307: Perfectionism, Anxiety, and Relationships with Trevor Huskey

Welcome back to The Couples Therapist Couch! This podcast is about the practice of Couples Therapy. Each week, Shane Birkel interviews an expert in the field of Couples Therapy to explore all about the world of relationships and how to be an amazing therapist.

In this episode, Shane talks with Trevor Huskey about perfectionism, anxiety, and relationships.  Listen to the episode on Apple Podcasts, Spotify, and your other favorite podcast spots, and watch it on YouTube – follow and leave a 5-star review.

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The Couples Therapist Couch 307: Perfectionism, Anxiety, and Relationships with Trevor Huskey

This episode is brought to you by Alma. Visit https://helloalma.com/dg/?utm_source=podcast&utm_medium=paid&utm_campaign=privatepractice to learn more

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In this episode, Shane talks with Trevor Huskey about perfectionism, anxiety, and relationships. Trevor Huskey, LCSW is a Therapist, Licensed Clinical Social Worker, and Author & Host of The Breathtaking World of Anxiety. Hear how people experience anxiety & perfectionism, how perfectionism & anxiety impact each other, the situations where anxiety & perfectionism are a good thing, how perfectionism & anxiety show up in relationships, and how to provide your clients with hope if they have some of these qualities.

 Here's a small sample of what you'll hear in this episode:

• How Trevor diagnosed his own anxiety while driving to work
• People stay editing forever so they never have to fail
• When anxiety actually helps vs. when it becomes self-punishing
• Perfectionists want to be bulletproof 
• Why people experience anxiety and perfectionism without recognizing it

To learn more about Trevor Huskey and check out his books & podcast, visit:

HopeForABetterTomorrow.com/Trevor-Huskey--LCSW

The Breathtaking World of Anxiety books on Amazon

The Breathtaking World of Anxiety Podcast 

Show Notes

• 307: Perfectionism, Anxiety, and Relationships with Trevor Huskey
• This episode is brought to you by Alma. Visit https://helloalma.com/dg/?utm_source=podcast&utm_medium=paid&utm_campaign=privatepractice to learn more
• [0:23] Welcome to The Couples Therapist Couch 
• [0:36] Welcome to the show Trevor Huskey
• [1:23] 22 years as a therapist specializing in anxiety, perfectionism, and ADHD
• [2:17] At its core, anxiety is self-doubt and a lack of trust in yourself
• [3:15] Why people experience anxiety and perfectionism without recognizing it
• [4:41] Perfectionists want to be bulletproof 
• [5:39] Anxiety as a signal, not an enemy 
• [6:39] The daily practice of giving yourself credit for three things
• [8:02] When anxiety actually helps vs. when it becomes self-punishing
• [9:27] The difference between worry and anxiety and catastrophic thinking
• [11:24] Perfectionism keeps people stuck
• [13:15] The goal isn’t to get rid of anxiety 
• [16:53] The five sources of anxiety 
• [18:42] How temperament differences between partners create recurring conflict that has nothing to do with the argument itself
• [19:35] Emotional trauma and why kids swallow experiences wholesale before age 12
• [21:02] Why socialization belongs in the lifestyle category 
• [22:25] Ambivalence vs. cognitive dissonance 
• [23:23] How Trevor diagnosed his own anxiety while driving to work
• [24:44] This episode is brought to you by Alma. Visit https://helloalma.com/dg/?utm_source=podcast&utm_medium=paid&utm_campaign=privatepractice to learn more
• [25:42] Noticing anxiety with curiosity rather than alarm
• [28:56] How perfectionism shows up in relationships 
• [30:17] The social triad: what do I think of myself, what do I think of others, what do I think others think of me?
• [33:07] How to work with an other-oriented perfectionist without taking anything away from them
• [35:27] The difference between depression and burnout 
• [37:20] The couple where the wife was ready for divorce 
• [41:05] Unconditional love vs. conditional regard 
• [43:31] When self-oriented and other-oriented perfectionism combine 
• [45:51] Helping the perfectionist see that their rules aren’t getting them what they actually want
• [47:45] A patient’s letter about what it felt like to finally understand she was a perfectionist
• [49:42] Treat yourself decently, it makes all the difference
• [50:10] Find Trevor at trevorhuskey.com and The Breathtaking World of Anxiety Podcast on iHeartRadio and Spotify
• This episode is brought to you by Alma. Visit https://helloalma.com/dg/?utm_source=podcast&utm_medium=paid&utm_campaign=privatepractice to learn more

 

What is The Couples Therapist Couch?

This podcast is about the practice of Couples Therapy. Many of the episodes are interviews with leaders in the field of Relationships. The show is meant to help Therapists and Coaches learn how to help people to deepen their connection, but in the process it explores what is most needed for each of us to love, heal, and grow. Each week, Shane Birkel interviews an expert in the field of Couples Therapy to explore all about the world of relationships and how to be an amazing therapist.

Learn more about the Couples Therapy 101 course: https://www.couplestherapistcouch.com/

Find out more about the Couples Therapist Inner Circle: https://www.couplestherapistcouch.com/inner-circle-new

Transcript

Please note: this transcript is not 100% accurate.

00:00
Being able to be aware of these dynamics within a relationship is huge.

00:09
to the Couples Therapist Couch, the podcast for couples therapists, marriage counselors, and relationship coaches to explore the practice of couples therapy. And now, your host, Shane Burkle.

