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Anxiety and Perfectionism: Case Study

Vol. XXVII, No. 3
July 2024

by A. Mechelle Haywood, Psy.D.

Sister Marnie and Father Tipton* were the first to arrive for the Monday evening anxiety support group. They exchanged nervous nods and waited for the meeting to begin. As other group members trickled in, and the room became crowded and loud, both Sister Marnie and Father Tipton found themselves sweating and becoming increasingly nervous.

Unbeknownst to each other, they were both second-guessing the decision to attend the anxiety support group. Father Tipton started rehearsing his therapist’s words in his head and thought about how helpful the group was the first two times he attended. Sister Marnie was thinking about how she would respond if asked to share and found herself worrying about what group members might think of her. She sat stiffly in the chair and waited for the group to begin.

Father Tipton, who did not like talking in group settings, and had never spoken during the support group, was determined to share at this Monday meeting. He wrote his thoughts on index cards and repeatedly practiced what he wanted to say. The group began and after several other shares, Father Tipton reluctantly participated. He started speaking and noticed he was rambling and fidgeting with his index cards. He thought to himself, This is not what I practiced. They are going to think I am silly. After a few deep breaths, he slowly started sharing his experience:

“I was 17 when my parents and a teacher first expressed concern about my tendency to study excessively, my fear of making mistakes, and my self-critical statements about anything I did. My parents encouraged me to enjoy being a teenager and my teacher suggested an extracurricular club to take a break from academics. Didn’t they understand I was focused on having the best application packet for college? I did not have time for enjoyment and leisure. I enrolled in a top university and was excelling until things came crashing down in my sophomore year of college. After a very difficult class I became consumed with fear, unable to move, feeling as if my heart was going to beat out of my chest. I gasped for breaths that simply would not come fast enough.  After hours sitting in the same place, I mustered up the strength to call my mother who helped me schedule an appointment at the campus health center. I met with a psychologist and was diagnosed with anxiety.

“I am 30 now and have worked with a therapist intermittently since my sophomore year. In therapy I learned that my desire to be perfect was unreasonable and unattainable. I realized that trying to do everything right, feelings of inadequacy, self-criticism and extreme fear of failure stemmed from perfectionism. This perfectionism controlled my life. I was often unhappy, overwhelmed, anxious and consumed with whatever task I was working on. I held incredibly high expectations for myself and others, and I avoided social situations out of fear that others would think I was inadequate. Throughout high school and college, I procrastinated on tasks out of fear that nothing I did would be good enough. My sleep was disrupted because I was either overworking or constantly thinking about what I needed to do in order to be better.”

Father Tipton slowed down and realized he was talking without referencing his index cards. He also noticed group members giving silent affirmation through smiles and head nods. He took a deep breath and exhaled a sigh of relief. It felt great to share and receive support from people who could relate to his struggles with perfectionism and anxiety.

When the group ended, Sister Marnie spoke with Father Tipton and thanked him for his openness. She shared that she was recently diagnosed with an anxiety disorder and that she struggles with perfectionism. For years she felt worthless, never good enough, and embarrassed whenever she made a mistake. She shared that when she gets feedback in community it can cause her to be very harsh with herself, causing her to shut down for days.

Father Tipton knew what Sister Marnie was experiencing, as his perfectionism also interfered with his personal and vocational life. He encouraged Sister Marnie to continue coming to the group and assured her the group was a safe place to share, learn, and ask questions. She thanked him and apprehensively agreed to come next week. Sister Marnie reflected on how difficult it had become managing her anxiety and perfectionistic traits and felt somewhat relieved and hopeful that there was another option.

Dr. A. Mechelle Haywood is a therapist at Saint Luke Institute in Silver Spring, Maryland.

*For confidentiality reasons, names, identifying data and other details have been altered.

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