Getting to Good Enough: How to Help Your Perfectionistic Teen

Recent media coverage of the striking increase in adolescent and young adult anxiety highlights what therapists and pediatricians see every day: sleep deprived, overly stressed and unhappy patients and families. Rising rates of depression, anxiety and suicide, requires us to attend to a vulnerable group of students who are often overlooked, perfectionists

 Perfectionism in our society is associated with motivation, a drive to do well and a willingness to work hard. Unhealthy Perfectionism is emotional torture afflicting children already vulnerable to anxiety. It can be nearly impossible to distinguish a healthy persistence from unhealthy perfectionism. These students look great to the outside world and they go to great lengths to mask their struggles.

Unhealthy perfectionism is marked by:

  • Excessively high standards for oneself and others
  • Measuring self-worth only in regard to productivity or accomplishment
  • Over-emphasis on “shoulds”
  • Persistent self-doubt, never feeling good enough
  • Belief that others are easily successful
  • Intense fear of making mistakes and of failure

 Underlying traits that are often precursors to unhealthy perfectionism include:

  • Rigid adherence to narrow sets of rules or expectations
  • Strong need for external approval
  • “All or Nothing” patterns of thinking; leading to belief that all mistakes are failures.
  • Anxious, ruminative and obsessive thoughts or behaviors

Academic perfectionism afflicts student prone to perfectionistic standards but with an obsessive and compulsive drive to achieve perfection at almost every level of academic expectation. Academic perfectionists are terrified of making mistakes or failure. They maintain a belief that academic imperfection will result in overall life failure and rejection.

 Specifically these students might:

  • Hyper focus on grades
  • Obsess about work appearing perfect
  • Miss the big picture because of focus on minor details
  • Have great difficulty starting assignments, particularly writing, because of the need to “get it right” the first time.
  • Catastrophize
  • Struggle to work through obstacles because of intolerance of mistakes
  • Anticipate and expect disapproval and rejection
  • Appear in control and focused, at odds with internal experience of loss of control and negative pre-occupations.


How does perfectionism become a problem?

 Reinforcement: Family members, teachers and other important adults often inadvertently reinforce unhealthy perfectionism. Praise, admiration and focus on the achievement, strengthens the child’s core belief that failure equals rejection. The pressure intensifies as expectations increase until a breaking point occurs. Parents feel confused or shocked, as their child seemed “happy”, “focused” and “successful”

 Procrastination and Avoidance is inevitable. The need to “get it right” the first time and rigid thinking does not allow for prioritizing, writing drafts or mediocrity. Falling farther and farther behind and fear of asking for help, leads to crisis.   When the student is “found out” the situation is often beyond repair and serious mental health symptoms have begun.

What can we do?

Teachers, Guidance Counselors, Pediatricians, School Nurses and most importantly parents, are in key positions to recognize the signs of unhealthy perfectionism and intervene quickly and with authority. For those with a “bright”, “gifted”, “high achieving” or “stressed out” student in their lives it is important to watch for following signs:

  • Social isolation
  • Performance anxiety
  • Procrastination
  • Limited interests
  • Excessive time spent on one task with little outcome
  • Disruption in sleep
  • Changes in appetite
  • A tendency to talk about all or nothing beliefs “If this isn’t perfect I will fail”
  • “The harder I work the better I will do.”
  • “I can’t relax or be happy unless I have all A’s”

 Find a Therapist

Careful diagnostic assessment is necessary and your child should be evaluated for Depression and all Anxiety Disorders. Specific assessment of perfectionism is fundamental. Therapists will collaborate with family and teachers to identify and reduce perfectionist behaviors and routines. A therapist trained in Cognitive Behavioral Therapy is suggested; there are developing cognitive behavioral treatment (CBT) plans specific to academic perfectionism and CBT has long-standing evidence-based success in the treatment of Anxiety.

Therapy goals include:

  • Learn flexible coping strategies for periods of uncertainty
  • Increase awareness of maladaptive thinking.
  • Understand the biopsychosocial factors that may interfere with healthy identity development
  • Examine core values that are separate from external achievement.
  • Exposure to vulnerability

Confronting mediocrity and failure while developing coping strategies for uncertainty, can lead to core self concept change: “I am lovable even when, especially when, I am not perfect.”

 Learn Coping Skills in Therapy and Beyond

  • Encourage realistic assessment of outcomes to address fear of failure and focus on setting realistic goals.
  • Learn to break up overwhelming tasks into small pieces and work on one thing at a time
  • Set time limits and learn pacing
  • Focus on the here and now rather than the “future” or “regrets”
  • Deliberate exposure to mistakes to reduce fear and reinforce the value of mistakes
  • Learn relaxation and distress tolerance skills
  • Practice compassionate self-talk, assign pleasant event tasks
  • Prioritize routines that promote balance:  sleep hygiene, nutrition, exercise and relaxation

 Model balance and focus holistically on healthy development and core values.

  • Communicate deliberate and mindful messages about achievement and success. Model the importance of intrinsic self-worth. Focus on the development of compassion, contribution, love and health as primary sources of life long happiness.
  • Insist on balance and be vigilant about supervision. Monitor deteriorating sleep, appetite or self-care. Develop family self-care rules and discourage a “success at all cost” attitude.

