Befriending the Bully Within: Perfectionism with Dr. Tara Cousineau

At age thirty-two, Tara Cousineau, PhD, had it all. But when a mysterious illness disrupted her life, her doctors blamed it on stress. Knowing something else was at play she searched until she discovered a pinched nerve that was indeed a physical ailment, but also exacerbated by stress.

Looking inward and discovering her own perfectionistic tendencies, Tara knew she wanted to help high achievers prevent burnout and illness. As a therapist, she set out on a path to improve the mental health of others and to educate those striving for excellence at all costs.

In this episode we learn Tara's working definition of perfectionism and how it can have a severe impact on one's quality of life.

Today, Tara works with students at Harvard University and she leads groups on Befriending the Inner Critic and Overcoming Perfectionism through Self-Compassion. She breaks down the parts of ourselves--that self-talk that includes the inner judge, inner bully, inner detective, and the inner joy thief.

She offers insight on how procrastination is linked to perfectionism, how perfectionism has a 40% genetic cause, and how internal family systems can be a breakthrough treatment for many--and how recovery begins by simply learning to sit in one's body, take inventory, and begin to feel.

Tara's The Perfectionist Dilemma, shares research and practical tools for striving for excellence with room for discovery, curiosity, and healthy mistakes along the way.

Listeners can find Dr. Tara’s book, The Perfectionist's Dilemma: Learn the Art of Self-Compassion and Become a Happy Achiever, at online book retailers and access to free Happy Achiever tools at https://perfectionistsdilemma.com.

They can also find more in "The Peaceful Perfectionist" Substack, https://taracousphd.substack.com

Transcript

Introduction to Perfectionism Dilemma

Janine 0:01

Welcome to Bipolar she. I'm your host, Janine Noel. Today I sit down with Tara Cousineau, author of the newly released book The Perfectionist Dilemma learn the art of self-compassion and become a happy achiever. It is an eye-opening conversation on how striving for perfection can cause severe problems in our lives. With our inner critics running rampant, it's no surprise that perfectionism can zap your life force. For those struggling with serious mental health conditions, including anxiety, ocd and eating disorders, perfectionistic thoughts and behaviors can cause or exacerbate symptoms. Perfectionism has increased 33% over the last three decades in children and teens, and this finding correlates to smartphone use and constant comparison in social media. And they've discovered perfectionism even has a genetic component. As a clinical psychologist who counsels and runs workshops for college-age students at Harvard, Tara sees perfectionism when it has deeply taken root. Her approach to working with perfection includes befriending your inner critic, mindfulness, mind-body medicine and internal family systems. Welcome, Tara.

Personal Mental Health Crisis Story

Janine 1:32

This episode is brought to you by the Soar with Tapping app created by expert EFT coach and friend of the show, amy Vinsa. If you're navigating anxiety, trauma or just trying to feel more grounded, tapping is a powerful, science-backed tool that can help calm your nervous system and gently release the emotional weight you've been carrying. Amy's guided sessions in the app make it very simple to start healing right from your phone. Visit the Soar with Tapping app in Apple or Google Play stores and start your journey towards freedom. Thank you so much for coming on the show. It's great to have you here and I'm really excited to talk about perfectionism and also about your book, the newest one, the Perfectionist Dilemma. I have so many questions, but I always like to start with a personal story of a time your mental health was impacted.

Tara 2:31

Yeah, I probably have a string of those stories, but I'm going to talk about one first. Just that kind of got me as a professional thinking about what was I doing in my own life. And here I am helping people, and I was about 32 at the time. I had two little kids, basically been a student my entire life. I was coming to the end of my PhD program. My husband and I just bought a house.

Tara 2:53

There was just a lot of stress, two little kids and we're in the backyard and we're barbecuing and my kids are on the swing set and all of a sudden I just started feeling the shooting pain from like the right side of my face down through my arm and I actually thought I was having a stroke and I just went into what I later determined was a panic. But I, you know, I looked at my husband and said call 911. And I passed out. And so my cute little family is just watching me be carried out on a stretcher to go to the emergency room and test me right away for stroke and all those kinds of things. And then I went through a series of doctor's appointments, like what was going on, you know, was it a nerve? Was there a tumor, I mean all of these things. And neurologist just said well, it's stress, which of course a patient never wants to hear. So for an entire year I'm feeling like I'm walking through spider webs, Like that was the physical sensation and I'm like this just can't be stress. This is definitely something else that's happening. And it was a dentist who said it seems like you have trigeminal neuralgia, which is sort of this pinching of the nerve, sort of where the jaw meets the ear, and immediately it made complete sense to me and I thought, okay, yes, I'm so stress intense. I mean I've had TMJ since I was 12. This kind of makes sense that it was just this sort of accumulation of stress and tension that had this physical manifestation. And so that just got me kind of in this path of how do I release the tension, what do I need to do?

