've been trying to maje it go away with supplements and hormone replacement. I am seeing now that I need to work on my mindset. You are very inspirational. I am living your podcast and book, and will be incorporating many of your suggestions to my own life and in the prescriptions I give my patients. I would love to connect with you on a professional level if you have the time ????

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Amy R Makurumidze

This article is so spot-on and just what I needed to read- thank you. I hope and intend to find practical ways to apply this in my daily life!

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A heart-felt "Thank you" Aviva, for all the helpful information you share. The kind & caring way you present things make you feel like you are conversing with a friend. Love your sense of humor that pops up! You have a special heart for service~we're blessed. I'm just finishing the 3rd part of your on-line course. I've leaned a lot! Again, in an easy and accessible way. Love the tiles and your book, too!

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Danielle Johnston, RN

Thank you Aviva for being a constant source of authenticity and inspiration. Your stories and knowledge empower so many women and give us permission to connect with our own inner wisdom. Seeing your emails in my inbox brings a smile to my face. Thank you for all that you do! Hugs and love:)

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Exactly the words I needed to read as I embrace this work of moving, "from perfection to peace." Thank you!

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Thank you for this article Aviva. It describes me to a T. I've always thought something just wasn't quite right and now I understand this is the reason why I constantly struggle with brought me to tears. These are going to be hard habits to break but I will try my best. Thank you so much.