00:25
Hey everybody, welcome back to the Couples Therapist's Couch. This is Shane Burkle and this is the podcast that's all about the practice of couples therapy. Thank you so much for tuning in. I'm a licensed marriage and family therapist and the goal of this podcast is to help you learn how to more effectively work with couples and possibly even learn how to have a better relationship. The episode this week is brought to you by Alma. They make it easy to get credentialed with major insurance plans at enhanced reimbursement rates.

00:54
Alma handles all of the paperwork and guarantees payment within two weeks. Visit hello Alma.com or click on the link in the show notes to learn more. Hey everyone. Welcome back to the couple's therapist couch. This is Shane Burkle. And today I'm speaking with Trevor Huskey, therapist, licensed social worker, and host of the podcast, the breathtaking world of anxiety. Hey Trevor, welcome to the show. Thank you so much, Shane. Appreciate being here with you today. Yeah. I'm really excited to talk about

01:23
Hopefully we'll talk all about perfectionism and relationships and how it impacts us. But before we get to that, why don't you tell everyone a little bit more about yourself? I've been a therapist 22 years and I also do presentations at public libraries, mental health agencies, universities, and at conferences on a wide range of topics, anxiety being my specialty. Certainly perfectionism, communication.

01:49
ADHD variety of topics, I thoroughly enjoy doing. That's great. I'm curious just to start, just to sort of lay the foundation for the conversation, you know, maybe it would be helpful to sort of give like a definition of anxiety because I feel like people use it in a lot of different ways. And sometimes people are like, no, I don't have anxiety. But then when we talk about it more like, Oh wait, actually, uh, maybe I do.

02:17
So I'm just kind of giving a definition of what we mean when we say that. Well, first of all, yes, a lot of people struggle with anxiety and have no idea, especially perfectionists. It's very interesting working with them in this way. And so for a lot of people, anxiety is worry, concern, panic, those kinds of things is how it presents for them. And for me, the underlying issue is self-doubt. I don't trust myself.

02:47
So that's a primary aspect of how it manifests and then it manifests in a lot of compulsive behaviors. So I'm driven to do these things and work is a lot of what people use to help themselves cope with anxiety because as long as I'm busy, then my anxiety isn't roaring to life and I don't have to deal with it. So there you go. That drives a lot of the, what's behind the perfectionism. Yeah. And, um, say more about

03:15
the way in which people experience anxiety or perfectionism, but don't realize that that's what's kind of drive, you know, maybe that it's the anxiety that's driving it. And that's primarily through work. Once again, a lot of people just stay busy and so they give themselves to work fully. So the self doubt that they experience is a form of not trusting themselves.

03:45
And so that's a big problem. Most people are doing a lot of really good things throughout the day. Instead, they tend to focus on what they're not doing well or well enough or what went wrong. With anxiety, you can go through, have a great experience and people will filter through the whole thing and they'll find the one thing that didn't work out perfectly and that's what they focus on and then they punish themselves with it. That's mainly what I'm working with people on when I'm working with perfectionism.

04:13
Yeah, as you say that, I'm imagining you're going, someone's going through their day, you know, they're with their family or in work situations and you know, they're 95 % of the time they're doing a great job. They're following through on things and they tend to really focus the self doubt kind of makes them focus on that 5 % that they're not doing well or that they didn't get exactly right or whatever. And then

04:41
you know, would you say that it's almost like if I work hard enough, then I won't have, you know, then I can achieve a hundred percent or something like that. Yeah. Perfectionists are guarded individuals. They want to be bulletproof. They don't want to have to tolerate criticism or uncertainty. Right. Yeah. I mean, obviously there are a lot of people who have anxiety who are not perfectionistic.

05:09
So the way in which that shows up in perfectionism, uh, I guess like defining anxiety and then more specifically, I mean, you did a good job just defining perfectionism already, but kind of, um, taking a step back and taking a look at like how this shows up for people like in their life and in their relationships. Yeah. So with anxiety, first of all, a lot of people have a negative association with anxiety and negative relationship with it. They think it's this horrible, awful, nasty thing trying to ruin their life.

05:39
It's not that at all though. It's a signal. Think of it as physical pain. What's the job of physical pain? It's to tell you something is wrong and it needs to be addressed. Two things. So with anxiety, it's predominantly about psychological pain. And that's what people are struggling with. And it's one of the most predominant conditions of the human experience. Most people experience it at some point in their lifetime, if not regularly. And even people who seem to have been immune to it.

06:09
for a lot of their life, all of a sudden they experience it and they're like, Holy cow, I had no idea what this was like. And wow, now I can understand other people who want, who have to struggle with it. Yeah. And I totally, it totally resonates with me when you were talking about the self doubt piece of it. I mean, I feel like with the anxiety, a lot of it is that inability to sort of give yourself grace or like have that flexibility or feel like it's okay to make mistakes.

06:39
or not be perfect in the world? Yeah, and one of the things that I work with my patients on in order to help themselves cope with their anxiety is for them to give themselves credit each day. It's a very basic goal. And I start off with give yourself credit for three things. And I don't care how big, how small, something new, something you do every single day, something somebody asks you to do or something you do voluntarily. None of that matters. It's just what are some good things that you were doing today?

07:06
Why is this so important? Because once again, they're going to be focused on the negative. And so they're going to spend a lot of time fixating on the negatives. And then this is just a way of balancing the scales to a certain degree. And so it's, in my opinion, the most basic form of self-compassion that you can practice on a regular basis. Now I do this myself still. And when I go through my day, I really go through, I woke up on time. I drank some water when I started my morning.

