The Price of Perfectionism

Do you worry that your life—or your figure, or your house—isn't exactly what it should be? Alice Domar, executive director of the Domar Center for Mind/Body Health in Boston and an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School, is a pioneer in the study of stress and its effect on the body. Her latest book, "Be Happy Without Being Perfect: How to Break Free from the Perfection Deception" (Crown), co-authored by Alice Lesch Kelly, hits bookstores Tuesday. NEWSWEEK's Claudia Kalb talked with Domar about her research, her findings, and her advice for American women. Excerpts:

NEWSWEEK: What got you thinking about perfectionism?
Alice Domar: I saw a patient about five years ago, and there was this "Aha! That's it!" moment. This woman had this phenomenal life: healthy kids, plenty of money, tons of friends. She was very fit, had great health habits. She was doing everything right, and yet she came to see me, which made no sense, because I don't see people who do everything right. What it came down to was that the clutter in her home made her feel terrible about herself. I started thinking about perfectionism, researching it and listening more carefully to my patients.

What did you find when you started looking into it?
I spent a number of years thinking about it and really spent a chunk of time brainstorming with my co-author and new editor about how to fine-tune this book. I was focused on making it a book on how women can see their lives as half full rather than half empty. I started talking about it, and the response was unbelievable. I sent out an e-mail to friends and patients. Hundreds of women responded saying they wanted to talk. We chose 50.

What does the science of perfectionism say?
People talk a lot about perfectionism either as social concept or psychiatric concept. I'm one of the few who's in the trenches. I'm a therapist; I see patients every day. I hear their stories. We sat down with textbooks on perfectionism. They're very focused on pathology. That's not what I'm talking about. I can't stand reading books that are all theory. This is hands-on. I'm not talking about a diagnosable psychiatric disorder. I'm talking about the average American woman who feels a consistent level of disappointment or dissatisfaction because she's constantly comparing herself. I'm talking about women like you and me who can't sit and relax if there are dishes in the sink or don't feel comfortable having dinner with their husbands if they've left the kids with a sitter already that week. Women who look in the mirror and as opposed to seeing glossy, beautiful hair see droopy boobs. Women will say, "For me to be happy I have to be in a relationship that's going really well, the kids have to be happy, the house has to look great, I have to have a great career, friends." If you have mind-set like that, you're never going to be happy.

Where does the pressure come from?
It's human nature in many of us to want to be the best we can. I think there's societal pressure, media pressure, partner pressure. Up until 30 years ago all the pressure really involved the home and children. The pressure on women was to be good wives and mothers. Right now that's two out of a number of things. Can you tell me any area where a woman can let go and feel comfortable?

Is it worse now than in the past?
I've been fascinated by Martha Stewart for a long time. I think it's because her entire business is perfectionism and she has been phenomenally successful in selling the concept. It's worse since Martha Stewart. Is there data to show that? No. But I actually had a patient who'd seen Martha Stewart's Thanksgiving special. She ordered everything [that Martha did]. Despite all that, the table didn't look like Martha's. Ever since women started to read, publishers have been telling women to be better than they are. Be a better mother, be a better wife, be fitter, be this. There's nothing that says you're great the way you are. I think most women out there should embrace the way they are and stop pushing themselves to be better.

How do American women compare to women in other countries?
In this country we have so much and we're not the happiest. Our lifespans are the longest. Women have more affluence, power, choice. We have a woman who's close to getting a nomination for president. Women are in a better place than they've ever been, and yet at some level they're at the worst place. They put so much pressure on themselves to be the best in everything they do.

Is there one perfectionist issue that stands out?
I'd say body image is number one. That's my clinical impression. It's huge. Girls die all the time from eating disorders … I've seen patients who are models, celebrities, who have beautiful bodies, but they always point out the faults. The funny thing is men don't look at women's bodies like that. Do you know any women who'd say they absolutely love their bodies? I've had a number of patients with cancer and, unfortunately, that's a big wakeup call. You really do appreciate your body. You stop obsessing about five pounds. You're grateful you're alive. Someone shouldn't have to go through something like that to appreciate what's really important. Why can't we look in the mirror and see the beauty?

Would you like to see a shift in how women perceive themselves?
Oh my God, yes … The fact is we're far kinder to people in our lives than we are to ourselves.

Does it get better or worse as women age?
The epidemiological research shows that women in their 50s and 60s are far happier than women in their 20s and 30s. Maybe part of it is that they put less pressure on themselves. By the time you're 60, a lot of the demons aren't important anymore. You've figured out your life partner, your kids are grown, you know what your career is or was. All these battles you've had, they tend to get easier. My guess is you'll find less of an issue with perfectionism as women age.

How do you treat your perfectionist patients?
Most of what I do is cognitive therapy. We use relaxation techniques, too, but the focus is cognitive therapy, looking at things in a different way, harshly examining what you're saying to yourself. For almost all of us, our worst enemy is our mind. I have so many friends who are so successful in so much of what they do, and they feel awful about themselves if their house is cluttered. That's what I'm trying to change. To get women to see that their glass is half full and to focus more on what they're good at. You can't be good at everything.