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Anxiety and emotional perfectionism

Dr Annie Hickox

When we feel anxious, panicky or constantly worried, we are responding to a sense of fear that something awful is about to happen. Once you begin to feel anxious, your thoughts and feelings snowball and can lead to a vicious cycle.

Negative thoughts fuel anxiety and the anxiety makes us feel worse. We end up feeling tense, tired and even that we may never get off this frightening treadmill.

If you are faced with a direct threat – a fear that MS will cause you to lose your job, social life, independence or dignity – it is easy enough to identify the source of fear.

A more subtle source of anxiety is what we call emotional perfectionism.

Impossible standards

We usually think of a perfectionist as someone who aims to achieve impossible standards at work or home, or perhaps in their appearance. But emotional perfectionism involves applying impossible standards to how we feel.

For example, ‘I should be able to control my emotions’. When a person has MS, such standards are not only unfair, but also unhelpful.

Other examples include:

  • I should never feel sad/scared/inadequate/vulnerable.
  • I must not let them see how I really feel – they will think I’m losing my grip.
  • I need to stay positive because I don’t want to upset my family. They need to believe I am coping.

These thoughts reflect an unrealistic aim of controlling and suppressing our deeper feelings, and a denial of our emotions. Over time, they can lead to emotional distancing, out of fear that if we ‘let go’ we’ll be overwhelmed by sadness.

Perfectionism sets an impossible bar for us to aim for and as we fail to meet such unrealistic standards, we are left feeling a sense of failure and worthlessness.

> Do you feel like anxious? Contact our MS Helpline.

Jacqui’s story

Jacqui’s mother encouraged her to keep her feelings to herself and to put on a bright front, regardless of how she felt.

As an adult, when Jacqui was diagnosed with MS, she did not acknowledge her distress following her diagnosis, and believed stoicism was the best way forward.

Over time she became self-critical, and if she did feel low or tearful, to tell herself: “I’ve got to be strong, not pathetic.”

This created a degree of tension in Jacqui, as the effort of holding back her feelings was tiring and gave her headaches, and led to a sense of distance between her and her family, as she refused to talk about her MS.

It’s ok to feel

Acknowledging and expressing your feelings is an essential part of coming to terms with a long-term condition, and it enables you to adjust to the ups and downs of MS.

It also opens doors to support from others who may be struggling to know how to help. Talking to relatives and friends, or your MS nurse or therapist, can be a valuable way of helping accept and manage MS.

Feeling emotions is a healthy and normal part of being human. Suppressing emotions may be helpful in specific situations, but it won’t help you move forward with your long-term MS symptoms.

Our MS Helpline helps all people affected by MS cope with issues including anxiety, depression, stress and emotional and behavioural changes.

> If you'd like to speak to someone about how you're feeling, email our MS Helpline or call 0808 800 8000.

Dr Annie Hickox is a Consultant Clinical Psychologist, with over 25 years of experience in neuropsychology - in the NHS and independently - dealing with cognition, emotions and behaviour.

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