Outwardly impressive, losing it on the inside? The cognitive distortions of a high achiever

Over years of clinical practice, psychologist Dr Mary Anderson started to notice a peculiar pattern across her many clients. Despite being impressive high achievers on the outside, inside they were struggling with burnout, imposter syndrome, anxiety and self-criticism. So she set out to develop a guide for these high achievers. A framework to support their success ... without sacrificing their mental health. If you loved this episode, you should listen to our story on controlling the chatter in your head https://www.abc.net.au/listen/programs/allinthemind/controlling-the-chatter-in-your-head/13739740. And if you haven't already, please take a moment to fill out our listener survey https://www.abc.net.au/listen/programs/allinthemind/audience-survey-feedback/105151860! It's only seven questions and we'd love to hear your thoughts on the show. Guests: Dr Mary AndersonPsychologist; Author, The Happy High Achiever Extra Information: The Happy High Achiever - Pan Macmillan Australia https://www.panmacmillan.com.au/9781035053537/

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  ABC Listen, podcasts, radio, news, music, and more.

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  You are self-critical, often thinking about what you should have done or should do in the future. You worry about your performance and others' perceptions of your performance. You like to feel special instead of like most people.

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  Does any of this feel like it's describing you?

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  You feel massive pressure to keep achieving big and impressive goals.

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  These kind of sound like affirmations, but warped ones, ones that have been run through a funhouse mirror. And so what's left is just a litany of your most anxious qualities.

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  You experience fear of failure, of making mistakes, or of being viewed as incompetent.

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  What these really are are some of the hallmarks of your typical high achiever. According to Mary Anderson, she's a clinical psychologist in private practice, and many of her clients are outwardly impressive, but they're quietly losing it on the inside.

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  High achievers often are productive, talented, goal-oriented, and skilled problem solvers, and they love a list. So those are all really advantageous traits. But I often see some less enjoyable traits that high achievers who are struggling with anxiety and worry often grapple with. You're afraid others will find out that you're not as smart or talented as they thought you were.

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  This is All in the Mind. I'm Sana Qadar. If you feel like you're being knocked off your game because of your internal monologue, Mary is walking us through how she helps her patients reorient their thinking. And she says you can implement these strategies on your own as well.

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  But does gaining balance mean losing performance? Can you be high achieving and be happy? And what if the thought that plagues you is, I should really be further ahead in my career by now? Today, how to keep your edge at work but ditch the self-flagellation.

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  Mary works in a part of the world that is packed with your stereotypical high achiever. She's in Boston, Massachusetts. So you've got Harvard and MIT nearby. The city's main industries are healthcare, finance, and insurance.

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  I would be in the office and I would have these amazing patients come in and vicious, high achieving, hardworking patients. So a successful business professional, doctors, lawyers, grad students, a lot of law students. And they would settle in on my couch across from me and they would really candidly and courageously describe struggling with chronic stress, anxiety, worry, perfectionism. And what I realized is they were these amazing people who really were not enjoying their excellence.

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  What she's noticed over the years is these types of high achieving patients seem to have three thoughts swirling in their heads, three types of cognitive distortions. They often engage in all or nothing thinking, jumping to conclusions, and should statements.

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  So cognitive distortions are unhelpful thoughts that are based on faulty beliefs, misconceptions, misinterpretations. So all or nothing sounds just like that. It's like forcing a dichotomy where there doesn't need to be. So people will say, Dr. A, you know, everyone needs to be totally blown away by my presentation. That's a lot of pressure, right? And I actually call all or nothing thinking pressure cooker thinking for that very reason. And so you'll hear a lot of like, everyone, always, everything, or nothing, you know, or always, I'm always falling behind. So that's the all or nothing thinking that's

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  really pervasive, so pernicious, so undermining of people's confidence because they're thinking that they need to do the impossible, which is to be perfect and flawless. Then we've got jumping to conclusions. And this kind of comes in two flavors. There's negative fortune telling, which is when we assume or predict something negative will happen, but it hasn't even happened yet. You know, like a law student or grad student would be like, I know, Dr. A. I know I'm not going to do well on this exam. And I'm like, the exam is still like three weeks away. And then there's mind reading. And this is where we think that people, we assume that people are judging us or thinking negatively about us, but we don't have evidence yet. So people will be like, I know they, you know, I know they're not going to like me, Dr. A.