07:35
I went for a walk, whatever it might be. And I will give myself credit for 30 to 40 things each day. Yeah, that's great. That's a great practice. Yeah, it's wonderful stuff. It's very, very helpful. Once again, it's a very direct way of addressing that sense of self doubt and the punishing aspect of anxiety when people fixate on the negative things. What if, what if someone were to say, well, uh, you know, my anxiety really helps me.

08:02
follow through on my goals or helps me see danger so that I can be prepared for it or things like that. Sure. And negative thoughts have their purpose in this world. There's no doubt. They're not a problem in and of themselves. We need to be able to have negative thoughts. We need to be able to anticipate problems and to backtrack and then to do what we need to do to make sure that they don't happen. So that's a given.

08:30
How much once again you feed into them and punish yourself with them is a very different matter. So being able to relate to your negative thoughts. Is this healthy for me right now? Okay, let me sit with this negative thought for two or three or four or five minutes. Okay, am I getting anything out of it? If I'm not then let me put it on the shelf right now. Let me get back to something else and I might come back to this later.

08:58
So being able to relate to our emotionality and our thoughts just in general, openly is very, very helpful. I feel like there's something very personal that happens. that's different in these situations where let's say I have a test coming up and I feel worried about getting a good grade on my test. So my anxiety kind of motivates me to study and to prepare, be prepared for the test.

09:27
which is different than if I feel like I'm a terrible person if I don't do well on this test. And there's like a more of a personal energy driving that that feels like it has to do with my self image or something like that. Yeah, there is a big difference between worry and anxiety. Worry is, okay, let me prepare for something here. Let me think about once again, all the different factors that I need to take into consideration with this problem, this goal of mine.

09:57
And then anxiety is much more internally driven, though, in terms of I have to do this. The pressure that you feel if I don't do this. Oh, my goodness. The world is going to collapse on me. That's that catastrophic thinking. So a lot of people fall into that catastrophic thinking and they will just go on down the line. I had a patient one time who said, I don't have my my glasses, my new glasses, and I'm driving to see a Packers game and I'm going to

10:27
you know, be driving on the highway and there's going to be drunk drivers and I'm going to get into a car wreck and I'm going to die and my kids are going to be orphans. And I mean, she was breaking down and just crying right in front of me. And if we, when we imagine things, it's like we're experiencing them. That's one the things that we have to keep in mind. And so with anxiety, we want to be able to be careful about that catastrophic thinking. That's where we can really get in trouble. I call it the what if cliff.

10:57
Okay, what if, what if, what if, what if, we just hammer away at ourselves at these things that haven't happened yet. And for a lot of people in a lot of situations in all likelihood are not going to happen. Right. Well, and I, I feel like with the perfectionism, sometimes it keeps people stuck where they're like, well, I'm going to be so prepared. I'm going to create the perfect situation where

11:24
you know, nothing bad could ever happen. But then it kind of, then they don't actually do anything because they can't do it until it feels like it's perfect. There's that. And also too, that if there's a potential of failure, if they entertain that, Oh, I might actually fail here. Then they just say, Oh, you know what? I'm not ever going to try because then that way I didn't fail. I chose not to even bother doing this. Right. Like if let's say they're

11:53
writing a paper or something like that, that, um, you know, they're editing it and editing it and editing it and it never feels quite perfect. And, um, I, that seems right on when you say that, you know, it's like, as, as long as they don't put it out in the world, they can say, well, I, you know, I haven't failed yet. Yep. Exactly. And back to your point about being driven and I don't trust myself.

12:20
be able to accomplish something without my anxiety pushing me. I worked with a guy who was a pharmacist and he did not, he worked an incredible amount of time each week and then he didn't trust himself that he could accomplish everything he needed to do without his anxiety. And I asked him, well, who's actually doing the work here? You or your anxiety? And he was like, Oh, I didn't think of it that way. And so he was able to then trust himself more.

12:49
just trusting himself as opposed to trust feeling like I have to have my anxiety pushing me. And that's what I really work with people on your relationship with yourself. My goal for my patients is not for them to get rid of their anxiety. I think that's a fool's errand. My goal is for them to be comfortable and confident in themselves. That's ultimately my goal with my patients. It's a positive orientation.

13:15
I want to get rid of my anxiety is a double negative orientation and people orient double negatively a lot. just, that's fine as an initial orientation. Okay, this is the problem. This is the guy, but then we want to swing that around and we want it to have to be a positive orientation. It's always going to work better. Yeah. I was thinking like I would, I would like it if my pharmacist had some anxiety as far as

13:41
you know, if they give you the wrong dose, you know, it could cause you to die or something like that. There, there are people who may, maybe who are on the other end of the spectrum who don't have nearly enough anxiety that, um, you know, maybe it wouldn't make a good pharmacist for example, but I feel like it's, it's not sort of putting that huge amount of pressure on your, so it's using that sort of attention to detail and, seeing that as a positive quality that I have or something like that. Yeah.

14:12
I certainly want people to be competent. I want them to be driven, especially once again, certain professions, my doctor, especially. so, but they don't need that anxiety though. can still have a protocol. can still have a system in place to make sure that you're doing a good job without the strife of anxiety. And the problem with the anxiety then is like, Oh wait, did I make a mistake? I get, you know, then you're distracted.

