Perfectionism and ADHD: Making ‘Good Enough’ Work for You | ADHD Experts Podcast with ADHD Expert Dr. Sharon Saline

Key Takeaways

  • Regardless of the type, underneath perfectionism is an effort to conceal problems or whatever the person considers to be their deficiencies
  • Perfectionism is linked with anxiety sensitivity (tendency to interpret anxious feelings as catastrophic)
  • All-or-nothing thinking increases concerns about negative responses and outcomes which intensifies perfectionism and anxiety
  • “Unreasonable standards and comparing yourself to others is common for perfectionists just as it is common for people with ADHD.”Sharon Saline
  • Perfectionism is one of the common ways people with ADHD try to control an outcome
  • Procrastination and perfectionism are related because they are both about delaying an activity
  • Common tools for decreasing procrastination:
    • Brain dump to declutter your mind and thoughts
    • Identify your priorities and deadlines (use an electronic calendar)
    • Think about what organizing systems make sense to your brain (efficacy, not perfection)
    • Break projects into smaller chunks
    • Set a strategy 
    • Pomodoro Technique (set a start and a stop time)
  • Working on interpersonal needs (precursors of perfectionism)
    • Do you need to be accepted?
    • Do you need to be cared for, to feel like you matter?
    • Addressing issues related to impostor syndrome
    • Fear of failure and shame (I’m not who people think I am)
    • These are the many facets behind perfectionism and core issues for many people with ADHD
  • Shift your focus from comparing your “inside” to other people’s “outside”
    • It may just be that they are really good at hiding their emotions
  • There are a million ways to do things
    • Instead of thinking about all of them, try just one

Intro

  • Perfectionism is a personality trait characterized by an unhealthy insistence on personal flawlessness. It’s linked to increased anxiety, shame, and low self-esteem. People with ADHD are more likely to procrastinate because they try hard to be perfect
    • Join Sharon Saline, Psy.D. (@DrSharonSaline) in exploring the roots of perfectionism, the relationship with ADHD, and anxiety. Learn how to shift to a healthier mindset
  • Stay connected with Sharon Seline via her website
    • All kinds of resources for people living with ADHD, anxiety, and more
  • Join ADDitude on Fridays for an interactive, real-time ADHD Support Group session
    • Wonderfull community of people waiting to support you

What Is Perfectionism?

  • “Perfectionism is the tendency to demand of others or oneself an extremely high or even flawless level of performance, above what is required by the situation.” (APA Dictionary of Psychology)
    • Toxic perfectionism – involves self-criticism and negative self-thought, fear of disappointment, avoidance of failure, sensitivity to feedback, incomplete goals, etc…
  • Self-directed perfectionism:
    • Irrational importance of being perfect
    • The harsh inner voice of self-abuse
    • Can establish a vulnerability to depression, anorexia, and suicide
  • Socially prescribed perfectionism:
    • Deeply connected to social anxiety
    • Belief in overly demanding social context
    • Needs to be perfect to obtain social acceptance
    • Pressure + hopelessness +helplessness
  • Other-oriented perfectionism:
    • When someone directs unrealistic standards that they hold for themselves to other people
    • Critical evaluation of others without forgiveness or empathy
    • Dangerous for intimate relationships and family dynamics
  • Regardless of the type, underneath perfectionism is an effort to conceal problems or whatever the person considers to be their deficiencies
  • Most common prominent traits of perfectionism:
    • All-or-nothing thinking
    • Negative comparison
    • Not feeling good enough
    • Living by the “shoulds”
    • Sensitivity to feedback