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  You know, I'm going to sound so stupid up there giving that presentation. The project's going to be a flop. And again, that really made them stressed out and undermined their motivation and confidence behaviorally. It did not help them. And then the last type of self-talk that I often, often hear from my patients are the shoulds, right? Super pervasive. And it comes in various ways. We should ourselves, we should other people, we should situations. Big one I hear is, I'm so behind. I should be farther ahead in my career. I should be farther ahead on completing my to-do list for the week. That again, puts so much pressure on people. And it actually has this opposite effect that shoulds usually keep us stuck. Because we don't feel good when we should ourselves.

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  I know I should be going to the gym more, Dr. A. But is that really motivating? No, they just feel badly about themselves.

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  So how do you get over this kind of thinking? Well, it's a journey. And Mary uses cognitive behavior therapy with her clients. And the first step is to realize you are having these kinds of thoughts, these cognitive distortions. And then you can move on to questioning their veracity and poking holes in them before replacing them with new thoughts.

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  The one thing we all are always in control of is the thought that we focus on. We'll have thousands of thoughts a day. Can't stop a thought, you can't control your thoughts. But you can choose which thought you want to focus your attention on. And which thought we focus our attention on directly impacts how we feel and how we behave or show up in the world.

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  And so here's an example of how she helped one client. A young woman named Tina, who was freaking out about a presentation she had to give at work and telling herself she couldn't do it.

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  I'm going to sound so stupid. I suck at public speaking. I should be better at this. So the question I asked Tina was, what thought is making you feel the most stressed out, Tina? And she thought about it and she said, you know, I just keep thinking to myself over and over, I can't do it. And so then what we do is question number two is, how is my thought not necessarily true? And so I said, well, have you never spoken at one of the meetings?

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  Turns out Tina had, not for very long, but for a few minutes. And she'd done a good job and she'd even gotten praise from colleagues and her boss.

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  That's why the boss asked her to speak again at this like meeting, which was, you know, happening next month. And so she reminded herself of all of the facts of the situation. And what it did, I call it poking holes. You gotta poke holes in that unhelpful thought. You gotta show yourself that it doesn't hold water. And then the last step is to ask yourself, what would be a more helpful thought to focus on? Because clearly Tina telling herself, I can't do this, is that helping her? Not at all. So how can we then help her create a thought that's based on the evidence that we just used? So it's, it's gotta be a reality based thought.

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  And that's really important because the more helpful thought, I call it new and improved self-talk. For new and improved self-talk to be effective, it's gotta be believable. Because why do our thoughts impact our feelings? Because we believe them. So we've got to make sure that our new and improved self-talk, that we're working to practice, that that is actually a believable thought.

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  Mary also says it's helpful if this believable new thought is short and punchy. Because if you think about your negative self-talk, you'll notice how short and generalized it often is. Thoughts like, I can't handle this, I can't do this, I'm not good enough.

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  These short little things that play over and over and that's why it sticks so easily. And it's, it's usually these like over generalizations, right? Like, I can't handle this, this is too much. And so those are the ones, again, we have to go after and poke holes in those suckers because there's so much evidence in a high achiever's life of like, actually you have handled a lot of difficult things before, you can deal with this. It might be challenging, but you can't. So Tina was able to say to herself, you know, I don't want to speak at the meeting next month. But I've spoken at meetings before and actually got some positive feedback. I can practice because again, I talked a lot with her about, you know, what's under your

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  control. And she said, you know, I can prepare and practice and I can do my best next month.

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  And so to narrow down that thought into something a bit sharper and shorter, here's what Mary did.

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  Within that balanced thought, I said, what is the part of that balanced thought that helps you the most? To feel better, to get some relief, right? Because that's what we're going after first. I always say when people walk in with anxiety, I want to help them feel relief and then joy, right? So relief and then joy. So for Tina to get some relief, she said, you know, what helps you feel relieved is I've done this before. I've done this before. Because she initially was saying, I can't do this. I can't do this. But once we helped her remember, I've done this before, that's what really helped her feel better. So we just took from the situation of Tina feeling terrified and saying, I can't do this, to now getting herself to the point of I've done this before.

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  And then we made a game plan and we helped her really plan how she would prepare and practice. By the day of the meeting, Tina crushed it. She did great. She was still feeling stressed the day of, but she was able to get out there and do it. And then it built even more evidence for her to then lean on in the future. I often say, use your memories of past successes as fuel for when you're climbing your next mountain.

• 10:29Speaker 01

  So that's one example of how you can use CBT to work through anxiety around an upcoming project or presentation. And you don't need a therapist for this. You can do this on your own as well. Self-guided CBT is a thing. But what if your work-related worry is broader than a single project?

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  Most people my age seem to have their careers really together. And I've had a few different careers and I just look at where everyone is and I'm so far behind them. Sometimes I wonder how well I'd be doing if I was a man instead of being a woman and how much further along in my career, how much more I'd be making. I feel like everyone can see that I'm having a bad day and they're going to punish me for it.