14:40
you're getting distracted from your built to stay focused and to be precise and to do the things that you need to do. And it runs a lot of interference when people, uh, aren't addressing it properly. That's a good point because people probably perform best when there's a level of feeling relaxed or, or a level of feel, you know, the, the more, if, if that voice is coming in too much,

15:06
or they're putting too much pressure on themselves, there's probably more mistakes that are likely to happen than when they're relaxed and feeling in the flow. It's one of the great ironies of anxiety and there's a lot of them. Yeah. Yes. If I'm trying to be a perfectionist, I'm trying too hard and then yes, I will end up making mistakes and then I feel really bad about those mistakes and then I'm going to punish myself. I'm to push myself further and harder.

15:33
And then I'm going to crash. With perfectionism, it's not this slow slope down, you know, in terms of like, oh, the problems associated with anxiety is drive, drive, drive, drive, and you hit the wall and then you go straight down. One of my first patients that I ever worked with, her doctor ordered her off work for three months because she was just taking on everything for everybody. She was at work and

15:56
You know, working, she worked in logistics and it was a lot of stress and strain with that job. You had to be very precise with things and her colleagues would be gone for the end of the day and she'd stay late. And as she was leaving, one of her colleagues phones would ring and she would go answer that phone. She just felt responsible for everything. Yeah. And it was the same way at home too, in her relationship with her partner. She was doing so much around the house. Then she finally just crashed.

16:26
by the time we were done working, she said, thank goodness, because I'm a different person now and I can live a very different life now. And it's not just full of stress and strain. Interesting. When, what's your, what are your thoughts on, you know, when someone's experiencing that, you know, and all of us experience, have our own issues, our own stuff, you know, where, and I'm

16:53
I guess part of the reason I'm asking is to think about what's most helpful for that person to address it. But like how much of that do you think is like wired in genetically versus like comes from things that we experienced growing up or experiences we've had in our life? Great question. So in my opinion, there's five sources of anxiety. One is biological. That is, you have two variations there.

17:21
So the first one that I put on the table is medical. Heart conditions, inner ear problems, anemia, thyroid, blood sugar issues, postpartum pre-meds. So postpartum, there's a couple of others too. Now those are medical conditions and they aren't necessarily true anxiety per se, but they manifest as anxiety like symptoms. If those are happening, you gotta address those through a doctor. Now I have hypoglycemia.

17:47
And so my blood sugar runs low. I have to be questioning myself. Okay, is this my anxiety or is this my blood sugar issue right now? When was the last time I ate? So that's the question that comes to my mind. The second one is temperament. Most people know the word temperament, but they don't really know what it means. We're born with nine different temperament traits and they range from low activity to high activity. We'll be one of them. There is no bad temperament trait. It just is what it is.

18:14
And so we need to be aware of our temperament traits and learn how to work with them and be able to be aware of other people's temperament traits and see how well they jive. Now individually, this is a great starting point. Why? Because our personality is made up of three things, temperament, experience, and values. Temperament is biological. And so when I do work with couples, I start off with a temperament handout between the two of them to see how well...

18:42
how closely they're aligned with their temperament traits and how far apart are they. Now there's two, three in particular that really stand out in couples work. And if you have this big separation between the two of them, it can just run interference on an ongoing basis because you're not talking about the car, the milk, the dog at that point in time. It's a temperament clash. So that's biological. Then we have experiential, that's trauma and

19:11
So we have two different types of trauma. We have physical trauma, emotional trauma. Now, as somebody who specializes in anxiety, the main issue that I'm really working on with most people is emotional trauma. And a lot of people dismiss it. It wasn't that big of a deal. They didn't mean anything by it. I turned out fine. Look at me. Everybody has to deal with something. So there's a lot of dismissal. But emotional trauma is very serious stuff.

19:35
And when we're children, we have no ability to process things, to put things in context for ourselves before the age of 12. We just really don't have that ability. And so these experiences happen to us and then we have to swallow them wholesale. And most adults aren't attending to kids' emotional trauma. So that's a big problem. And so then we're going along life with these hurts and also to these different kinds of fundamental beliefs.

20:05
from those experiences that are like computer programs in the back of our mind just driving us in ways that we're not aware of. Third one is lifestyle. So sleep, substance use, diet, exercise, socialization, organization. And if you're living a healthy lifestyle, great, it's going to be very helpful. If you're not, it's going to be a problem on an ongoing basis, that's for sure. Why do I include socialization in there?

20:34
because we are extremely social creatures. As Don Siegel said, are physically, we are fully integrated creatures physically, mentally, emotionally, socially. And we really found out about that last one socially during COVID. So loneliness can bite very quickly and it can create a sense of anxiety and depressed mood. Why is that? Because we as a species survive not because we're big, strong, or fast or anything like that, but by our ability to cooperate.

21:02
That's how we survive in the dangerous natural world. And so on this fundamental level baked into our system is this, I need other people to survive. That's baked into our DNA. That's lifestyle. the fourth one is insecurity. So most people are insecure about something. Now a lot of people try to hide their insecurity. Why? Because we live in social hierarchies. Social hierarchies dictate people at the top have access to power and control resources.

21:31
People at the bottom get jacked squat. And so we all want to look good in that social hierarchy. Who wants to be in the bottom half of that social hierarchy? It doesn't make sense that that's what you would want. So we tend to be guarded and show our best selves to other people. But a lot of people make the mistake of running away from their insecurities. That doesn't work. Why? What's the message that you're sending to yourself about your insecurity? I can't handle it.