Perfectionism and Anxiety Disorders Go Hand-in-Hand

  • Perfectionism is a trait, anxiety is more of a “state” 
    • Anxiety disorders are problems related to fears and worries
    • They differ based on the focus of the person’s worry
    • Anxiety wants safety and security, doesn’t like uncomfortable feelings or uncertainty
    • Anxious adults often have lower self-confidence as well as peer difficulties and family conflicts
  • Anxiety is a natural human response and serves a purpose, that’s why our goal should never be to dismiss it entirely, it’s not realistic
    • Instead, learn to turn down the volume on the intensity of anxiety and make it more manageable
    • There is also a genetic component: children of anxious parents are more likely to be anxious themselves
  • Perfectionism often reflects performance anxiety
    • Anxiety sensitivity (fear of your anxiety) 
    • Perfectionism is linked with anxiety sensitivity (tendency to interpret anxious feelings as catastrophic)
    • It can fuel anxiety by creating high standards
  • Anxiety will want to protect you from stress, worry, and uncertainty preventing you from achieving your goals
    • You can’t achieve high standards because anxiety gets in your way
    • All-or-nothing thinking increases concerns about negative responses and outcomes which intensifies perfectionism and anxiety

The Relationship Between ADHD and Perfectionism

  • Perfectionists are often driven by fear of disappointment
    • They can be all-or-nothing thinkers
    • This is also true for people with ADHD
  • “Unreasonable standards and comparing yourself to others is common for perfectionists just as it is common for people with ADHD.”Sharon Saline
    • They often compare themselves critically to neurotypical peers
    • Both perfectionists and people with ADHD are sensitive to criticism 
    • Extreme emotional sensitivity – rejection sensitive dysphoria (RSD)
    • They can be easily discouraged when they can’t meet a goal
  • Perfectionism is one of the common ways people with ADHD try to control an outcome
    • Living with ADHD frequently means experiencing moments when you are aware that you are struggling or you messed up but you don’t know why and how to fix it
    • This develops into a persistent worry that leads to anxiety
  • People with ADHD and perfectionists blame themselves for things that aren’t their responsibility or their fault, and then they shame themselves for making mistakes
    • Depending on other people for validation is also something they both do, particularly those who struggle with social anxiety and procrastination

Perfectionism, ADHD, and Procrastination

  • Procrastinators are doing nothing – a common myth
    • Many procrastinators can be productive as long as they are not doing something that doesn’t interest them or takes too much effort
    • Procrastination and perfectionism are related because they are both about delaying an activity
  • The perfectionism-procrastination loop is when you want things to be a certain way so you give up or postpone doing them when you think they can’t
    • Perfectionism can be helpful; motivation by meeting deadlines, comforting order by how you do things, the importance of routine, expecting validation
    • But it can also hurt you because you can’t get started, can’t meet the idealized version of how it should be, feel like it’s never finished (indefinitely tweaking things)
  • Avoidance procrastination
    • When things seem too difficult or unpleasant, to begin with
    • Lack of confidence in your ability matched with difficulty gauging how to approach a task
  • Productive procrastination
    • Generally a delay tactic 
    • Avoiding the big task and keeping yourself busy with other things
    • It can be something that needs to be accomplished but is less urgent or important – short term relief but long term stress

Tools for Decreasing Procrastination

  • How to get around the desire to put it off if you can’t do it how you want?
  • Common tools for decreasing procrastination:
    • Brain dump to declutter your mind and thoughts
    • Identify your priorities and deadlines (use an electronic calendar)
    • Think about what organizing systems make sense to your brain (efficacy, not perfection)
    • Break projects into smaller chunks
    • Set a strategy (do you like to do small chunks first to warm up?)
  • Pomodoro Technique (set a start and a stop time)
    • Set the timer for 25 minutes
    • Work on the task
    • End work when the timer rings and take a 5-10 minute break
    • Repeat this four times and then take a 20-30 minute break
  • Saline recommends creating phrases to talk back to the procrastinator part of yourself:
    • “Yes, I can do this and I’ve succeeded in the past.”
    • “I’ve set my timers, I’ve planned my rewards.”
  • The key is to get started with something (that’s why you should do it in parts)

