Perfectionism, Anxiety, and Trauma: Why High Achievers Struggle to Slow Down
A Conversation Between Hilary Kopple, LCSW and Jessica Aronson, LCSW-R, CEDS-C, ACSW, CGP
High-achieving adults are often admired for their ambition, work ethic, and ability to excel under pressure. Yet many people who appear successful on the outside quietly struggle with anxiety, self-criticism, chronic overthinking, and an inability to truly rest. For some, achievement becomes more than a pursuit of success. It becomes a way to manage emotional discomfort, create a sense of control, or avoid feelings of inadequacy.
To explore the deeper connections between perfectionism, anxiety, trauma, and eating disorders, I spoke with Jessica Aronson, LCSW-R, CEDS-C, ACSW, CGP, founder of Jessica Aronson Therapy, a New York City psychotherapy practice specializing in eating disorders, trauma, anxiety, and EMDR-informed treatment.
As a therapist who works extensively with high-functioning adults struggling with perfectionism, anxiety, overthinking, and trauma, I often see how achievement can become intertwined with self-worth. Through Internal Family Systems (IFS), Cognitive Behavioral Therapy (CBT), and somatic approaches, I help clients understand the patterns that keep them stuck and develop a more compassionate and flexible relationship with themselves.
Jessica Aronson, LCSW, P.C.
Jessica's work approaches many of these same challenges from a complementary perspective. As a Certified Eating Disorders Specialist and trauma-informed psychotherapist, she helps adults uncover the emotional and relational experiences that often drive perfectionism, self-criticism, and struggles with body image.
While our specialties differ, we both work with individuals who appear highly capable on the outside but feel trapped in cycles of striving, self-pressure, and emotional exhaustion. Our shared perspective is that healing is not about lowering standards or giving up ambition. It is about creating enough internal safety that success no longer becomes the primary measure of worth.
Achievement as Protection
Hilary: In my work with high-achieving adults, I often see achievement functioning as a way people manage anxiety and protect themselves from feeling inadequate. In your eating disorder work, how do you see perfectionism and striving show up? What's different about that lens?
Jessica: Achievement becomes a coping strategy when a person's sense of safety, worth, or identity becomes dependent on performance. Many individuals learn early in life that praise, validation, or acceptance comes through achievement. When dialed up, these states can produce a feeling of calm and regulation. Over time, success can begin to function as protection against feelings of inadequacy, rejection, or vulnerability. While striving for excellence is not inherently problematic, it becomes maladaptive when it begins to define one's relationship with their body.
Why Success Never Feels Like Enough
Hilary: In my work with high-achieving adults, I often see people caught in a cycle where accomplishment provides temporary relief from anxiety, but the feeling never lasts. They reach one goal and immediately move on to the next, often struggling to slow down or enjoy what they've achieved. I tend to view this as more than ambition—it often feels connected to deeper beliefs about worth, safety, and identity. How does that show up in your work, particularly with individuals struggling with eating disorders and perfectionism?
Jessica: For many people, there is an internal belief that rest must be earned. Even after reaching a goal, the mind quickly moves to the next benchmark because slowing down can bring up emotions that achievement temporarily helps suppress. Anxiety, self-doubt, and fear of failure often remain active beneath the surface. The result is a cycle where accomplishment provides only brief relief before the pressure returns.
The Hidden Forms of Trauma
Hilary: One of the misconceptions I frequently help clients understand is that trauma isn't limited to major life events. Many people develop anxiety, perfectionism, or chronic self-criticism in response to experiences like emotional neglect, chronic criticism, or growing up feeling responsible for other people's emotions. From your perspective, how do these less visible experiences influence someone's relationship with achievement, control, and self-worth?
Jessica: Trauma is not defined solely by what happened to us, but by how those experiences affected us internally and in our bodies. Repeated criticism, emotional invalidation, or growing up in environments where emotional needs were overlooked can have lasting effects. Individuals may become highly attuned to others' expectations and develop perfectionistic tendencies to avoid disappointment or maintain connection. Achievement can then become intertwined with self-worth, making it difficult to feel valuable without constant effort or external validation.
The Body as a Control System
Hilary: I work with many people who default into what I think of as "frozen" responses—shutting down, disconnecting, or becoming highly controlled rather than acting out. Restrictive eating and over-exercise often seem to serve a similar purpose. Is that what you're seeing?
Jessica: Perfectionism and control often emerge as attempts to create predictability when life feels emotionally overwhelming. Eating disorders can function similarly, providing structure and certainty in the face of distress. While the specific behaviors vary, the underlying goal is often the same: managing emotions that feel difficult, painful, or unsafe to experience directly. Understanding those emotional needs is an important part of recovery.
Beyond Insight: Creating Lasting Change
Hilary: A major focus of my work is helping clients move beyond intellectual understanding and experience change at the nervous system level. Through IFS, CBT, and somatic approaches, I often see that insight alone isn't enough if the body continues to respond as though old threats are still present. You work from an EMDR and trauma-informed perspective. Do you find we're ultimately helping clients reach a similar place, even if our methods differ?
Jessica: I do. While the approaches are different, they share an understanding that lasting change involves more than simply understanding a pattern. EMDR helps people process experiences that continue to shape how they see themselves and the world. As those experiences become integrated, clients often find that their perfectionism, anxiety, or self-criticism no longer feel as automatic or necessary. The goal isn't simply understanding the story—it's helping the nervous system stop responding as if the threat is still present.
What Healing Actually Looks Like
Hilary: From your perspective, what changes when someone moves beyond understanding these patterns and begins genuinely healing them?
Jessica: Some common signs include less self-criticism, a greater ability to rest without guilt, reduced anxiety around productivity, and a stronger sense of worth that isn't tied to achievement or appearance. Healing does not require giving up ambition or success. Instead, it involves developing a more flexible and compassionate relationship with yourself. Recovery allows people to pursue goals from a place of choice and fulfillment rather than fear.
Final Thoughts
As this conversation highlights, perfectionism is rarely just about having high standards. For many high-achieving adults, it represents an attempt to create safety, predictability, and self-worth in response to deeper emotional experiences.
The encouraging news is that healing does not require abandoning ambition. Whether through Internal Family Systems (IFS), CBT, somatic therapy, EMDR, or other trauma-informed approaches, lasting change becomes possible when success is no longer responsible for carrying the weight of one's identity.
When individuals begin to feel safer within themselves, they can pursue achievement from a place of choice rather than fear, and self-worth becomes rooted in something deeper than performance.
For those struggling with perfectionism, chronic anxiety, overthinking, body image concerns, or trauma-related patterns, support is available.
Learn more about IFS Therapy for Anxiety and Perfectionism,Anxiety Therapy NYC, or Trauma Therapy NYC through Hilary Kopple LCSW. You can also learn more abouttrauma and eating disorder treatment through Jessica Aronson Therapy.
Author Bio
Hilary Kopple, LCSW, is an Anxiety Therapist in NYC
Hilary Kopple, LCSW, is a therapist in New York City specializing in anxiety and trauma therapy for adults who have built good lives and still feel like something is missing. She works with people who overthink, overfunction, and are tired of their own patterns, whether or not they can explain them.She integrates IFS, CBT, and somatic therapy, not as a menu but as a combined approach that works on thoughts, the body, and the deeper patterns underneath both.To learn more, visit her Home page or read about her background on her About page.