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  Oh God, like I really need to speed things up here. It really makes me feel like, I don't know, I'm not accelerating enough in my industry, simply because the pay packet doesn't reflect that.

• 11:26Speaker 01

  You mentioned earlier, one type of should thought you often hear is, "I should be further ahead in my career." This is something I've heard from so many friends over the years. It's something I've felt many times. And it can really gnaw at your sense of self-worth, especially if your identity is so tied up in your work. How do you help people deal with this thought?

• 11:49Speaker 00

  Great question. Well, first, I just want to normalize that is something that is quite common for high-achievers, especially who are struggling with stress and anxiety. They'll, they'll think that to themselves. And something that you said absolutely is part of it is often we tie our self-worth to our achievements, appearance, or performance. And when people do that, it really leads to chronic stress and anxiety and makes people feel less than. I always say with shoulds, we feel stuck because we're feeling deficient. And initially, it's helping them remember your self-worth is not tied to your achievements, appearance, or performance. So really helping them remember that their self-worth is inherent and unconditional.

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  We got to start from there. And instead of focusing on how far you have left to go or how you're not measuring up, it's so important for people to give themselves credit for how far they already have come, how much progress they've already made. And from there, then I work on helping them set goals that are doable and that sets them up for success, rather than keeping them stuck in this place of, "I should be doing more, I should be further ahead."

• 13:02Speaker 01

  It seems, in one sense, straightforward. You know, untie your sense of self-worth from your work and accomplishments. Stop comparing yourself to others. Those are straightforward enough, but very difficult to do. Like, I imagine you have to go on a real journey to reach the point where you do those things.

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  I work on this actually a lot with lawyers, interestingly, because I think they're really competitive by nature as well. And so helping them remember why they do the work they do has been really helpful, that they are really dedicated to moving justice forward in the world. I think that's what's been helpful when they'll see their friends becoming judges or getting promotions or, you know, becoming editors of journals and different things. And sometimes I'll also ask them, Yes, that's a, you know, a huge accomplishment. Your friend became a judge or is an editor of a journal. And then I'll say, do you think you'd actually want to do that? And that's been very, very helpful.

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  That question of, yes, it looks shiny from far away. It's that achievement. It's that trophy or that award. But then look closer and be like, would you actually want to live the daily life of a judge? And they're like, no. You know? Or do you want to be a professor at that top school? And think about all that would go into that? And maybe you would. And if that's the truth, then great. Let's help you set goals to get you there. But I have to say, the most interesting thing is very often people say, well, I don't actually even want that for myself.

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  You're listening to All in the Mind. I'm Sana Qadar.

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  Dr. Mary Anderson is a clinical psychologist and author of The Happy High Achiever. Eight Essentials to Overcome Anxiety, Manage Stress, and Energize Yourself to Success Without Losing Your Edge.

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  Now, I mentioned Mary uses CBT, Cognitive Behavior Therapy. And she reckons this is especially effective with her high achieving clients.

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  They like having concrete, science-based, actionable strategies and skills that they can begin to implement.

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  But one element of CBT she finds she really has to emphasize with these kinds of clients is self-care.

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  So self-care, there's this kind of myth out there, right? That self-care is like taking bubble baths or going on shopping sprees or meditation vacations, you know? And those things are great, you know, if you want to do those. But I've got to boil it down for people to how to take care of themselves. When I talk about self-care, I'm just talking about how to take good care of yourself on a regular basis. So I talk about this acronym, SELF, S-E-L-F. And it's the four science-based self-care fundamentals that are most important to prioritize for, for really for everyone. And certainly for my high achievers, if they want to be high performing.

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  SELF stands for sleep.

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  As adults, we want to aim for seven to nine hours of sleep a night.

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  Exercise.

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  We want to aim for at least 30 minutes or more of physical movement most days of the week.

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  Look forward.

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  And this is really important and often surprises high achievers because I talk about have at least one pleasant activity to look forward to. Each week.

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  And actually, let's just pause here for a moment on the L in self, look forward.

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  And that's because often when people come in to see me, guess how many pleasant activities they have regularly scheduled into their weeks?

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  Not very many.

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  Zero.

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  Oh, wow.

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  No, they have none. And so having something to look forward to is this, it provides this powerful mood boost because then life isn't just going to bed, waking up and going to work, coming home and, you know, rinse and repeat. They have something to look forward to, like a meetup with a friend on, you know, Saturday, or, you know, they book a massage, or they even just queue up one of their favorite Netflix episodes and say, you know, no matter what, on Thursday night, I know Thursday is gonna be a long day, I'm gonna make sure I watch a Netflix episode that I like on Thursday night.

