The Epidemic of Perfectionism in Silicon Valley

Searching for answers in a world overrun by perfectionism.

In 2015, my life looked textbook-charmed. I’d lived in San Francisco for 12 years — long enough to understand its ups and downs — and worked in tech nearly as long. I had a thoughtful, handsome husband and a wise, funny, five-year-old daughter.

But this is what my life felt like:

Almost daily migraines, crippling neck and shoulder pain, and a nauseated stomach that sometimes forced me off the bus to keep me from fainting.

I’d long ago given up on finding a cause for these pains, so I went to my annual neurologist appointment ready for my regular dose of confused irresolution. Instead, shockingly, she diagnosed me with generalized anxiety disorder, and my life changed on the spot.

An Elusive Epidemic

Generalized anxiety is an umbrella term, meaning that there are lots of different types of people to be found under there when it rains. 

The statistics shared on ADAA suggest that 6.8 million Americans, or a little over 3% of the population, has generalized anxiety disorder. (I think that’s massively understated, incidentally).

Another skepticism (settle in, cause I’m full of them) has to do with just what GAD is. “Excessive worry,” as the disorder’s most common descriptor, was problematic for me, because for 39 years, I didn’t consider myself a worrier.

I was an overthinker with migraines.

And since I never used the words or mindset that the health industry used, I found very few examples that rang true when I searched for more information about generalized anxiety. In person and online, though, I met tons of people who were, in fact, just like me: men and women experiencing physical pain resulting from perfectionism, fear of failure, and overthinking.

The disconnect between how people talk about anxiety and what anxiety actually feels like is the engine that drives me to write about this phenomenon. Thanks to my diagnosis, what was once invisible now has shape, and I understand the world around me differently.

I hear the hum of the ambient complaints in a new way.

Was My Experience Unusual? 

A few months after going on anti-anxiety medication, I went back to my neurologist at UCSF and explained that my once-daily headaches were now down to one per month. I was grateful. I was also curious to know if my experience was unusual. From what I could tell, it seemed surprisingly common.

But—cue the overthinking—maybe I was overestimating it. Like every good student of anxiety, I had memorized my list of cognitive biases. Was I overgeneralizing? Was my sense that people around me were experiencing physical pain as a result of perfectionism simply projecting my problem onto others?

Was I hearing only what fit my story?

An illustrated guide to cognitive biases, as seen in Business Insider.

My neurologist listened to my concerns and then replied, “This problem — the problem of perfectionism and anxiety — is getting bigger and bigger every day.”

She described seeing an average of three people a day suffering from some form of chronic physical pain who had one thing in common: perfectionism.

“It’s extremely common in the tech industry,” she said. “These people are very successful. They want to do everything right.”

She then said something that stayed with me. It’s a statement so clear, so unwavering, that I knew I needed to reckon with it (and still do): “One of the groups that has the hardest time seeing GAD in themselves is psychiatrists and psychologists.”

Where We Came From

In the past, if you had a physical problem, you’d visit a doctor.

If you were having a mental problem, you’d visit an office like this:

Treating symptoms meant sitting in a room with an expert, looking for answers together.

If your physical symptoms spring from your intense pursuit of perfectionism, however, this method is problematic. You can visit doctors of all stripes, and they won’t find anything physically wrong with you. Therapists may enjoy your confessional insights and wit as much as you enjoy sharing them—but they won’t help you when your back gives out again.

It's Up to You to Connect the Dots

Anxiety, though chemically and genetically influenced, is, at its most fundamental, a system of messages the body is trying to send the mind. It’s similar to an allergic reaction where the body overreacts to stimuli. In this case, the fear of losing control causes an adrenalin and cortisol rush in the body. Our minds work to avoid negative feelings (or the stimuli that caused it). Yet the effort of avoidance ends up creating more fear—and more overreaction. Doctors have long seen a connection between the physical pain that people feel and the emotions they are repressing.

For perfectionists, the mind is trying to tell itself the truth: “I can’t live up to my own expectations.” But inherent in the perfectionist problem is an inability to accept this reality. The mind deflects the message of impossible expectations and literally pushes it into the body.

My neighbor is an example of this. Let’s call him Shane. Shane is an artist and teacher who spends a lot of time worried about what other people think about him. His standards for work are extremely high.

He also has a lot of neck and back pain, sudden bouts of sweating, and dizziness. He takes 3–4 ibuprofen a night for “sore muscles.” He needs a whiskey to help him fall asleep.

He knows that he has anxiety, but hasn’t yet figured out how to listen to what his body is telling him, or how to address the pain.

When I learned about my generalized anxiety disorder, I started with the treatment path of medication (Lexapro, 10 mg every day), meditation (Headspace, 20 min every day), and communication (writing, talking, all the ways). Treating perfectionism meant I’ve been forced to stop comparing myself to other people, especially on social media. I’ve had to learn how to turn up the volume on my own voice of confidence and creativity. I did this by creating a project that looks at perfectionism from a bird’s eye view.

Helping Perfectionists Learn From Each Other

For over a year and a half, I’ve been working to create a place for perfectionists to meet and learn stress relieving techniques from each other. It’s called The Beautiful Voyager. 

My goal with the site was to create a space where it was OK to be imperfect. I threw my real, far-from-perfect self, out into the world for everyone to see, hoping that other people like me might find comfort and common cause in my struggle. It’s like training wheels for social interactions. As confidence builds, pain subsides.

