So you're a self-identified perfectionist. You've read about perfectly hidden depression (PHD) and you identify with it. You've taken the questionnaire and scored fairly high. You've either contacted a therapist or you've decided to take the bull by the horns and begin to risk some changes yourself.
What could you discover that might feel overwhelming? What are potential stumbling blocks to commitment you might encounter along the way? What might act to drown out the voice of your silent despair and loneliness because of the fear of change?
Here are six situations that might make you quit the work—or perhaps, never begin. Most of them are unique to the perfectionist. Others are more about the challenges of change in and of itself.
Your commitment must be perfect... if it's not, you shame yourself.
You pride yourself on getting work done. If you've set something as a goal or a task you want to complete, you need assurance of your success. But if and when that goal isn't easy to attain, you're uncomfortable. You should be able to do it - no problem.
I've had perfectionistic patients who are lonely and suffering tremendously and who become extremely impatient with the time it takes for actual change. After only a few weeks, they're expecting themselves to alter engrained patterns of hiding that have taken years to develop and, suddenly, be able to be vulnerable and open.
It doesn't happen overnight.
What you may be forgetting is your perfectionistic behaviors have kept your life orderly, highly productive, and, at least from others' perspectives, quite giving of yourself. Let's say you decide you want to take more time for self-care, so you'll get a massage every month. You book it and enjoy it the first month. The second? Well, that's the week your boss is going on vacation—or the kids are home from summer camp—or your best friend is having a mastectomy. So you don't do it. A very familiar shameful voice creeps in. "You see, you can't do this. It's just not you. Forget it." The third month rolls around and your perfectionistic voice says, "Well, that didn't work. It's simply not do-able."
And the work stops because even adequate self-care didn't come easily.
You have to accept that this may be the hardest work of your life. And you'll do it imperfectly.
You begin with a goal that's too hard.
Practice makes perfect. Yet you may choose a goal for yourself and greatly discount how difficult it's going to be to alter your thinking or behavior. If, for example, the goal you've chosen first is to open up more to your friends, or at least to one other person. But you can't think of anyone that you might trust. Accepting that is a far better response than hating that fact or wasting energy trying for weeks to come up with someone.
Choose a goal that's truly do-able—that won't challenge you too much initially. (And again, that's not in your nature to choose simplicity.) Don't wear makeup to the grocery store. Take a nap. Go to a movie instead of being productive. It doesn't matter where you begin—it matters that you begin. And celebrate the achievement of that beginning.
How many times has someone come in and begun the session with these words, "Well, it's not much but...". I stop them right there. Yes, it is "much." It's a beginning. A start. And that's to be celebrated.
You don't ask for help or for what you need.
Whether you're doing this work with the guidance of a counselor or by yourself, asking for help is a challenge for you. Let's say your therapist has asked you to begin journaling about your emotions, trying to feel them as you go. You're finding that to be very difficult. You're not accustomed to revealing vulnerability, so you might avoid the topic of journaling altogether, and if she asks you how it's going, you can say, "Fine."
Or you can stumble around a bit, swallow hard, and bring the topic up yourself. You can learn to ask for help. And you take that risk.
You ask, "How exactly do I get in touch with my feelings? I can write about them, but I can't feel them." Research has shown that perfectionists can describe their feelings quite well, but actually feeling them is another matter. An experienced therapist can help you find strategies for that—whether mindfulness exercises, meditation, looking at how you're going about it, or other components that might help the feelings to surface such as maybe writing in letter form instead of free form.
Asking for help is very freeing.
As you give up the familiar, the tried and true, your stress will increase.
The very characteristics—the behaviors and beliefs—of PHD have served a purpose. They've kept you safe. They've given your life order. They've become how you know yourself and others know you.
"Jonas is simply a born leader."
"I don't know how Melanie gets everything she does done."
If you begin to allow others to take the lead, if you don't get everything done on your list for the day or week and take time for you, if you begin realizing that you've kept painful emotions at bay but they're waiting for you, then your stress level is going to increase. Positive change is stressful as well. You're not going to know quite what to feel or how to feel it. It'll be awkward and may bring out sudden emotions, like anger or fear. And the impulse to hide from or avoid those feelings will be strong.
You're giving up what you know hasn't worked long-term, but it's certainly been the short-term answer. It will take a new kind of courage to allow yourself to be vulnerable enough to truly find hope in lasting change.
Stress can increase whatever anxiety or need for control you have.
You may have actual diagnosable mental illnesses along with your perfectionism and PHD. It could be an eating disorder, obsessive-compulsive disorder, or anxiety. You could be trying to escape your depression and anxiety through the use of alcohol, sedatives, shopping too much, or other addictions. These problems can easily worsen as you begin to challenge the old system, get help, and start to feel emotions that you've been suppressing—perhaps for a lifetime. The need to escape from them can feel paramount so you stop eating, or you drink too much, or your compulsion to count things comes back.
It's important to get the support you need. Contact your treating therapist or doctor to let him or her know what's going on. Making sure, if you take medication, that it's still effective. You may need to pause your work on your PHD to deal with what can be serious consequences from some of these issues.
That's not failure. You're learning along the way. And that's self-acceptance, accepting where you are in this very moment. And working with the real you—right there.
Those around you push back against this new change.
Then there's pushback—or perhaps better stated—change-back behavior from others. Felicia, a woman who was doing this work, told her 15-year-old son, "I'm going to start taking better care of myself and stop doing so much for other people." HIs quick answer was, "Good for you, Mom. But please stay the way you are with me."
Your family and friends may support you in your change—they may even have been concerned for you. But your making serious changes in your own choices will cause their lives to change as well. And sometimes, that's not anticipated and isn't so welcome. Or you yourself struggle with the idea of anyone's life being made more difficult because of the value of the change for you. You're not accustomed at all to your own needs being considered.
Or you could be surrounded with people who don't want you to stop over-functioning. Their own lives are easier because of that. Or they have other motives that involve your being a constant workhorse. This could be your employer, your spouse, or even a friend.
Or they themselves don't know how to really be open. And it's very frightening for them to even consider these changes. I noticed when I began being much more open about my own panic disorder and other vulnerabilities, some friends welcome the change. Others? Not so much.
Talk with others about what these changes mean for both of you, compromise when necessary if the change is happening too fast, and do some couples work on how to frame your new relationship—all of these can happen. And change can be incorporated into the entire family system.
Good luck to you. This change, as difficult as it may be, is so worth it.
For a questionnaire to see where you might fall on the spectrum of PHD, click here.
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