Episode 161: Perfectionism with Dr. Judy Tsafrir

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Perfectionism & Autoimmune Disease

Often, perfectionism is seen as a positive trait. What’s wrong with striving for excellence? Nothing, but there’s a difference between healthy striving and perfectionism. Healthy striving is a self-compassionate mindset that allows for mistakes, learns from them, sets challenging but achievable goals, and adapts as needed. Perfectionism fears failure, despises mistakes, sets unattainable goals, and feels shame and self-judgement when those impossible goals aren’t met. When you apply perfectionism to autoimmune disease, your diagnosis may feel like your fault, and every flare may feel like a failure. You may believe that if you just lived your life perfectly, you could cure yourself. It’s trying to control the uncontrollable, which leads to higher stress and autoimmune symptoms. I am a recovering perfectionist, so I have felt all of these things. Don’t judge yourself if you have felt this way, too. In this podcast, we explore the connection between autoimmune disease and perfectionism, and share tips for shifting to a healthier mindset instead. My guest is Dr. Judy Tsafrir, a holistic psychiatrist who approaches mental health from a functional medicine perspective. She strives to treat root causes in her practice, rather than just symptoms.

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Show Notes

  • Intro (0:00)
  • Thank You to Our Podcast Sponsor – Paleo on the Go (2:21)
    • A frozen meal delivery service, 100% of their menu is compliant with the elimination phase of the paleo autoimmune protocol (AIP). They have over 5o items, including entrees, side dishes, broth, AIP-friendly bacon, and desserts.
    • Use the code PHOENIX for 10% off your first order.
  • Meet Dr. Judy Tsafrir (4:00)
    • Dr. Judy Tsafrir is a holistic psychiatrist. Her goal is to approach each patient from multiple perspectives: body, mind, heart, and spirit.
    • She’s a conventionally trained MD (and even on the faculty of Harvard Medical School), but was always interested in helping people beyond medication. That began with psychoanalysis and expanded to include astrology, energy healing, and nutritional healing (including the GAPS, AIP, and Walsh Protocols).
    • When Judy developed mold toxicity herself, she learned how the environment can impact a person’s physical and mental health. Now, that is one of the specialties of her practice.
    • Listen to my prior interview with Judy: Overcoming Self-Sabotage.
  • Perfectionism vs. Simply Having High Standards (6:52)
    • When someone simply has high standards, they set challenging goals for themselves that require them to grow, stretch, and work to achieve them, but they are achievable goals. They have a self-affirming, positive mindset. They see mistakes as learning opportunities. They enjoy the journey toward their goals – learning, experiencing, and trying new things. They strive for excellence, but not perfection.
    • Perfectionism sets the standard at perfection, which is impossible to achieve. This sets people up for disappointment. Perfectionists are often driven by fear and feelings of inadequacy. They feel defined by their mistakes, and those mistakes can trigger harsh self-criticism. There’s no room for flexibility. This creates a high level of stress that can undermine health and relationships. When they have a goal, they’re fixated on outcome and don’t enjoy the process of getting there. When perfection isn’t achieved, they obsess over what went wrong and don’t pay attention to all the things that went right. They don’t see the value of doing anything less than perfectly, so they often avoid new experiences out of fear of making a mistake.
    • There is a spectrum of perfectionism. For some people it’s a coping mechanism under times of stress, but not a core part of their personality. For others, it’s how they approach life every day.
    • Our society praises perfectionism as if it’s a good thing, and it’s often mistaken for a healthy striving for excellence. However, these are very different things.
  • Perfectionism & Negativity Bias (11:25)
    • Our brains are wired for negativity. It’s an evolutionary trait that kept us alive by scanning our environment for danger. It’s a protective impulse.
    • In modern life, our brain is still scanning for danger, but tagging too many things in this category. This leads to chronic stress.
    • In perfectionists, the brain scans for mistakes, triggering a stress response as if mistakes are dangerous.
  • Perfectionism & Mental Illness (13:19)
    • Perfectionism can trigger a wide variety of mental health issues.
    • When self-worth is tied to the impossible, it can cause depression and anxiety. Then anxiety can trigger more perfectionism, creating a vicious cycle.
    • Many eating disorders and body dysmorphia focus on a perfect standard for the body.
    • Narcissism and grandiosity often contain a belief that perfection is possible. When it’s not achieved, feelings of worthlessness rise to the surface.
    • Self-criticism for mistakes can be so harsh that it can lead to suicidal thoughts or impulses.
  • Root Causes of Perfectionism (14:49)
    • Family of origin with high expectations where love felt conditional on your achievement.
    • Adverse childhood experiences (ACEs), such as trauma, abuse, neglect, addiction, etc. A child can turn to perfectionism to cope for two reasons: (1) To try to exert some control on an out-of-control situation. (2) To try to fix the problem. Many children feel responsible for whatever is happening in their family.
    • Undermethylation. Methylation is a foundational process in the body that supports many vital functions, including gene expression, protein synthesis, neurotransmitter synthesis, and detoxification. When this process isn’t functioning optimally, a common symptom is perfectionistic behavior.
    • Stress can also trigger perfectionism as a coping mechanism.
  • Overlapping Root Causes of Autoimmune Disease (17:46)
  • Perfectionism & Autoimmune Health (20:16)
  • Thank You to Our Podcast Sponsor – ShopAIP (27:12)
    • Today, I’m highlighting their Healthy Fats category. In spite of the low-fat craze that swept the world for decades, chronic disease continued to rise. That’s because our bodies need dietary fats. They are the building blocks of our body, making up 50% of every cell membrane. They’re essential to everything from gut health to blood sugar regulation to fertility to nutrition. However, there’s a big difference between healthy and unhealthy fats, and ShopAIP sells all of the healthy ones! If you’d like to learn more about the science of dietary fats, I have a post on my website: The Complete Guide to Fats on the Paleo Autoimmune Protocol.