Tara 4:22

Started doing all the alternative medicine things like chiropractic acupressure and those things actually did help. And I got back to yoga, which I had done when I was younger, and I just had to kind of reorient the thinking. But of course it would take years to kind of really determine what was going on in my life and my habits, that I was constantly in a state of chronic tension, essentially. And then I started in my private practice and coaching. I was just working with a lot of high achievers and they were like exactly like me, basically helping people who are coming to me with the same problems that I had which is always how it happens and realizing that, you know, there's just these threads of perfectionism.

Tara 5:07

And then fast forward 20 years into my career. I was working at an Ivy League counseling center, which kind of brought me back to the beginning all over again of having, you know, just young people come in, smart, passionate, you know they want to make a difference in the world and they were just so down on themselves, harsh inner critics, and that just got me started like, okay, I got to nip this in the bud earlier for people instead of having to wait another 15 years and they end up in a psychotherapy office. But here they were in my office. The last six years I've been running these workshops called befriending the inner critic and overcome perfectionism through self-compassion and really kind of bringing in a blend of techniques and skills to help high achievers essentially not self-sabotage and actually love themselves, because most of them weren't doing that at all.

Janine 5:57

So I'm curious how you even define perfectionism.

Tara 6:01

Basically define it as perfectionism is the paradox that's created by the need for belonging and the fear of rejection, paired with these unrealistic expectations for achievement and approval that sap your energy or life force. Perfectionism has a consequence, you know. Eventually it has a really big consequence. I work with people across the lifespan and I work maybe two days with the younger cohort anywhere between 18 and 28 on average, I would say undergrads and graduates and they have an awareness that their perfectionism by the time they come into counseling, for example, they have a sense that something's not going right or they just have a really severe inner critic.

Tara 6:44

Like some people wouldn't even define it as perfectionism per se, but they would come in and just say I'm so stupid, I don't deserve to be here, it was a mistake. A lot of imposter feelings. So I think they might relate more to the imposter feelings than perfectionism per se. But some people come in and just say I'm a perfectionist, I've been this way my whole life. I need it, it's not going to change. It's sort of like the favorite flaw that people kind of wear as a badge.

Janine 7:10

Yeah, do all of us have parts of perfectionism within us.

Tara 7:16

Well, so in my book I describe that sort of the facets of perfectionism really arise through sort of two main influences. One is going to be culture, right, society culture, especially young people who basically you know, as actually someone said to me last week she's 27 years old, she said I think the hardest thing is going through puberty with Instagram. I was like yeah, that's pretty apt. There's definitely the sociocultural influence which is kind of immersed in it. And then there's internal factors, more personal factors, and that might be associated with you came into the world as highly sensitive or you grew up in a family where being sort of efficient, organized, smart was just the norm and you didn't know any different, and so it's kind of like almost an epigenetic kind of thing. There is some heredity factors. It's maybe like 40% perfectionistic traits can be inherited. The overlap is really what people say to themselves, sort of the inner critical narrative. So maybe you don't consider yourself a perfectionist per se, but there's something that you're not good enough.

Janine 8:20

Right, so are there different archetypes of perfectionism that you repeatedly see?

Tara 8:26

Well, I've come up with my own slew which are very sort of non-scientific but as a psychologist with a PhD I need to actually have a nod towards the research and they define perfectionism as sort of three types or categories and these overlap, obviously. But one is sort of this self-oriented perfectionism and that's kind of you're setting the milestones for yourself, you have this sense of what is expected of you, you're setting the bar high for yourself. It's very internally driven. Then there's this category called other-oriented perfectionism, which is, I think, really what the stigma is in movies and TV shows, like the mean boss, the harsh bully, the expectation that everybody else does things perfectly and right, and that can come with a lot of tension, obviously. And then there's socially prescribed perfectionism, and this is the kind of perfectionism I call it the compare and despair perfectionism. It's really more where the imposterism might come in, where you're constantly the external criteria, you're just comparing yourself all the time and that's relentless. And the research does show that this socially prescribed perfectionism is the one that's correlated with more of the mental health challenges like anxiety, depression. But what I have found is that people come in and they start sharing what they say to themselves. And this is where I try to get people to almost have a relationship with that part of themselves. I've kind of broken things down into have a relationship with that part of themselves. I've kind of broken things down into the inner judge voice. It's like a Judge Judy that's constantly there scrutinizing everything there could be.

