The following update is from the March 2014 version of  ‘Overcome your emetophobia and thrive’.

The update is from the section on the “Perfectionist thinking style’

The perfectionist style

‘I’m a bit of a perfectionist’, is something that I quite often hear coming from my social phobic/ brooder/ obsessive/ catastrophic/ black and white thinking style clients during our initial consultation/assessment session. It sounds quite nice if you think about it – ‘I’m a bit of a perfectionist’. It’s a little bit like saying ‘yes, I am a little bit special’.

Difficulty is, due to the intense social anxiety these people suffer from (although they often don’t know it), there is a lot of ‘spin’ going on with a phrase like this.  I say this, because actually a ‘perfectionist’ is really a person running away from feeling like shit.  Deep down, they usually feel worthless, unlovable and a failure. They are continually fighting to get away from these unbearable deep-down feelings. As a result, they set themselves very high standards. They cannot tolerate failure, because failure puts them back in touch with some very uncomfortable feelings.

The trouble is, if you set yourself ridiculously high standards you inevitably do not meet them a lot of the time. This means that you frequently see yourself as failing – which is exactly what you were trying to avoid! You then tend to give yourself a really hard time for failing to reach your standards, often berating yourself for days after a perceived poor performance. This only increases your desire to be ‘perfect’ so that you can get away from these feelings of worthlessness and ‘not being good enough’. You, therefore, work even harder at being faultless, setting further high standards for yourself.

As perfectionists have low self-esteem and quite often a very negative underlying attitude towards themselves, they do tend to focus on their failings rather than their successes. So even if they do meet most of their very high targets, they tend to brood about the ones they didn’t meet. Perfectionists tend not to ‘see’, or process their achievements. When you are striving to be perfect, ‘normal’ accomplishments tend not to be seen as note worthy! Perfectionists often do not process the things that many people would be really pleased and proud to have achieved (e.g. going into work despite suffering from a heavy cold, or managing to achieve and maintain a good level of fitness). They dismiss or explain away their many successes. This explaining away of achievements can also be partly due to social anxiety and a desire not to appear big-headed or arrogant to others.

Even when perfectionists do achieve a difficult goal they have set themselves, they tend to move the goalposts and the success is yet again mitigated: ‘well I only achieved that because I was lucky’ or ‘it wasn’t really that difficult to achieve’ or ‘I should have pushed myself harder and done such and such as well’ or ‘so-and-so achieved a lot more than I did, so I didn’t really do that well’.

A typical perfectionist cycle of thinking is as follows:

 perfectionsit cycle

Perfectionists do tend to be highly achieving people as they spend so much time working to improve upon everything they do! Yet (deep down) you do not see yourself as successful if you are a perfectionist. All your achievements are set aside, as you strive to improve yourself and become faultless. Sooner or later you are inevitably going to be disappointed in your inability to meet the high standards you have set.

So, as a perfectionist, your thinking is likely to be quite distorted and you see yourself through those ‘shit-tinted spectacles’ I mentioned earlier. An example of this is a recent client of mine, Liz, who was always striving to excel at whatever she did, but she really didn’t see herself as having achieved anything much at all. Instead she was focused in on the fact that a number of years ago she had, unfairly, been sacked from her job. Yet many other people would love to be as successful as she is. She is very fit and healthy, has a great figure, studied at Harvard University, has won several university rowing races and now has a high-flying career.

By default, the perfectionist also tends to have the negative, obsessive and catastrophic styles that I have just discussed and ALWAYS has the black and white thinking style.

People with emetophobia often have a perfectionist thinking style, both in relation to their fear and in other areas of their lives. Many emetophobes, for example, beat themselves up for having emetophobia in the first place, seeing themselves as ‘stupid’ or a ‘failure’ because of their fear. Emetophobia is often a ‘secret phobia’ – 44 out of 58 (68.6%) of respondents in my recent research survey stated that they hadn’t told anyone about their fear. Sufferers frequently hid the fact that they have this phobia and try to appear perfect in daily life. They don’t want people to think that they have faults. Due to their low self-esteem and social anxiety, they don’t want to seem weak and to ask for help.

Many emetophobes display perfectionism in their attitude towards overcoming their phobia, wanting to quickly and completely rid themselves of any dislike of vomiting, thinking that they would be a failure otherwise. You do not want to pressure yourself in this way, instead allow yourself to slowly build up the knowledge and skills you need to make permanent changes. Because of their perfectionism, it is also really common for emetophobes to overreact to minor blips whilst working through this book. As soon as they have a wobble they tend to think something along the lines of ‘I’ve ruined everything, I’m so stupid, I’m never going to get better’. ‘Beating yourself up’ in this way is enough in itself to maintain your emetophobia, because it drags in all your other thinking styles and beliefs. So stop it. Stop beating yourself up, it serves no purpose at all, other than ensuring you stay emetophobic.  Give yourself a break, be nice to yourself and tolerate the blips.

You want to realise that you are going to create good days and not-so-good days in the forthcoming weeks. You are going to feel that you are getting somewhere but then create a bad day. Tolerate it. Put up with it. It’s par for the course. Early on in putting this programme into action, you aren’t going to be able to find and challenge every single unhelpful thought or belief that you have. Some – probably many in fact – are going to slip through your net. This means, that in the near future at least, you are still going to have some anxiety about sickness. If you have a difficult day, calm yourself down, reassure yourself, and move on. Most often, all you’ll need to do is remind yourself that there are always going to be ‘blips’ along the way. Every time you create a blip (remember: they don’t happen ‘to’ you) remind yourself that you are learning something else about your thinking and beliefs that will ultimately help you to overcome your fear. Everybody has blips. Even people who are completely thriving have blips every so often. It is the way in which you react to them that is important. The following drawing demonstrates the two main responses you can have to a blip: you either manage your thinking and emotions well and get over it, or you ‘tear the arse out of it’ and create a three day catastrophe…

 perfectionist blipSo, the drawing shows four days in the life of an emetophobe going through this programme. Position (1) shows them steadily improving up to position (2) where they have a bit of a blip… Here they have two choices: they either put in lots of helpful effort and overcome the blip, or they over-react with the perfectionist thinking style, beating themselves up and catastrophising their ‘stupidity’ or ‘complete lack of control’. If they prevent themselves from over-reacting at position (2) (by using whichever ACTION is appropriate at the time) they get out of their blip, usually within 10-30 minutes, and don’t lose any forward momentum (3).

If they do over react to their blip, the emotional reaction they create can be huge. They can make themselves go from being happy, feeling positive, feeling in control and really beginning to change their limiting beliefs, to, feeling totally worthless, hopeless and stupid. In fact they can make themselves so low, that they might even temporarily become worse than they have been for a long time. Position (4) shows them really beating themselves up, thinking things like ‘I’ve fucked this up’, ‘this isn’t working’, ‘I’m never going to get over this bloody thing’ and  ‘I’m so stupid’.  They hit rock bottom and make themselves feel completely useless and really low.  Sooner or later (the maximum is usually about three days!) they run out of energy to keep on berating themselves and stop it. As they stop, their mood starts to improve, they start to put effort in again, and start to get better. In fact, it’s completely inevitable that they will start to get better and get back on track again. The shaded area (5) shows the three days of feeling like an abject failure – three days that could have been limited to three minutes… In order to minimise any blips, you, therefore, want to really work on your perfectionist thinking.