21:58
That's a very powerful message to send to yourself that feeds self-doubt. So you want to address your insecurity directly. And there usually is something that we can do very concretely about our insecurities. And so let's get to work on that. Last one is ambivalence. Most people don't know the word ambivalence. They think of apathy. I don't care. Ambivalence is when you're conflicted about something.

22:25
Okay, my aunt's in the hospital. I need to go visit her because she may not make it tonight. It's my best friend's birthday. The whole crew is going to a concert together. I can't miss it. I've got this conflict now. And so there's a lot. We're ambivalent about most things. Why? Because there's basically pros and cons to everything. So we have to deal with our ambivalence and that's consciously we can deal with that. Then we have what's called cognitive dissonance.

22:53
which is subconscious conflict. Now that's when a fundamental belief in life is clashing with a reality here that is in opposition to that fundamental belief for whatever reason. And in that moment then we can't make sense of it. So it's just a big clash going on and that's going to trigger some real anxiety for us. So those are the five sources. When you experience anxiety, you can put it into any of those buckets. Sometimes it'll be multiple ones though. And I'll give an example.

23:23
So one day I was driving to work and this was about 10 years ago and I thought, oh, there's my anxiety. Hear that? It's not like, oh my God, there's my anxiety. What's the matter with me? It's just, oh, there's my anxiety. That awareness, basic awareness. And then I got curious about it. I wonder where it's coming from because this is a little unusual right now. And I thought, okay, well, I'm, I...

23:47
Oftentimes when I had this one day job, I would do as much at home as I could before I left for work to make things easier on my wife when she got home and was taking care of the kids after school. And I thought, oh, no, doesn't, and the anxiety held steady. So I was like, oh, that's not it. And then I thought, okay, well, what else is going on? I thought, well, I'm driving to work. And the anxiety just, just settled. And I was like, oh, okay. So it's related to work. It was a very stressful job. I lived on the edge of burnout for five years there.

24:16
It was tough stuff. And I gave notice probably about three weeks later. My anxiety was just telling me, it's time. So, and I had been there for 14 years, learned a lot, great experiences, but a real grind. a private practice can be challenging. Filing all of the right paperwork is time consuming and tedious. And even after you're done, it can take months to get credentialed and start seeing clients.

24:44
That's why Alma makes it easy and financially rewarding to accept insurance. When you join Alma, you can get credentialed within 45 days and access enhanced reimbursement rates with major payers. They also handle all of the paperwork from eligibility checks to claim submissions and guarantee payment within two weeks of each appointment. Plus, when you join Alma, you'll get access to time-saving tools for intakes, scheduling, treatment plans, progress notes, and more in their included platform.

25:13
Alma helps you spend less time on administrative work and more time offering great care to your clients. Visit helloalma.com or click the link in the show notes to learn more. Um, I love, well, and that was really helpful to hear you go through the, those five elements. And you know, one of the things I think is that it helps you when you understand that it just helps you move into compassion for yourself or for, or your partner or whoever else like

25:42
you know, when you're talking about the differences in temperament or something like that, it's like, it's not necessarily right, wrong, good, bad. It's just kind of understanding that this is part of who I am. And, and the other thing before I forget, I loved what you, how you just modeled that awareness, right? Sort of the, the noticing of the anxiety where you're kind of an observer.

26:10
instead of feeling entirely wrapped up in it. Uh, and that might be a good practice for people. You know, when you said like, Oh, there's my anxiety, right? Like it's like a curi, there's a curiosity you're approaching it with. It's not like, necessarily getting wrapped up in this is an emergency. I have to do something right away because a lot of times it's you'll, you'll get some more insight.

26:35
by sort of like taking a deep breath, taking a step back and slowing down a little bit with it. I don't know if that's how you see it as well. Oh, absolutely. Yes. And the biggest problem with people's anxiety is what? That they feed into it right away. Oh my God, what's the matter with me? Why am I experiencing this? I'm the only one. I've got so many problems, you know, and anxiety is very powerful, very dynamic. I have the ultimate respect for it. It's tied to fear.

27:03
Fear is about imminent physical danger. My life is threatened. Anxiety is once again, psychological pain. But anything can become a source of anxiety in the modern world. So we don't have Jaguars to have to contend with anymore. But with anxiety, because people don't understand the source of it, it can actually be more problematic than fear. Why? Fear is concrete. I'm aware of the danger. With anxiety,

27:29
It's like you're in that movie in a fog bank and you can't see anything. And all of a sudden you hear the Jaguar, you know, it's there, you know, it's about to attack you, but you don't know what to do. You can't do anything to defend yourself. That's more terrifying than actually seeing a Jaguar. Yeah. Well, there's this thing, I feel like if there is a Jaguar or some equivalent to that in our modern day society, that people actually

27:57
have way more ability to deal with what's in front of them than they realize. Like when we're actually in a serious situation, we tend to bring a level of consciousness and energy and figure out how to deal with what's in front of us. I feel like the anxiety is often where it's not, there's not actually the present danger happening. It's more of the worrying that it could or something like that. Yeah. It's coming from somewhere. It doesn't come willy nilly. It, you know,

28:27
none of our thoughts and none of our feelings happen for no reason. They're always happening for a reason. And if we embrace that as a mindset, it really opens up a very different way of working with ourselves. Yeah. I'm wondering if we could talk a little bit more about how this could show up in relationships, you know, where one or both partners are experiencing that perfectionism or anxiety and how that impacts things.