Careful attention to students presenting with unhealthy perfectionism and deliberate, early intervention and treatment could go a long way in turning the tide of the anxiety epidemic in our adolescent and young adult populations.

Jennifer Tsappis, LICSW










Helping Your Child to Cope With Post-Election Worry and Anxiety

Political and social uncertainty or crisis can produce anxiety in children or worsen symptoms for children already struggling with anxiety. Common signs of anxiety in children and adolescents include:

  • Excessive worry most days of the week.
  • Trouble sleeping at night or sleepiness during the day.
  • Restlessness or fatigue during waking hours.
  • Trouble concentrating.
  • New or renewed separation anxiety.
  • Unexplained somatic complaints like headaches or stomach-aches.

If your child is presenting with any of these signs in the coming weeks after this highly charged election, there are many ways you can help them.   Here are some strategies and ideas to reduce excessive worry and restore emotional safety for your child.

Home is Where We Start From

Your child’s basic sense of security begins at home. Remind your child that you are in charge with keeping them safe and this will not change.

Children feel safe with predictable routine and structure. Remain consistent with daily routines that we know are essential to mental health:

  • Sleep: children need a lot of sleep and a sleep routine that is calming, predictable and involves letting go of stressful events of the day.
  • Nutrition: maintain regular mealtimes and with food choices that are healthy and rich in nutrients. Minimize processed foods and too much sugar.
  • Maintain screen time limits and screen free bedtime routines. Children are sponges and will absorb all stimulation around them. Reducing stimulation will allow their brains to rest and recover from the physiological burden of anxiety.
  • Model emotion regulation by talking about your feelings in developmentally appropriate terms, practicing good self-care and relaxation. Maintain fun, established outlets.
  • Model respectful communication, conflict resolution and relationship repair.  Be clear about your values and the values you want to impart on your child.
  • Make sure your language and behavior reflect those values.

Encourage your child to share their feelings

  • Bottling up bad thoughts can leave you feeling angry or alone. Feeling sad, scared or confused is ok and its also important to talk about what’s going on so you can understand your feelings better.
  • Help your child to identify their feelings so you can use this opportunity to teach them strategies to cope with emotions. Ask them to tell you where in their body the feel worry or fear and help them to label their emotions accurately.
  • Reassure your child that they can talk to you about anything and you will not be angry or judgmental.
  • Young children communicate through play; increase non-structured playtime and be there to mirror their play and ask simple questions.
  • Talk about the importance of sadness, fear, and anger in our lives and that they are temporary and manageable emotional states.

Teach emotion regulation skills.

Talk to your child about how we may not always have control of what we feel or think, but we can always control our behavior.

Teach your child to express feelings safely by:

  • Talking about them,
  • Writing them down,
  • Drawing about them,
  • Exercising
  • Going outside, in nature
  • Deep breathing
  • Relaxation, yoga, mindfulness

 Encourage increased support

  • Ask your child to find other adults they trust to talk to, especially older children and adolescents who might be more withdrawn with their parents.

Set aside worry time each day

  • People generally cannot “just not worry about something.” Actually, trying not to worry usually makes us more anxious. Learning to turn your mind to what is front of you (like school, sports, friends, activities) instead of worries, is a valuable anxiety management tool.

If your child is worried about specific issues related to the presidency, Educate Them

  • Talk about what a president does and how democracy works in age appropriate terms. Include in these discussions that Presidents are not “Kings or Queens” and there are many other adults involved in making decisions that are safe for everyone (checks and balance system). Explain that each president only has 4 years before there is another opportunity to elect someone else.
  • Offer reassurance and comfort and avoid complicated and fretful explanations that could leave them more frightened and confused.
  • Tell your child that your family’s political views can be private and that adults are responsible for voting, not children because they have not had time to establish their own beliefs and opinions.
  • Talk about what your child can say if someone wants them to talk about politics and they do not want to “My family keeps our political views private”

When your child hears something scary or mean, Talk About It.

  • Ask your child to tell you what harmful or hurtful words were used. Talk about your values as a family and how to talk about differences safely and respectfully
  • Encourage your older child to research issues they do not understand in order to process distressing events and feelings.
  • Encourage your older children to get more information. Teach them about opinions and how they are different from facts. Talk to them about the importance of establishing their own informed opinions.
  • Read stories to young children about overcoming adversity and stories that are diverse and represent values that are important for your family.

Teach Empathy

  • Have your child imagine what it would feel like to be someone who might not fit in, or who feels different, or heard something mean about his or her skin color, religion or culture.
  • Explain that some things that happen in the world are done because of hate or fear and bad thoughts
  • Explain that it can help to focus on good thoughts and get more people involved in things that have a positive effect.
  • Talk about ways to help, take action or advocate for issues that are important to them. Encourage volunteering, advocacy and standing up for yourself and others who are hurt.

For most children, increased worry or anxiety should subside quickly. If your child’s symptoms persist beyond a few weeks, or are seriously impacting their ability to go to school and engage in their normal activities, talk to your pediatrician or local mental health professional.

Jennifer Tsappis,  LICSW