Depression

Why Be Perfect When You Can Be Good Enough?

I recently read a fascinating book on creativity:  Imagination in Action, by Shaun McNiff (Shambhala Publications, 2015).  While the book has much to offer in the way of developing one’s creativity and therapeutic value of making art, McNiff noted that perfectionism is often one of the blocks to fulfilling creative potential.  He then went on to offer an insight that resonated with me:  pessimism is "a close cousin" to perfectionism (p.191).  Although it’s not a new idea, the relationship between perfectionism and pessimism is a fascinating and important one. 

Perfectionism manifests in many ways:  reaching for the perfect body, the perfect relationship, having the perfect career, completing job tasks perfectly, acing the test, creating the "perfect life".  The fantasy of perfection includes notions about a carefree life of ease which will last forever.  Of course, such ease is fleeting, and when life intervenes and things change, you're back to pursuing a new goal that will be more perfect than the last.  Reaching for perfection usually creates stress, especially when success is equated with perfection and you cannot be satisfied with any other outcome.  It can be exhausting--just ask any perfectionist.  

However, perfectionism doesn’t have to be bad.  Some psychologists differentiate between adaptive perfectionists—those people who can accept small flaws or mistakes while continuing to see their overall efforts as successful—and maladaptive perfectionists—those people who are overly critical when they make mistakes, are excessively concerned with the expectations and achievements of others, and are critical of the overall quality of their efforts.  As you might expect, the line between adaptive and maladaptive perfectionism is usually blurry.

Significantly, perfectionism is a often strategy of avoidance:  the perfectionist constantly strives for what ‘could be’ while often dismissing what is.  Ironically, perfectionists demands total commitment, total engagement in order to achieve a very specific, but usually elusive, ill-defined and sometimes irrational goal.  Moreover, the standards of “perfection” are ever-evolving, which, on another level, underscores the truth that perfection is socially constructed and doesn’t exist outside the human mind.  

Perfectionism is ultimately driven by fear:  fear of making a mistake; fear of failure; fear of being humiliated.

Many clients I see talk about their struggles with perfectionism, the belief that “I must be perfect in order to feel good about myself, to be accepted, to belong, to be loved.”  And often at the core of perfectionism is the painful belief that “I am inadequate; I am flawed.”  Striving to be perfect, then, protects you from that negative belief:  “if I’m perfect, no one will see how flawed I really am.”  The trouble is this: failure to achieve that elusive standard of perfection—and being seen as flawed—is catastrophic in the mind of the perfectionist, leading to self-denigrating thoughts,  withdrawal and hopelessness—a sure recipe for depression.

So, the very heart of perfectionism is pessimistic:  “Reality is not good enough, I’m not good enough.”  And because perfection is impossible and accepted notions of perfection change, pursuing perfection cab eventually lead to becomes to another pessimistic thought: “why bother? I’ll just fail again.”  

Having aspirations to grow and achieve is healthy.  Striving to achieve perfection—holding yourself to impossibly high expectations while being highly self-critical and unforgiving—is not. 

As a recovering perfectionist myself, I’ve learned to embrace being ‘good enough’:  you do your best, acknowledge when your efforts miss the mark, and try to improve the next time.  It’s also helpful to let go of trying to control for a very specific outcome.  Similarly, it’s helpful to distinguish between having aspirations and striving for perfection.  In short, be gentle with yourself. 

When you’re good enough, you give your best effort and are mindful of several thoughts:

·       Perfect according to who?  Whose voice speaks when you tell yourself you MUST be perfect?  Chances are you’ve learned about being perfect from someone.  No one is born with ideas about being perfect. 

·       Perfect does not exist.  Perfection is an idea, not a reality. 

·       Everyone makes mistakes.  It is part of being human.  When you accept your mistakes, you accept your humanity.  Learn to forgive your mistakes and move on.

·       When you make a mistake, look at it as an opportunity to learn and improve. In 12-step meetings, you often hear the slogan “progress, not perfection.”  Wise people remember and practice this.

·       What would you say to a friend who berates herself about her failures?  Practice using the same language on yourself.

·       Keep the bigger picture in mind.  Perfection tends to narrow your focus.  Broadening your perspective can help you discern the line between having aspirations and being perfect.

·       When you meet a high standard of achievement, celebrate it. And then move on.

Be patient with yourself.  It took time to develop the maladaptive perfectionist mindset, and it will take time to learn a more adaptive one.  Therapy can help.