The Only Map is Buried Deep

I used to think, "There's no map to understanding anxiety." But that's not true. There is a map. It's just that each person's is unique and buried deep inside of them. It takes a long time to navigate your own internal terrain. I created this site because it helps to have other navigators around during the map-hunting process.

If you or someone you love is experiencing symptoms like those on this list from my neurologist, take a closer look at how anxiety isn’t always what it seems.

• migraines
• dizziness
• nausea
• back pain
• neck pain
• tingling
• chest pressure
• palpitations
• light-headedness

This is one epidemic we can do something about, but we have to work together. So as you go out into the world, or deep into the world within, in search of the map you need, know that you’re not alone.

I’ll meet you there.

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Originally published on Heleo on October 6, 2016. Republished and updated on Bevoya.com on May 2, 2017.

The Best Little Boy: How Growing Up in the Bronx in the 70s Led to Perfectionism

Welcome to the third installment of Tales of the Wave. In this series, I’ll share recent conversations with friends and acquaintances whose insight about the wave might help you, too.

Bronx best boy-in-training. Victor B at 4 years old.

He was Dr. B when I met him. He was great at his job—diligent, detailed, and genuinely interested in everyone around him. Victor B loved his work and his practice, which he had built from the ground up. 

Two years ago, along with the rest of his patients, I was shocked to hear that Victor was leaving his practice. Crippling physical pain had stopped him from being able to continue his work. It was terrible news.

When he reached out to me about this project, the pieces started to fall into place. The way he ran himself into the ground while making everyone around him happy (and love him). His success with his business. His focus and determination. Yep, this was a fellow voyager alright. We met here in San Francisco on Mission St for chai, and I learned more about Victor's background. I asked if he'd be willing to talk publicly about the things he's learned in the hopes of clarifying things for others, and this conversation is the result.

I'm so thankful to Victor for his openness and strength. These things aren't easy to talk about. Sharing them often brings up its own anxieties and black holes in our stomachs. Thank you, Victor! I hope that sharing will prove rewarding in the end.—Meredith

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Me: When we spoke, you educated me about the writer Andrew Tobias's notion of The Best Little Boy in the World. Can you talk about how that book affected you? How did growing up gay when you did affect your anxiety? Has it changed as our culture has changed?

Victor: I think a lot of my anxiety stems from the same place. It starts with the question: What will people think of me if...? The "if's" are many. The biggest one was: What if they find out I am gay?

My biggest fear was rejection. They won't love me, they won't like me, they will be mad at me, they will think something is wrong with me, they will be embarrassed by me. The list goes on...and on...and on...

I simply always felt and believed I was not good enough. I don't like to put it all on being gay, but it honestly did do a number on me given I was always trying to hide the person I really was. The Best Little Boy in the World  definitely helped put things in perspective. But I didn't learn about the book or idea until I was in my second round of therapy in my early 40's. I think having an older gay man as my therapist at the time helped quite a bit.

Growing up in the Bronx in an Italian-American, Catholic home the message was clear...it is wrong to be gay.  Were these words ever directly spoken? I can't say. But I absolutely understood it and moreover, I believed it was true. 

Where did the message come from? Hearing the men in my family talking; hearing my brother and his friends talking; the implied expectations of being a male...when you should be dating, who you should be attracted to, games and sports to play, also games and things you should not be playing with...even television shows and movies poked fun at the effeminate/gay characters. Attending Catholic schools through high school, and attending church regularly...the message of Catholicism was clear: to be a homosexual is a sin.

My family was very actively involved in our church. Alter boys, lectors, ushers. Imagine my confusion as an alter boy, standing on the alter serving mass, and at the same time feeling such attraction to my fellow alter boys, priests and men in the congregation.

To conceal my true self, I truly became the "best little boy": A-student, perfectionist, mommy's helper, meticulously clean, neat and organized. By excelling, I was hoping to distract anyone from discovering my secret...or stopping them from questioning who I was.

My other big source of anxiety is/was worry.  I have a tendency to want to take care of everyone and "fix it" as best I can. I make everyone else feel good. This often time resulted in making myself the sacrificial lamb and thereby being taken advantage of both emotionally and, in some cases, financially.

Not having a true sense of self allowed me to put everyone else first. It was easier.

Me: Do you know other "best boys"? Is the behavior talked about openly? 

Victor: I really do not? I have touched on the topic with some friends, but I don't think many people know about it. Each experience growing up feeling "different" varies. We all have the same story of hiding the truth for as long as we could.

Me: What would you say to young kids who feel the best boy traits within themselves? Do you have any advice for them?

Victor: Absolutely! Be true to yourself and honest with those who love you. Do not fear rejection! Everyone who loves you will continue to do so. If they don't, then it is not your place to change their beliefs or perspective.

Continue to be the person you are. If they cannot see the beauty in you, move on. It's their loss. They don't deserve you, and have no right to make you feel bad about yourself and who you are.  You do not have to do anything or try and be a "best boy" in order to "make up" for being gay. Being gay is not a bad thing. It is a beautiful thing. Who you love does not matter. How you love yourself makes you the best person you can possibly be.  This will allow you to form deep and true friendships and relationships with everyone in your world...from family members to friends, classmates and colleagues.

Oh how I wish someone would have said that to me about 45 years ago!!

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Thank you to Victor B and all of the other "best boys" out there who push their way through the confusion to forge their own paths. Your work is helping others in ways that might even surprise you.

Originally published May 12, 2016. Updated April 17, 2017.