    • ShopAIP is an online store dedicated to the Paleo Autoimmune Protocol. With hundreds of items for the elimination phase of the AIP, and new products labeled by reintroduction category as well. You can find protein bars, sauces and condiments, AIP-friendly spices, cooking and baking ingredients, delicious snacks, non-toxic skincare, and more.
    • If you’re a first-time customer, use the code PHOENIX for 10% off your order. Purchase here.
  • AIP Perfectionism (29:11)
    • The elimination phase requires a certain amount of perfection to get a clear baseline for reintroductions. How can we approach this phase with a healthy mindset?
    • First, remember that perfection is impossible and it’s often fear-driven, which increases stress. Commit to doing your best, but don’t beat yourself up if you make a mistake. Some people take a few tries before successfully making it through the elimination phase, and that’s OK.
    • Tune in and be aware of your mindset, understanding that fear is a red flag. It’s not a mistake to feel fear – it’s simply an emotion that can drive perfectionism, and knowing that, you can interrupt that cycle.
    • Also, set up a support system before doing the elimination phase. It’s a challenging protocol and a very big change. Many people in your life may not understand what you’re doing and may criticize or undercut your efforts. Having a counselor, a health coach, a group class, or a friend doing it with you can be very helpful.
    • Some signs of AIP perfectionism:
  • Perfectionism & Long-Term Healing (36:58)
    • After the elimination phase of the AIP, when we’ve gone through reintroductions and personalized our diet, we move into a long-term healing lifestyle. This doesn’t mean holding yourself to the intense standard of the elimination phase. Here is where you experiment and find your own food freedom. Among the foods that cause you to flare, which elicit a mild vs. severe response? How long does it take you to recover? In some moments, is it worth it? Replace perfectionism with self-awareness, and replace rigidity with flexibility.
    • When it comes to lifestyle practices, the mind-body connection, and integrative medicine, there are many things we can do to support autoimmune health. Don’t try to do everything at once. Pace yourself, choosing one new self-experiment or intervention at a time, and don’t set perfection as your goal.
    • It’s also important that your diagnosis and diet don’t become the central part of your identity. Your diet may be an important tool to optimize your health, but always remember you are more than what you eat. You are more than autoimmune disease.
    • Perfectionism and self-sabotage can seem like opposite behaviors, but they’re really two sides of the same coin. Perfectionism can be a form of self-sabotage, and also inspire it. Rigid rules can lead to rebellion, even when we are the ones making the rules.
  • Perfectionism & Social Media (31:58 & 41:27)
    • Social media is notorious for presenting false images of perfection.
    • Pay attention to how social media makes you feel. Are there profiles (or entire social media platforms) that trigger a compare-and-despair mindset? Sometimes we compare ourselves to healthy people, despairing that we have autoimmune disease. Other times, we compare ourselves to fellow autoimmune warriors who claim to be cured and only share their successes not their struggles. Be aware that people’s online life doesn’t always match reality.
    • An empowered social media approach includes unfollowing accounts that trigger negative feelings, and limiting time on social media overall. Consider taking social media sabbaticals regularly – a day offline a week, or a week offline each month.
    • A personal growth approach is to understand that comparison is the thief of joy. When someone makes you feel “less than”, explore that feeling and belief – perhaps through a journal, or counseling. Emotional triggers are uncomfortable, but they’re also powerful messengers.
  • The Antidote to Perfectionism (44:35)
    • Self-compassion is a practice that replaces the inner critic with an inner friend instead. It’s a loving stance toward yourself.
    • In addition to speaking to yourself in a kind voice, particularly when you are going through something difficult, self-compassion can incorporate gestures like laying a hand over your heart, or gently stroking your cheek like you would to a child who was sad.
    • It also helps to inject a little humor and distance between yourself and your inner critic by giving that voice a name. Sharon Salzberg, a teacher of self-compassion, calls her critical voice Lucy, after the character in the Peanuts cartoon.
    • Resource podcast: Ep. 80 – Self-Compassion.
  • Qualities to Nurture in Place of Perfectionism (47:32)
    • Humor.
    • Forgiveness.
    • Flexibility.
    • Tolerance.
    • Willingness to try new things.
    • Understanding that when things go wrong it’s not always a catastrophe. Most things can be repaired, and we learn from those experiences.
  • Final Tips for Overcoming Perfectionism (49:44)
    • When you are judging yourself for being imperfect, stop and ask yourself what you would say to a friend in the same situation.
    • Judy recommends a book called Feel the Fear and Do It Anyway by Susan Jeffers. A mantra shared in the book is: “No matter what happens, I can handle it.”
    • Understand that many things in life are beyond our control. Trying to control the uncontrollable doesn’t lessen suffering – it increases it.
  • Outro (52:42)
    • Dr. Judy Tsafrir is accepting new patients, and she works with people around the world via telehealth. She also has an in-person practice in Boston, MA. And she shares free insights and resources through her blog. You can connect with her through her website.
    • Eileen (your podcast host) is the author of multiple books, written to help people thrive with autoimmune disease. Learn more on the Books Page.
    • If you like this podcast, follow or subscribe through your favorite podcast app. You can also subscribe to Eileen’s biweekly newsletter.
    • Check out the entire archive of podcast episodes.

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2 comments on “Episode 161: Perfectionism with Dr. Judy Tsafrir”

  1. Joannabanana1989 .

    I say the Serenity Prayer every night before I say the rest of my prayers. I have always loved it and feel centered when I say it. I understand why addiction programs like to use it as well.

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