The Landscape of Depression

All the signs were there: pervasive feelings of sadness, inability to eat, insomnia, the sense that he was in a rut and could not break out of it, chronic pessimism, perceptions that he could not solve his problems, the belief that he would always come up “short”. In a word, he was depressed—although initially he bristled at the word “depression.” As he put it, “I don’t think of myself as depressed. I’m just going through a hard time right now.” However, as the session progressed he revealed that he had been feeling this way for months. In fact, he told me that he could not recall a time when he felt otherwise. Although he admitted to feeling depressed for a long time, the event that brought him into therapy centered on receiving a critical performance evaluation. The evaluation triggered a cascade of feelings and thoughts; he wanted to “re-evaluate my whole life” and felt overwhelmed by alternating feelings of sadness, helplessness, and anger.

Depression is most typically associated with a mood—usually sadness, feelings of helplessness and hopelessness. However, other feelings can be present in depression—feelings that, to an onlooker, do not look at all like depression: early in my training I worked with a man who was constantly agitated, irritable, and angry. I recall being surprised when my supervisor remarked that the client had an agitated depression; he certainly did not look depressed to me. However, I began to understand how complex depression really is when I hospitalized him after he became violently suicidal. Indeed, depression is an insidious illness.

Depression often has a particular texture: heaviness, lethargy, lack of energy. Sometimes, the sensations of depression are acutely painful. (This was especially true of the client I hospitalized: after he was stabilized and released from the hospital, he insightfully told me that he had been fighting the feeling of lethargy for quite some time; his agitation and anger had kept him from falling into the "abyss".) The novelist William Styron wrote of “the slowed down responses, near paralysis, psychic energy throttled back close to zero. Ultimately, the body is affected and feels sapped, drained… depression takes on the quality of physical pain” (from Darkness Visible, 1992). The pain of major depression can become so acute that thoughts of self-harm or even suicide arise. Although the client I described at the beginning of this essay did not report physical pain or suicidal thoughts, he reported a persistent feeling of fatigue, of “being weighted down.” (In Bi-polar disorder, the sensation of lethargy and heaviness alternates with the sensation of manic energy and a kind of pressure to discharge that energy.)

It’s been my experience, though, that a hallmark of depression centers on a particular pattern of thinking. The depressed person’s thoughts are distorted: life events are negatively personalized (e.g., “this would only happen to me” or “she didn’t answer my call; she must be mad at me”); perceived in stark, absolute terms (“only bad things ever happen to me” or “I can’t do anything right” or “I’m worthless”). The negative is accentuated while the positive is filtered out or minimized (“the glass is half empty”). As these distortions take hold, the depressed person loses a sense of communal context and tends to become isolated; the world narrows as the depressed person loses interest in people and activities that previously gave enjoyment or fulfillment.

At the core of these distorted thoughts (made worse, of course, by the physical sensations that can also manifest) are beliefs that are central to depression. Like the distorted thoughts, these belief are distorted and tend to center on self-efficacy, the sense of not having mastered or being able to meet and master life’s challenges, and one’s sense of relatedness: “I can’t do anything right. I am inadequate. I am incompetent. I am unlovable. I will always be this way, and I will always be alone.”

The landscape of depression is different for each person. Likewise, treatment will vary from person to person. Some people may require medication to address the imbalances of their brains’ chemistry and to ameliorate their physical symptoms. It’s important to be evaluated by a psychiatrist or psychopharmacologist for medication—especially when insomnia, changes in appetite, extreme lethargy, physical pain, suicidal thoughts or thoughts of self-harm occurs.

It's important to seek help to treat depression. It's often not a matter of "pulling yourself up by your own bootstraps." Indeed in major depression, it's not physically possible to move yourself out of depression. Moreover since the landscape of depression is typified by distortions in sensation and cognition, psychotherapy is even more critical to becoming well. It often takes a trained professional to spot depression because its signs can be so subtle and insidious. But once depression has been identified, a great deal can be done to treat it. Therapy is typically directed at assessing the patterns of thinking and beliefs that manifest, challenging and correcting the distortions in thinking, and eventually getting at the root causes of the depression.

The landscape of depression is full of shadows and can be dangerous. However, just as there are pathways that lead into the landscape of depression, so too there are pathways that lead out of it. To my mind, a healing relationship is critical to finding the pathway out of depression. Indeed, whatever the specific path one takes to enter the landscape of wellness, having someone who knows and understands the path and can serve as a guide seems key. A therapist can be just that guide.