Tara 10:01

The inner bully, as I mentioned, it's just very harsh and demanding. It's kind of like the mean coach, like certain kinds of fixation. So I call that the inner detective. And a lot of perfectionists get that. They keep thinking that they can't leave any stone unturned. They have to keep going and going and going and they don't know when to stop and that obviously is not helpful. Over time place and look aesthetically pleasing and be super organized and that can take up a lot of your time when you've got sort of that voice telling you where things should go and how they should be.

Tara 10:41

And then a medical student who in her own journaling of her inner thoughts said mooch is that it was just mooching her of her pleasure and her joy. She wasn't allowing herself to go out to dinner. So I call that your inner joy thief. You're working so hard and you don't let yourself play or have fun because it's taking the time away from what you should be doing instead. So there could be plenty of different kinds of narratives, but people relate to those and like oh yeah, no, I definitely have that internet picker. Or ah, when you said joy thief, that's so right, I don't allow myself to have any fun. And it starts to kind of release that tension. You know about how they think, about their perfectionism, like, oh, it's a part of me.

Janine 11:24

So how do you begin to work with those different parts and help someone become less perfectionist?

The Internal Critical Voices

Tara 11:31

Well, I think you know I'm gonna go back to the research for a minute, because there's some new research that I find interesting, because it's what I see in terms of like people with their dreams and their goals is that Patrick Gaudreau, if I'm saying his name right, is a researcher in Canada and he looks at sort of achievement and goal seeking, and what he has described is sort of the difference between described as sort of the difference between excellence-ism, which is this striving for excellence with flexibility, with curiosity, versus perfectionism, which is a rigid standard, right that things have to be flawless. So there's a tipping point. He calls it sort of like a point of diminishing returns. And there's nothing wrong with striving for excellence and wanting things to be right and to be good at things, of course right, but there comes a point of diminishing returns, and there's nothing wrong with striving for excellence and wanting things to be right and to be good at things, of course right, but there comes a point where the extra effort no longer pays off, right. And so when I work with people, I'm really looking at that sort of difference between sort of the striving for excellence and this perfectionism and where there might be some movement to be more flexible, like to really start to invite in curiosity and flexibility, and also practicing failure and making mistakes, and that's okay and you'll still survive.

Tara 12:45

I do think to your question it's like well, how do you start? Well, I feel like it's a little bit of the awareness step first. So it's just being aware that if you're labeling it yourself as perfectionism, how are you actually in your body? You know, how are you feeling it? Those are usually where the first signs are, and it's usually tension or IBS or chronic migraines or insomnia. I mean, the list goes on and on. But they're not really making the connection that, oh, their striving is also having an impact on their internal resources, just on their own energy. That's why I add that sort of like. You know, the perfectionism saps your energy or life force, because it really does over time.

Janine 13:32

I'm also curious about internal family systems. I know that's part of your therapeutic approach.

Tara 13:39

Yeah, so I introduced that I'm trained in the second level of that particular methodology, so I feel like I'm still very much a practitioner and a student at the same time. But what I love about internal family systems is basically it's this methodology, founded by a psychologist who used to work with families and family systems is basically it's this methodology, founded by a psychologist who used to work with families and family systems and then started to recognize that the patients he was working with and really, you know, patients with severe issues like eating disorders or anorexia started talking about their parts and not in kind of like a dissociative identity disorder perspective. But you know, there's a part of me that really wants to do this, but no, the part of me saying I can't do that Right. So people are talking in terms of dialectics and their various parts. So he developed this method and what I love about it is like, if you recognize that you have an inner bully, let's say, or an inner nitpicker, is really turning towards that part of you and becoming curious about it, like what you know? How is it trying to help you? How has it served you in your life? When did it show up and when you start getting curious about that aspect of your inner life. You can almost unblend from it. And that can actually take time, because this young woman who kept coming into my groups and just saying, no, I'm really stupid, you have no idea what I did last week, I'm stupid, stupid, stupid, I mean, this is what she would say.

Tara 14:58

And she had a really hard time sort of separating herself from that experience. Like she really felt that she was stupid, until we started doing a little bit of just parts detection, if you will like naming the part. Well, it's the part when she's in class and she's talking to people and she's doing this comparison. And then it was like how long has this been going on? And she could date it back to a certain time period in her life. And then she was like, oh, oh, I get it. I'm saying this to myself before anybody else can.

