Panic Attacks

People who have a tendency towards perfectionism may tell you that being a perfectionist drives their success. That striving for flawlessness makes them the best at what they do. And sometimes, it actually does pay off, at least in some ways. But overall, the relentless pursuit of perfection can often feel more like a heavy and unfulfilling emotional tax rather than rewarding.

This is when perfectionism crosses over from striving for excellence and instead becomes a source of stress and a feeling of inadequacy and failure.

Aiming for Excellence, Running From Fear

When perfectionism begins to backfire, your drive towards excellence may start to feel like you're running from fear (and it can often be both at the same time, however the running from fear begins to hold more power than the drive towards excellence). This type of perfectionism is often a powerful, rigid shield against things such as feeling inadequate, feeling like a failure, making a mistake, or the shame of falling short of what can be lofty expectations. In this cycle, your focus may unconsciously turn to eliminating the threat of shame, failure, and inadequacy, rather than trying to reach reasonable goals with reasonable expectations.

In a more fearful state, people can set impossible expectations for themselves, hoping to prove their worth (to themselves and others), only to find that the expectations aren't reached. This can lead to self-blame and strip away confidence (or make it hard to build confidence that was already low). When in a place where the rigidity of perfectionism is consuming you, it can be a set up so either you achieve perfection, or anything less is inadequate and not good enough. There is little to no window of flexibility for mistakes or "good enough" to exist. This can have a suffocating impact on mental health, often resulting in intense stress and pressure to do things the "right" way, which can also strongly impact relationships.

Avoidance If Perfection Is Too Daunting

When you’re stuck in this fear-driven cycle, it can be tempting to become inflexible, sometimes without even realizing it. The pressure and anxiety may continue to grow as you're striving for perfection.

This often shows up in unexpected ways. For some, it results in procrastination. After all, if you don’t start something, you can’t mess it up or fail. For others, the pressure to be perfect may show up as overworking and compulsively checking (and re-checking) every detail, which may feel productive in the moment, but over time can result in burnout. It also may show up as inflexibility with others around you when the way you do things may differ from theirs. These are all different forms of avoidance, aimed at keeping uncomfortable, unwanted feelings of doubt and inadequacy at bay as long as possible.

It may feel within yourself like you're always working hard to keep things together, and that any mistake or failure feels like you'll lose control and everything is going to fall apart. It can make anything less than perfection feel scary and catastrophic. Therefore, avoidance can be a common response to fear of failure.

The Harsh Inner Critic

One of the most destructive responses that comes with this kind of pressure is debilitating self-criticism. When you inevitably are unable to meet an arbitrary, impossibly high standard, the immediate response can often be a harsh and unrelenting internal attack. It’s a vicious cycle. Your high standards may generate fear and anxiety, and when that fear is validated (that you're not good enough), you may respond with judgment and self-blame. This only intensifies the anxiety and the pressure to do better next time—making it even harder to succeed the next time and more likely you'll end up back in the self-judgment.

What's even more complex is that, every so often, some people may reach the high mark they have set. However, it then becomes about the anxiety of sustaining that bar, and any movement away from it becomes the new failure. It can become exhausting and defeating constantly trying to meet or maintain a standard that almost sets up failure from the start. It's these setups that really need to be understood on a deeper level when working through perfectionistic tendencies.

Shame, Anxiety, Panic Attacks, and Moving Forward...

There are many reasons perfectionism can show up in people's lives. But when you're going through it, it can feel like there is no room for compassion, no room for mistakes (obviously, within reason) to be okay, and no room for good enough. There can be so much shame, guilt, anxiety, fear, tension and other feelings that uphold perfectionism—and it's often when these feelings go unacknowledged that perfectionism can take a stronger, even paralyzing hold. This can eventually turn into panic attacks, phobias, and more.

It is possible to move forward from perfectionism. Therapy is a place to be able to slow down and become more in touch with the deeper anxieties and fears that lead to the urge to be perfect, and learn how to feel safe without continuing these patterns.

If you live with panic attacks or panic disorder (with or without agoraphobia), you already know how consuming they can be. The racing heart. The fear of losing control. The constant scanning of your body. Over time, life can quietly shrink—avoided places, canceled plans, and staying home because it feels safer. Your family and loved ones just don't understand that you are trying your best, but anxiety often wins.

Many people come to therapy having talked extensively about their panic. While that can bring temporary relief, it often doesn’t lead to lasting change. Venting helps you feel better in the moment, but it rarely teaches your nervous system that panic itself is not dangerous.

I understand this deeply—because I was once skeptical myself about Exposure and Response Prevention (ERP).

When I first learned ERP for panic attacks and panic disorder, I remember thinking: This feels too structured. I don't think my clients will like it. It is too methodical. Where is the space to vent? To connect? How can healing happen without open-ended talk therapy?

What I learned—through training, experience, and watching clients reclaim their lives—is this:

The process is what heals.

My hunch was right. Many of my clients did not like the process, but they disliked -- or hated -- panic attacks even more. They chose to be uncomfortable in therapy for the short term in order to no longer have panic attacks ruining their life for the long term.

ERP doesn’t just reduce stress; it retrains the brain and body. Instead of avoiding panic symptoms or organizing life around preventing them, clients learn—step by step—how to face panic safely, until the fear loses its grip. In many cases, panic attacks are extinguished altogether. In others, they become truly manageable, no longer dictating choices or limiting relationships. For many people, staying home once felt like the solution. Over time, it became the problem.

If you’re done talking about panic—and ready to do something about it—ERP may be the next step. Here are the Core Principles of ERP treatment for Panic Attacks or Panic Disorder:

​Intentional exposure to feared bodily sensations (not avoidance)

Response prevention—reducing safety behaviors and coping rituals

Learning through experience that panic is uncomfortable, not dangerous

Habituation and inhibitory learning over time

Between-session practice and healing assignments to reinforce real-world change

Therapist guidance and collaboration throughout the process

Ready for a Different Outcome?

If panic attacks are controlling your life—and you’re ready to move beyond temporary relief toward real change—I invite you to take the next step, find a provider that offers ERP, a robust, evidence-based treatment therapy that goes beyond talk therapy to provide life-changing results.#stoptalkingaboutpanic #erp2treatpanic

You don’t have to live smaller to feel safe.