28:56
And in relationships, one person usually is going to be one person who's a perfectionist is going to be very driven. These are highly accomplished individuals. They're very intelligent most of the time and very driven. And so they want things to be very exact. They have very strong opinions and they can be very demanding of their partners. So with perfectionism, we have three different types of perfectionism and this relates to how they show up.

29:25
in terms of relationship. So we have self-oriented, I believe I have to be perfect. We have other oriented perfectionism. I believe other people expect me to be perfect. And then other oriented perfectionism, which is I expect other people to be perfect. So out of the three, the other oriented perfectionism can be hardest on the partner in the relationship because they're just like, you know, no, the

29:53
pressure for them to be perfect in order to, to assuage that person's anxiety is tremendous. And what's interesting about these three different versions of perfectionism is I heard self oriented and then other oriented. And what's the third one? Uh, socially prescribed. Okay. Yeah.

30:17
And what's interesting about these three forms of perfectionism is they correlate to what I call the social triad. This is the three ways that we orient socially. What do I think about myself? How well do I know myself? Do I like myself? Have I embraced myself? Am I once again kind to myself? That's the world of self-esteem. That's why that industry is so big. Then we have what do I think about other people?

30:44
So a lot of people say you can't judge other people. That's one of the biggest lies in life, I believe, because we judge other people automatically all the time. We need to judge other people. Who is this person? What is my relationship to them? How are they behaving? What are the implications of their behavior? And then how closely should I align myself to them? So we need to pay attention to these things. And then we need to be honest about red flags when they present themselves.

31:12
That makes a big difference because I've worked with too many people who ignored red flag after red flag after red flag. And then the situation just blows up. And then we have what do other people think about me? So for most people with anxiety, is they focus on this one to the exclusion of the other two. They're so focused on other people and they're oftentimes thinking, oh my goodness, these people must be thinking bad thoughts about me. Now, when that's happening, who's actually thinking negative thoughts?

31:42
you are. And so that's one of the great ironies of anxiety as well. So once I share that with people, they're like, Oh, I never thought of it like that. And most people are preoccupied with themselves. So they're not thinking about you nearly as much as you think they are. Right. Right. I feel like that resonates for me, uh, you know, and I, well, and I have teenage kids now, you know, and they're so worried about what everyone else thinks of them or so worried about.

32:11
how they look or how people are going to perceive them or something like that. And I feel like it's been helpful for me to see that, that I do that too. And it's like, when I'm experiencing the world, I'm not thinking anything negative about anyone else or like judging them or, or in a negative way or anything like that. And the reality is people probably aren't thinking about us at all. Well, they are. We live in social hierarchies and there's this sense of, okay,

32:38
What are other people doing? How is that important to me or not? Those kind of things. But we just need balance between all three of them. All three of them count equally. And we just need to be aware of these dynamics and to work with ourselves accordingly. And so back to the relationships. So other oriented perfectionists, those are, like I said, the hardest. I worked for one for five years. That was a tough gig.

33:07
One of my favorite days in life, not top five, but certainly top 20 probably, was quitting that job. it was just, oh, goodness, I'm free. And it's interesting too, because in advice columns, you'll see people writing in about perfectionists. And sometimes the advice columnist does not put it in that kind of context for people.

33:30
they kind of offer this, Oh, well you should try to work with them in this way or that way. And it's like, no, you're missing the point there. That's a big, and you need to be aware that they're perfectionist and B understand what that dynamic implies and how to, how to relate to them and how to guard yourself against that unintentional hostility of theirs. Right, right. Well, and I feel like there are a lot of people who tend to be more

33:58
self-oriented and a lot of people who tend to fall in the category of other oriented. And it's sort of like, let's say that you, something bad happens. That's really nobody's fault. I think there are a lot of people who are like, Oh, what did I do wrong? And then there are other people in the other category are like, Oh, who can I blame for this? Or something like that. And we all do both of those things, but I feel like there's a little bit different mindset about those.

34:28
Yeah, we're all defensive creatures. And that's the case. When I work with couples, that's one of the things I have to work with them in session on a lot. Let's pause before we respond because if you respond right away, what are you doing? In all likelihood, you're responding defensively. able to be aware of these dynamics within a relationship is huge. so let me give you an example of some different couples that I work with.

34:57
So a lot of perfectionists too are in these fields where they're in tech, biotech, engineering, and medical fields like doctors and surgeons and things like that. And for them, they're usually coming in because A, their partners are bringing them in because their partners can't tolerate it anymore. B, they're having panic attacks or what they think is depression, but it's actually burnout.

35:27
And there's a big difference between those two depression, classic depression usually has sadness. There's about loss, but burnout is I feel depressed, but it's really just this empty feeling because you got nothing left in the tank. So those are the two main ways that they come into treatment and being able to recognize the dynamics. I do a lot of education around them with them first in terms of gently putting on the table about this idea of them being perfectionists.

35:56
So a lot of them can't recognize this initially and it takes a little time for them to be able to accept it. Why? Because it's been working very well for them in life. They're very successful. They're very accomplished individuals and they see themselves primarily as bulletproof. So why would they give these things up? Why would they change the fundamental way that they're living their life? It's not

36:24
part of a lifestyle. This is a pervasive issue. It dominates their life. And so to all of a sudden have to completely change how you're living your life, oh you've got to know what you're doing when you're working with perfectionists because they will test you too. They will push back against that. They will not buy into it initially and you have to gently coax them along in order for them to be able to accept, yes this is the case.