• 17:11Speaker 01

  Your clients are sounding like people that are all work, no fun. Is that what the trap that these people fall into?

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  Sometimes that's really what can happen because their jobs are just so busy and they have back-to-back meetings. I have people where I'm like imploring them to take a break. I'm like, we have to help you get up from your desk. Even if they're working from home, they're just constantly in meetings. And I'm like, okay, you have to get up, at the very least, take your bathroom break, do some, a few deep breaths, make sure you're, so the S E L F, S is sleep, E is exercise, L is afford, and F is fuel, right? And so this is very much relevant to what we're talking here, is fuel, making sure people drink water, that they're fueling themselves with healthy nutrition, so fruits, veggies, lean protein, and making sure they also fuel themselves with some moments of quiet. So

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  I use the Calm app for meditation, but people can even just take three deep breaths if they can get outside, get some fresh air. So what I find is when people come to see me who really, especially have been struggling for years with chronic stress, anxiety, worry, they haven't been regularly implementing this self-care. So if they're prioritizing sleep, if they're prioritizing exercise, if they're prioritizing having something to look forward to, it makes it easier for them to think and feel in healthier ways.

• 18:33Speaker 00

  And in terms of their self-talk, just think about if you're ever tired, hungry, and rushing, it's not usually our best time of how we're thinking about ourselves and the world, right? So that's why self-care becomes so essential to the sustainability of both happiness and high achievement for these for these patients and for everyone out there.

• 18:58Speaker 01

  Yeah, I was gonna say, like, it sounds like a lot of what you're talking about is stuff that can apply to anyone's life, not just someone who potentially counts themselves as a high achiever.

• 19:07Speaker 00

  Absolutely. So CBT, cognitive behavioral therapy, is empirically supportive for the treatment of anxiety and depression. And it really can benefit everyone out there. I think for high achievers, what I do in my book, The Happy High Achiever, is to specifically tailor the examples and the strategies for people who are living with jam-packed schedules and who are really ambitious.

• 19:33Speaker 01

  One of the ways Mary does that is to break her advice down into bite-sized pieces, her essentials, as she calls them, like strive for excellence, not perfection.

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  The main difference is that excellence allows for high achievement and our humanity, which is to say, can we ever be flawless, perfect, never make mistakes? No, that's not possible. We are not machines, right? What we can do is we can do our best and to know that our best will differ by the day, right? So if we've just got eight hours of good sleep, we've been exercising, we're eating healthy, think of that versus for a lot of people who are doing travel. So I work with consultants or just people who are, you know, doing international travel, there's jet lag. Is it reasonable to expect yourself to be able to perform at that same level if you're, you know, dealing with jet

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  lag or the flu, or if I have people, you know, just in the middle of a recent romantic breakup? So when I talk about strive for excellence, not perfection, it's not about lowering standards where we're acquiescing to mediocrity and stagnation. That's really important. Because I think a lot of times, people who are ambitious are so afraid of, well, why would I strive for anything less than perfection? Because, paradoxically, you striving for perfection is going to be counterproductive. And usually perfection is almost entirely externally focused.

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  Yeah.

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  Being very much measured, right, by what someone else's definition of success and perfection is. And that's what's so problematic. If you make your internal worth beholden to external validation, you will live with chronic anxiety and pain.

• 21:22Speaker 01

  Another one of your essentials is navigate uncertainty with curiosity. What do you mean by that?

• 21:27Speaker 00

  Yes, oh, uncertainty. Anytime where we're having to sit with uncertainty as human beings, we don't like that. But it's something that's really necessary to be able to cope with if we want to be high achievers. Because part of high achievement is setting goals and working towards them. And is there ever a guarantee you will achieve every goal we set? Of course not, right? So if we really want to be sustainably high achieving, it really behooves us to learn how to sit with uncertainty and navigate it so that it doesn't make us so anxious and overwhelmed that we avoid it. So this is a quick, quick pro tip. When you notice you're saying, what if, you know, what if I don't get the job?

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  What if I don't do well on the exam? What if the presentation isn't flawless? Instead of saying what if, which is just gonna, again, ratchet up your anxiety, just shifting ever so slightly to, I wonder. I wonder what's gonna be on the exam. I wonder what I can do to best prepare. I wonder how I'll do. Do you see how that's so much more empowering? And it gives us agency. So we still have to sit with the uncertainty. I like to be real with people. I'm an optimist, but it's so important to be real. You're still gonna have to sit with uncertainty. You're still gonna have some stress. But again, the thought you choose to focus your attention on is what's going to make the difference. That's the game changer for how manageable the level of stress feels.