Tara 15:31

And that was a real revelation for her, you know, is that she was carrying this burden, and so the work was really about kind of turning towards that younger part of herself, like, literally, that has been there since she was like 10 years old.

Tara 15:43

And like if that 10 year old girl was sitting right next to you right now, what would you say, oh, it's going to be okay, you're not stupid, you're doing the best that you can, you're not alone, let me give you a hug, right. And so that's where we start really developing the self-compassion which is a big part of what I try to teach in my book and my work. And there is research that shows I mean, that sort of inner loop that we do in our minds with critical thoughts kind of resides in a certain neural network in the brain and yet when people start practicing self-compassion, that starts to sort of diminish, if you will, over time. So it's such an important practice and it's the one that people resist the most in my experience. So if you think that you've got oh, I've got a bunch of parts, I'm like, yeah, I've got my little temper tantrum part, who's five, and I've got the sort of the awkward teenager, who's 12. You know, I can apply that kindness to those parts, right, that self-compassion, and that becomes a practice.

Janine 16:43

I think you wrote about how it can show up as procrastination, which I find really surprising. So I'm just wondering if there are other ways it shows up that we would be surprised.

Treating Perfectionism with Self-Compassion

Tara 16:56

Well, I always say that with perfectionism, sort of the near sisters of perfectionism is workaholism on the one side and procrastination on the other side, like they just kind of go in tandem. But if you take a lens from like internal family systems, let's say, or parts where that inner judge or bully is trying to manage your life, it's trying to control things right, and over time that can be sort of well really just exhausting. And so there's another element or part of yourself that says I've had enough, I need to slow down, this is too scary, I don't want to do it, it's too hard, and so that's just another part of like our nervous system that says it's like putting on the brakes. So the perfectionist part is the foot on the gas pedal and the procrastination part has got the foot on the brakes. And when that's happening simultaneously all the time, you can imagine what that tension is like, right?

Tara 17:45

So people often identify more with the procrastination than they do with the perfectionism. But underlying both is really a failure anxiety. If you're making a mistake, doing something wrong, it's just manifesting in those particular ways. I do see, like in the university setting there is a lot of sort of just right OCD and it can sort of manifest as I can't get my papers in until they're absolutely perfect, or the points on my chart have to be in exactly the right place, or a ton of overthinking and fixations. You know, medications can help mostly with the anxiety versus the perfectionism per se, and that can be enormously life-changing for some people. I think it's a longer process, though, for many to kind of understand, not even really why perfectionism has settled in, but how and then how to change it.

Janine 18:43

So if you're going to start working with someone at any age that is dealing with perfectionism, what are the first steps? To prescribe failure Sounds so intense and difficult to do. Are there some first steps that are a little bit easier than that?

Tara 19:00

Well, you know, it's interesting. I really actually enjoy working with people in groups, which is the last thing that a lot of people want to do, but when they realize that they're not alone in the way that their mind works, it's super helpful. So at first I do a lot of psychoeducation on sort of our tricky brains, how we make these associations, and also on the nervous system, because I do feel that when people can learn how to regulate their nervous system, in other words, when they've had a distressing moment, that they can kind of come back to some sort of center and grounding and that actually takes practice. It's not like, oh yeah, I'm going to breathe for three minutes and I'll be okay. It's like it's repeated efforts over and over, so that you start sort of recognizing that there are these experiences in your body and that you actually have skills on how to do it and there are a variety of skills and it's almost kind of like you have to find the right match for people. They have to kind of try a few things. So I've got a number of people that really love emotional freedom technique which is tapping, which is tapping on acupressure points, just tapping on acupressure points, and I like that technique as well, because it's actually a little bit of emotional exposure because you're holding in the present moment what is upsetting and distressing At the same time. You are saying a self-compassion statement or a self-acceptance statement while you're tapping on these points known to help sort of calm the amygdala. So some people just love those. Other people are like no, I can't do that. But they might find actually physical activity is super helpful, regular physical activity, breathing techniques.