36:50
And how would that negatively be impacting their relationship? Because of the pressure, they either feel on themselves for everything to be perfect within the relationship, within the home, within their career. They will work excessive hours at work, 60, 70 hours a week. And so there's very little time left for their partner. They will come home and they'll either like just start jumping right into task oriented stuff as opposed to, Oh, let's have some time together here for the two of us.

37:20
Let's just be together. Let's enjoy life a little bit here. And so there's very little leftover for anything or anybody else besides work usually. Yeah. And I feel like part of it is maybe holding two truths at the same time. Like there are lot of aspects of this part of you that help you be successful in your job. And you know, your partner would really like

37:49
a little bit more time where you can just be present with each other or you can slow down a little bit to connect. Yeah. And I'm not trying to take anything away from them. That's a mistake. know, a lot of people, well, some people might work with a perfectionist. Oh, let's get you to stop caring so much about work. No, I want you to be an exceptional individual at work. Yes. Be successful. I have great appreciation for efficiency and competence. At the same time, let's bring some self-compassion to the table.

38:19
Let's create some space here for yourself. And it's interesting because some of the things that I work with people on is with the perfectionist is I have fun. I like to have some fun with them. And I say, let's have you try to do nothing for five minutes. Let's have that as a goal for you. And it's all of a sudden they're like, what are you talking about? And I get to have these really interesting fun.

38:43
little debates with them about what that really looks like. And oftentimes they're like, well, how about if I do this? I'll meditate. And I'm like, no, that's doing something. And it's just about getting them to expand their sense. It's not really something that I expect them to be able to really do. Now, I will talk about how I do that for myself. Like I'll just go into the backyard and I'll just sit in the backyard and lull on the grass and look up at the sky and things like that. So I allow that for myself. And so it's more of, once again, getting them to

39:12
their sense of what is possible in life. So it's a fun little exercise. Yeah. And I feel like there's the, the level of whether they believe like, like I feel like people who are perfectionists often have, um, like it's almost like I need to be useful all the time. And, so, trying to convince them like, is that really true? Is there something valuable about slowing down and just staring at the sky?

39:41
But then the second part is if they, even if they believe that's true, how, how capable are they of actually doing it? It takes time. Yeah, it really does. I'm working with a couple right now. Wife brought husband in because she was ready for a divorce. mean, she was adamant about that and, um, he's a perfectionist. She has a trauma history and, uh, it took him a while to really buy into this concept and, um,

40:10
Yeah. And at one point he said, well, I haven't always been a perfectionist. And his wife was like, are you serious? Oh my goodness. He came from, he comes from a family of perfectionists. And as we continue to talk about things, he would continue to say, oh yeah, this and there's this. would say, yeah, his friends would come over from college and visit. they're like, oh my God, I've never seen a house like this before. It's like a museum, you know? And then he was able to correlate with incidents that happened when he was a kid.

40:37
that exemplified some of the emotional trauma. Like he was riding with his sister on a bike and fell over. And instead of like attending to her brother, my patient, she was like, get up, get up, get up, get up. Cause she didn't want the neighbors to see that he had actually fallen. there's this pressure to once again, how you present to the rest of the world. It's extreme and punishing for people. And this sense of like, I have to be perfect.

41:05
This goes to the parenting part of side of things. So there's a big difference between unconditional love and conditional regard. And conditional love is I love you for who you are full stop. And I as a parent, I'm going to respect you as a person. I'm going to pay attention to you. I'm going to learn about you. I'm going to take delight in you and I'm going to support you. All these kinds of wonderful things. It gives you the foundation in life that you can't get anywhere else.

41:34
And then you can take on that big bad world out there with, hey, I've got this incredibly solid foundation. Conditional regard is something very different. It's I'm going to regard you in relation to how you behave, how you represent family, how well you adhere to my rules, my expectations, my commands, my demands, whatever it might be. And that's very hurtful for people. It's not seeing them as a person.

42:02
I've had patients talk about being a trophy, a show pony. mean, those are quotes and they talked about how hurtful that was, how undermining for them as a person and the incredible pressures that come along with that, especially for most people regarding school and grades. You're right. So I just have a lot of people in my case that I have some teenagers right now who, once again, my goodness, the schedules that they have for themselves are just unrelenting.

42:32
Yeah. Yeah. And that's where I think there's a lot of potential to help people. think in a lot of families going out into the world, it's like, you have to look perfect. You have to dress perfect. You have to behave perfectly. You have to get good grades. You have to be good at sports. And as long as you do all of these things, then you'll get love and acceptance within the family. And you know, that becomes sort of imprinted in their nervous system.

43:02
And then as an adult, I think it shows up and it makes people really hard on themselves or hard on their partner or hard on their own kids. And it's a really different way of seeing the world when you start to talk about that unconditional love. Yeah. I had a guy who was a nurse in an ER and the interesting thing too about the three different versions of perfectionism, it's not just one oftentimes for people. can be multiple

43:31
versions of that. And for him, he would have these blow ups in the ER because he expected himself to be perfect and he expected everybody else to be perfect. he would just and came from, once again, this this abuse, emotional abuse in childhood. The pressure that his parents put on him in school was just horrendous. mean, physical abuse along with the emotional abuse. So once again, as an adult, then there was this incredible pressure of like, no, things can't go wrong. And

43:58
you know, if they do go wrong, I'm just going to get punished extremely, you know, in an extreme way here. And that's not a deal that I can accept. So in the last example you gave, I just want to really hit, hit home the, relationship example, you know, where the wife is at the point where she's ready to leave their relationship. I mean, oftentimes is it that they're bringing that mindset that they took from childhood where

44:29
Everything has to be perfect. And it's like you said, it can be both like they're hard on themselves, but they're also hard on their partner where it's like, you know, things have to look a certain way. Things have to be a certain way. And then if it's not, then they're just sort of getting upset, getting frustrated, getting angry and making it really hard for the other person to feel accepted. Yeah.