Tools for Decreasing Perfectionism

  • Working on interpersonal needs (precursors of perfectionism)
    • Do you need to be accepted?
    • Do you need to be cared for, to feel like you matter?
    • Addressing issues related to impostor syndrome
    • Fear of failure and shame (I’m not who people think I am)
    • These are the many facets behind perfectionism and core issues for many people with ADHD
  • Imposter syndrome is commonly associated with social anxiety
    • People think that who they really are is not going to be accepted
    • “Comparison is the thief of joy.”Theodore Roosevelt 
  • Look forwards and backward, not sideways (what other people are doing)
    • Don’t engage in “compare and despair” (a common trait of perfectionists)
    • Look at where you’ve come from and where you are going
  • “We want to move away from focusing on the unreasonable and false standards of what it means to be a good mother, or a good worker, or a good friend, that is perpetuated by popular culture and social media.”Sharon Saline
  • Ask yourself how you managed to deal with perfectionism in the past
    • “Anxiety erases memories of success.”Sharon Saline
    • Engage a friend, family member to help you recall and hold you as you attempt to notice that you are human and accepted instead of trying to meet an impossible standard

Changing Our Relationship with Worry

  • Anxiety is manipulative and wants comfort and security
    • It’s the reaction to your worries related to perfectionism, not eliminating them that makes the difference
    • You can’t close the uncertainty gap
  • Perfectionism is a signal that your coping skills are too overwhelmed in the face of a challenge
    • Slow down, pay attention, and think in a different category
  • Validate your experience instead of dismissing it
    • It’s natural to worry and feel stress when things get hard
    • “Remember that to reduce perfectionism is a recovery process, not a process of elimination.” Sharon Saline

Metacognitive Strategies

  • Building awareness (mindfulness, not necessarily meditation)
    • Your goal is to be present (mindfulness) when feeling anxious
    • Actively choosing to pay attention to something small you can do that is going to take you to your desired goals
  • Assess your goals, are they realistic? Ask someone about your concerns, get assistance to make the goals seem more possible
  • Don’t ignore your inner critic
    • Use preset phrases that you can save on your phone and access in stressful moments
  • Ask for help with prioritizing and chunking tasks
    • You don’t have to do everything on your own
    • Building awareness and being mindful also means assessing when you need help
  • Shift your focus and pay more attention to the things you do well, write them down and put them on the wall
  • Make a habit of doing a voice memo or journaling about three things that went well each day
    • It can be as little as making a great cup of coffee or nailing a presentation at work

“I Wear My Emotions on My Sleeve, Do You?” – Sharon Saline

  • Shift your focus from comparing your “inside” to other people’s “outside”
    • It may just be that they are really good at hiding their emotions
  • Learning to enjoy small achievements is a challenge for any perfectionist
    • The essence of a growth mindset – stumbling, picking yourself up, and trying again
  • Regrouping and making changes does not equal failure
    • This is what it means to be human and live on this planet
  • Be kinder to yourself when you mess up or when things haven’t turned out as you hoped they would

Gracefully Receive Feedback 

  • Receiving feedback is one of the biggest challenges for perfectionism
  • Every day someone is going to give you feedback for your words, emotions, actions, etc.
    • Try to accept what you hear with some neutrality and grace
    • Reflective listening to deflect emotional response
  • “What I heard you say is X, is there anything else?” – Sharon Saline
    • Pause before responding, acknowledge what the other person said and take some time to reflect on their feedback
  • Ask yourself the following questions:
    • Are you denying a compliment?
    • How true is what they are saying?
    • Can you make a positive change?
    • Avoid defensiveness and stop the shame spiral 
    • Ask yourself: how can this help me move forward in life?

Saying Yes to Life as It Is

  • Radical self-acceptance is the most fundamental tool
    • Refers to the ability to accept situations that are outside of our control
    • Without judging them or judging ourselves
  • Accepting life on its terms without resisting
    • Accepting who you are and being open to a growth mindset
    • This can mean confronting anxiety about not getting something right

Haunted by Past Failures

  • The best quote comes from one of the participants of the webinar:
    • “I feel like my procrastination is based on past failures and not wanting to experience that again, which then guarantees failure.”
  • The challenge is to look at past failures with perspective:: 
    • What was going on at that moment for you? 
    • What was the environment?
    • All of these things affect how you are going to take risks
    • Start with a small step to build confidence and create a new narrative for yourself
    • You can’t live life without taking risks

Analysis Paralysis – Is There Always a Better Way?

  • There are a million ways to do things
    • Instead of thinking about all of them, just try one
  • If you take a path and get stuck, you might try something else
    • Narrow the field, and try one thing
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Notes By Dario

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