• 22:55Speaker 01

  Hmm. Okay. The final essential I want to talk about is um celebrate wins. Why is that one so important?

• 23:03Speaker 00

  Is such an important essential because unfortunately I have found that a lot of high achievers oftentimes we are what I call on to the next. And I'll work with patients and I'll say, so I see them usually once a week, 55 minute sessions. And I'll say, I'll be like, do you remember the presentation like Tina, right? That presentation that we talked about how to help prepare yourself and tell yourself I've done this before, the whole thing. She's like, oh yeah, it went fine. And then she's like, oh no, but now I just had a meeting, you know, today where now I found out about X, Y, Z. And so it's so important to pause and take in that victory because it reminds ourselves of what we're capable of.

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  And those become the fuel to move us forward as we're aspiring to complete our next goal.

• 23:56Speaker 01

  Celebrating your wins can be as simple as journaling about your wins or going out to dinner with friends.

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  And it's a great time also to make sure they are doing some self-care. Because so often I hear from my patients, yeah, yeah, Dr. A, I'll go to the gym after this project's done. Or you know, if it's lawyers and they're finishing up a big trial, they'll be like, yeah, you know, I'll take time to relax or create a time for a pleasant activity, Dr. A, like after this trial's done. But once one trial's done, guess what happens? They're on to the next trial, right?

• 24:28Speaker 01

  Wondering if generally you feel like your job has become, I don't want to say easier, but um people are more receptive to what you're saying now than before, like has the tide turned on hustle culture, do you think?

• 24:40Speaker 00

  Yeah, I think so.

• 24:43Speaker 00

  I think what I've noticed is post-COVID, like a post-COVID world, I find people are more psychologically minded. I think the focus on work-life balance is much more resonant for people. And so absolutely, it's honestly made my job a lot easier. I think, I will say this, interestingly, the thing that's been fascinating to me. Is there's rampant perfectionism going on, just rampant. That's been the hardest thing is seeing people just be relentlessly hard on themselves because I think the social comparison being fueled by social media. That's been the difference I've noticed. And they're just saying like, look, Dr. A, look at what this person's doing. See, I should be where they're at.

• 25:28Speaker 00

  And it becomes this fuel of shoulding themselves.

• 25:32Speaker 01

  Yeah, our brains weren't made to have this much constant information about how everyone is doing at all times, right?

• 25:38Speaker 00

  Absolutely. And I think that's the great thing about remembering our own humanity. There is not one person who has everything totally figured out. And so I try to help people remember that even if their colleague gets a promotion or does something well, we all have our turn in the swamp. So that colleague of yours, she either just emerged from a swamp or she's headed into one, or maybe she's even trudging through a swamp that you just don't know about. So that's the thing to remember, people's humanity.

• 26:07Speaker 01

  I love that so much. If they're not in the swamp now, they're probably heading there or emerging from it.

• 26:12Speaker 00

  That's life. I I'm an optimist, but I like to be real with people that life is beautiful and wonderful, but it's also messy and gnarly. And it's kind of just navigating the vicissitudes of life, right? Those ups and downs that we all must face at different times. And I think there's really a connection that can come from that is knowing no one's perfect, no matter what their social media account looks like. No one is perfect. So shoulding ourselves isn't going to be helpful, but setting doable goals and setting ourselves up for success is really what's going to move us forward.

• 26:50Speaker 01

  That is Dr. Mary Anderson. She's a clinical psychologist in private practice and she's the author of The Happy High Achiever: Eight Essentials to Overcome Anxiety, Manage Stress, and Energize Yourself to Success Without Losing Your Edge.

• 27:08Speaker 01

  Now, I just want to say a quick thank you to everyone who's taken the time to fill out our audience survey. We've had nearly a thousand responses and we've gotten so much helpful feedback, so much love for the show as well, which has been really gratifying. So, thank you. We really hope we can cross a thousand responses. So, if you haven't taken that survey yet and you want to, please do. We'll keep it live for a little bit longer and you'll find the link to it in the description for this episode in our show notes. One thing that's been really interesting is that 70% of the people who have replied have been women. So, if there's any men or gender diverse people out there who have been thinking about filling out that survey and haven't gotten around to

• 27:52Speaker 01

  it, go ahead and do it. We'd love to hear your thoughts as well. As I've said many times over, it's only seven questions. It's quick and snappy. That's it for All in the Mind this week. Thanks to producer Rose Kerr and senior producer James Bullen. Our sound engineer this week was Tegan Nichols. I'm Sana Qadar. Thank you for listening. I'll catch you next time.

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