44:53
And there is a lot of feelings there, this sense of I'm inadequate, I'm not good enough. And, you know, for his wife, she grew up with that kind of experience within her own family. So that was her emotional trauma. Her mom was very hard on her. And so then she was in this relationship where her husband was very hard on her, too. He would come home from work and just stay busy, busy, busy. And then also to be very critical of her in a lot of different ways. And she just at a certain point.

45:22
Just, can't, I can't do deal with this. The other part too, that's hard too, is if you have a perfectionist as a partner, it's hard living in that shadow of perfectionism. It can be this sense of, wow, they're just killing it every single day. Look at them and what am I in comparison? You know, I feel so inadequate here. That was also a dynamic in their relationship that we had to address and very painful stuff, incredibly painful for people. Yeah.

45:51
And I feel like for the person who, is perfectionistic, feel like creating that cognitive dissonance that you mentioned earlier is so important where they, what they believe that this is the way of getting love and connection because growing up in their family, this was the way that they got approval or love or something like that. And they're operating from, from rules that aren't working in their present day relationship.

46:19
And sort of creating that sense of what do really want? If you do really want love and connection from your partner and to help them see if you continue approaching your relationship in this way, you're not going to get those things that you really want. Absolutely. And that pressure from childhood, once again, it's just so commanding that there's no room for once again, this unconditional love. That's not anything that they knew growing up.

46:49
So how can they bring that to their adult relationship? Unless they've had a full blown crisis in life. You don't ultimately change. Most people don't change unless there's a crisis in life. We as therapists know that, okay, well we got a crisis bringing somebody in here. Okay, let's get to work. And so this fundamental belief then about I have to be perfect. I expect other people to be perfect. It has to be addressed. And finally, thank goodness. And I have so many patients who

47:18
Yeah, wow, this is really tough work. But I'm so glad that I'm able to live life in a very different way here. Yeah, great. Well, thank you so much, Trevor. Any other final thoughts before we wrap it up here? Sure. Well, I'd just like to read, I had three perfectionists write about their experience in terms of our work together. And I'd just like to read one written by one of the women that I work with. Great.

47:45
When my therapist first told me that I was a perfectionist, I didn't believe him. I thought I was probably the last person on earth who could be called one. I always thought perfectionists were people who were always on time, did everything the right way, found 100 % accurate answers, and were happy with themselves because they did things so well. That was definitely not how I saw myself. Despite the objective evidence of what I had accomplished in my life, I could always find many things I was not doing well enough.

48:15
Then I started to pay attention to how I talk to myself. My inner critic hasn't been working 24-7 for more than 50 years. It is very good at pointing out what I do wrong, what I could have done better, and what is wrong with me. No matter what I accomplish, there's always something that could have been better. Once I started noticing this, I began to see the pattern everywhere. From my simple morning routine to my professional life, there was always something I should be doing better.

48:43
Understanding this has helped me take some pressure off myself. I'm learning to notice what I do right instead of always focusing on what I could have done better. I'm learning to give myself credit for what I accomplished. Most importantly, I'm learning to be easier on myself and to allow room for mistakes, flaws, and things that are simply good enough. Am I doing this 100 % perfectly? Of course not. And that's okay. Oh, that's great. Thank you so much for sharing that. My pleasure.

49:13
Yeah. It touched when I read it too. Yeah. Well, and I think that's a wonderful way of wrapping up to sort of people who do identify as having some of these qualities just to give them hope. there's, it's not to say that, you know, you're flawed or anything like that. It's just to say, like, when you can begin to, to become aware of some of these things, there's a lot of hope for change and being able to heal and grow and

49:42
see the world in a different way. Yeah. And to treat yourself decently. makes a huge difference in life for people. If you treat yourself decently, then life can be a very good experience overall. If all you're doing is being demanding and punishing of yourself, it's a grind and it will grind you to dust at a certain point. So, yeah. Can you mention your podcast again or your website? How can people find you?

50:10
Yeah, the breathtaking world of anxiety is available on iHeartRadio and Spotify. That's about 13 episodes. They're five to six minutes long. Just a primer on anxiety, one to two takeaways. So really nice straightforward stuff. Great. And my website, I'm redoing that right now, but that should be ready by the time this episode comes out. And that's trevorhuskey.com. Great, great.

50:36
Thank you so much. And thank you for coming on the show. really appreciate it. My pleasure, Shane. Thank you so much for having me on board here. The episode this week is brought to you by Alma. They make it easy to get credentialed with major insurance plans at enhanced reimbursement rates. Alma handles all of the paperwork and guarantees payment within two weeks. Visit helloalma.com or click on the link in the show notes to learn more. And thank you again, everybody. This is Shane Burkle and this is the couple's therapist couch.

51:05
podcast. It's all about the practice of couples therapy. I hope you have a great week and we'll see you next time. Bye everybody.