When Perfectionism Meets Panic: A TEAM-CBT Approach
A panic attack can strike anywhere – in a classroom, at work…even during routine errands. Your heart races, your vision narrows, and an overwhelming sense of doom takes hold. If you struggle with perfectionism, these experiences come with an additional layer of complexity.
What Does Panic Disorder Look Like?
Meet Elliott: Perfectionism and Panic Combine Forces
Elliott was in his second year of grad school (details changed for privacy) and started therapy after having a panic attack in the hallway outside one of his classes. He was behind on a paper he needed to write, struggling to keep up with huge quantities of reading for classroom discussions, and frozen by the looming pressure of comprehensive exams that would make or break his presence in the program. He was managing to get by until one day in class. He tried to respond to a question only to have his professor point out to everyone that he’d misunderstood a critical point.
He waited as long as he could, then excused himself to use the restroom and stepped out into the hallway where he felt stuck in a tunnel of intense fear and dread with no way out. He felt like he was going to die or lose control or fall out of touch with reality. He couldn’t trust his body and he was intensely aware of still being in a public place.
Leaving the classroom made this less disruptive but he wasn’t at home where he could blast music or pet his dog or stand in the shower until it passed. He was also intensely embarrassed. He felt sure his classmates knew what was really going on and that they were judging him for losing it like this.
The Perfectionism-Panic Connection
The link between perfectionism and anxiety might seem obvious — perfectionists tend to maintain high standards and vigilantly guard against mistakes. But that doesn’t exactly explain panic.
Panic is an escalating sense of terror about the sensations that accompany anxiety. You feel your heart race or your face gets hot, your skin starts to prickle, your vision narrows. In response, you get even more anxious, afraid the escalation is never going to stop. That ratchets the intensity up even more, and suddenly, you’re in a vicious cycle.
Anxiety About Anxiety
Perfectionism isn't just about doing everything right – it's about *feeling* everything right too. The drive to present a flawless image to the world often includes the pressure to maintain perfect emotional control. When intense emotions arise, they represent a threat to this carefully maintained facade.
Emotional perfectionism is part of living a life without apparent flaws. If you’re hiding flaws from people, one of the big ones to hide is the set of socially unacceptable negative emotions. For perfectionists, who tend to strongly prefer a sense of having things under control, the unpredictability of panic attacks is particularly threatening.
Elliott’s Experience
The moment his teacher called him out, Elliott, for example, felt his cheeks get hot, noticed his heart start pounding, and felt flooded all over with a prickly, loud thrum. He was caught off guard by the physical response and an absolute need to get as far away as possible. He didn’t understand himself though. He thought it was important to be open to feedback and own up to his shortcomings, he just usually avoided actually doing that by staying one step ahead of every criticism.
He wanted to take it in stride but his blood pressure was revealing his true feelings whether he liked it or not. And once that started, it felt like he was on a one-way conveyor belt he had no control over.
Identifying Panic: Beyond the Obvious Signs
Unlike a lot of mental health diagnoses, panic does have a way of reminding you it exists. One of its main features is its intensity! At the same time, it can seem like a one-off. It might appear to be a heart attack or other physical illness and confuse you and everyone around you.
In my own experience, panic has actually been tricky to identify because I cry when I’m panicked. For a long time, I didn’t see it as panic or even anxiety necessarily, because tears were so set in my brain as signs of sadness that it took me a while to see that these particular tears were anxious. It was also incredibly confusing to the people around me!
The classic components of panic were there, though. I had an anxious response so intense that it felt totally disproportionate to the setting. Then I got anxious about my physical response and how much it was ramping up - would it stop? Had I stopped making any sense? And the icing on the cake was feeling ashamed and self-conscious because I had no way of hiding the fact that I was freaking out for no apparent reason.
TEAM-CBT can Help with Panic Disorder
TEAM-CBT offers a powerful approach that might initially seem too simple: identifying the exact thoughts present at the onset of panic. While this may sound basic, it addresses a core challenge of panic attacks – the confusion we feel about their origin and the disruptions they cause to our self-image.
If you can name your emotions and figure out where they’re coming from, they’re much less overwhelming and much more manageable.
The approach goes beyond understanding, though. A crucial component involves gradually confronting panic triggers. This process, while challenging, consistently proves effective.
In Elliott's case, his fundamental fear centered on losing others' respect. Through role-playing and real-world experiments, he tested his fear that he couldn't handle rejection or judgment. As he discovered his capacity to cope with these situations, his anxiety dropped drastically. He still had access to the surge of energy and effort he needed to perform well, but not so much that his system couldn’t handle it.
Begin Counseling for Panic Attacks in Georgia
For those in Georgia struggling with panic attacks – whether connected to perfectionism or not – professional support is available. A free 20-minute consultation can provide insight into how therapy might help transform your relationship with anxiety.
The best way to learn more and find out if we’d be a good fit is to read the Rates & Details page, then schedule a free 20-minute consultation. You’ll have a chance to tell me more about yourself and your goals and then ask questions about what working together would look like.
Bit by Bit Counseling’s Other Services
Mood problems tend to overlap a fair bit. If you’ve had panic attacks, you probably have some experience with generalized anxiety, OCD, trauma, or relationship problems. Learn more about each of those and how life might be different with effective treatment.
I love showing people how to feel more joy, more contentment, and a deeper sense of connection. Panic, in particular, can make such a dramatic shift in a relatively short period of time. If you’re willing to face your fears, you can find freedom pretty quickly.
Cheryl Delaney, MS, LPC
I’m Cheryl Delaney, a Georgia-based therapist specializing in therapy for perfectionism through online counseling.
I’ve had lots of different forms of anxiety and some experience with depression, too! I’ve faced some of my own biggest fears, and love showing other people the way out. Learn more about me and my approach (TEAM-CBT), or schedule a free consultation to ask questions about how therapy might work for you.