Tara 20:32

And if a lot of perfectionists have a hard time with meditation at first because they're so in their heads already, so sometimes it's and I'm a certified meditation teacher meditation might not be the first approach with perfectionists because it might actually reinforce rumination, because they don a group or learning to kind of find people that can actually validate, give you meaningful, kind, good feedback in a way that you might not have received, that you could kind of metabolize. So validation is really important. Sometimes it's as basic as naming how you feel and a lot of it's as basic as naming how you feel and a lot of people have a hard time naming how they feel, starting to do that kind of awareness and development, connecting it to sensations in your body. And then I do have the sort of the parts work. It's just starting to identify and naming the thoughts and the feelings, open your heart to those parts and kind of love the inner critic which is what people are like what, what are you talking about? And it's very hard to turn towards that harsh critic, that saying you're so stupid, stupid, stupid. You know, like I can't do that.

Tara 21:57

But if they started to develop those first few steps of embodying the present moment, learning how to self-regulate, they can tolerate the distress, and so emotional courage is really kind of turning towards that part and say, oh, I see you, you're here, why are you here now? Oh, right, because this presentation is really important to me. I don't want to mess it up, but instead of having that part take over as a worry ward, you're going to turn towards and say you know what? I've got this, I've got this, I've got my note cards, I'm going to be okay, right, so. So there's that piece. And then there's this sort of making a commitment to yourself.

Practical Tools for Change

Tara 22:30

So I think you know, with behavior change, like if you recognize that these are behaviors, you really actually have to commit to doing them, and a lot of people don't. You don't have sort of a certain set of practices or skills that are authentic to you, you know like. So for one person it might be journal writing, taking walks, talking to themselves kindly Great, perfect. For another person, it might be like I need to make sure that I'm eating regularly throughout the day. I need to call my best friend you know like, and you've got your sort of like little toolkit and then you commit to it.

Tara 23:05

Because this is how change happens by these small, repeatable actions over time. Perfections, in particular, minimize the positive constantly, like it's almost like they're inoculated against positive feedback, like they can't take it in. And so there's this real like oh, you just got some really beautiful feedback from I don't know your friend or a professor or your boss. How can we help you? Take this in, write it down, put it in a journal, share it with a friend, remember that this happened, stay with it a little bit longer. All of a sudden, you feel more centered, your energy starts to shift a little bit, and when that happens, you're on your way.

Janine 23:44

Yeah, it's so well put in the book and it makes change actionable, which is exciting. At the same time. I wonder if there's someone that's a perfectionist in your home, someone you love. Is there a different way to say perfectionist? Like that is a little kinder? I mean, this change and this help sounds wonderful, but like, how do you nudge someone to do this?

Tara 24:11

take it in right, they might become defensive. If that's what you're getting at, I actually think it's just really important for you to kind of recognize how you're affected by someone's perfectionism, as opposed to telling or pointing out to somebody else what they're doing. You know, just a kind of clear communication of oh, the other day, when you pointed this out, a part of me felt really tense and even a little bit angry, and I've been really reflecting on why I had that experience and I realized that in that moment I just needed appreciation, you know. So I wonder, next time something like this comes up, we might communicate about this differently, right? So that way you are owning your own stuff. How will that land with another person? Again, this takes practice. I mean, what I just kind of walked through there was sort of a version of nonviolent communication, also called compassionate communication, where you're just really recognizing what your feeling state is, you're recognizing the unmet need underneath that and then you're making some sort of request for a shift or a change. And sometimes it takes a lot of practice to do that for yourself, but usually it can help mitigate another person's defensiveness. So to really see that it can be very detrimental to us.

Closing Thoughts and Podcast Outro

Tara 26:04

I was a perfectionist growing up. It was coping skill, though, and then I made that. What I say all the time is that perfectionism is protection, is that you've used it as a way to get through something or some perception of your life, and it worked at the time and it was logical to you, whatever age you were, when you sort of cultivated that skill. So I think when people can recognize that perfectionism is some kind of protection and getting really curious about that, it kind of changes the whole conversation. It becomes less, I don't know, pejorative or shaming, and and the fact that you made a commitment to doing things differently is really, I think, the key to all change. If you wanted to leave advice for the struggling perfectionist Love all of your parts that are there for a reason, and once you can kind of identify that, you've got this sort of little motley crew inside you and they're just kind of like little children, teenagers, that need your love and attention, and once they have that, they'll relax. Life gets easier.

Janine 27:05

I just feel lucky to have you on the show, so thank you.

Tara 27:08

You're welcome.

Janine 27:30

Hi, it's Janine Bipolar. She is currently an independent podcast. I'm its writer, producer and host. Please consider this podcast as a work of advocacy, getting important stories to those that need them. As we gather ideas how to keep the show running financially, please do engage with the podcast wherever you find it, offer up some stars and some likes. You can visit us at VipolarShecom or at VipolarShePod on Instagram, and thank you, as always, for your support.