Therapist in NYC for depression, relationships and perfectionismOn almost every block in New York City you will find either a bank, Duane Read or Starbucks. If you look close enough you will also find a psychotherapist. In the popular 10003 zip code on Psychology Today there are over 500 plus psychotherapists or psychologists listed. Is there really a need for this many therapists? Maybe? NYC, the epicenter of finance and culture is also, possibly the epicenter of depression. Studies by the Department of Health indicate one in five New Yorker’s either have depression or another similar psychiatric issue. A recent study indicates that New York City is the unhappiest city (Glaeser, Gottlieb, & Ziv, 2014) in America. Why are so many New Yorkers struggling with psychological difficulties? The article will explore the connection between depression, NYC and perfectionism. The article will also provide tips on how to manage perfectionism.

Depression & NYC: Perfectionism a contributing factor

  1. Selection Bias: Many people migrate to New York City because as Sinatra sings they “want to be king of the hill, top of the heap”. They choose New York because they want to work at the elite law firms, advertising agencies or have their artistic talent discovered. In general, many New Yorkers are highly ambitious, which is not necessarily maladaptive. However, a subgroup of these individuals may be prone to perfectionism. Perfectionists often have unrealistic and rigid expectations. When perfectionists fall short of meeting a professional or personal goal they feel like a failure on a holistic level. They can become very punitive towards themselves. This self-punishment is what is mostly problematic, not their ambition. As result of their self–flagellation, when a goal is not met, they may be prone to depression or other psychological difficulties.
  2. Competition: The perfectionist who decides to move to New York City may experience dream decay. Upon arrival to the Big City the eager New Yorker discovers the competition is fierce. For example, in their acting class they may meet others who are equally as skilled or superior. They realize they may fall short of their goals. This awakening can lead to doubt as their dreams may become deflated and gradually transform into despair. In comparison, the non-perfectionist, although disappointed and possibly sad when goals are not met, are typically more tolerant and emotionally resilient.
  3. Choices: – Studies indicate perfectionism is associated with the decision making process of maximization (Bergman, Nyland & Lawerence, 2007). This is looking for the most optimal outcome when it comes to making a decision. The perfectionist wants to make the perfect choice. The combination of perfectionism and New York City can be problematic because of the abundance of options. What therapist should I choose? Who should I date? What job do I take? The perfectionist weighing these options can become exhausted, experience self-doubt and fantasies of the road not traveled. They are hyper aware of all the possibilities. Too many choices can lead to inaction (Iyengar, & Lepper 2000). Non-action and indecisiveness can contribute significantly to depression.
  4. Often perfectionist’s lack of making a choice and commitment can also lead to isolation. For example, they may not select a girlfriend or boyfriend as they ponder the thousands of other possibilities available to them via New York City and the numerous dating apps at their fingertips.

  5. The Landscape: Crowded streets and subways, loud noises and noxious smells clearly can be unpleasant for anyone. However, studies suggest perfectionists in comparison to non-perfectionists, experience daily hassles more intensely because they cope with them in a more negative fashion (Dunkley & Blankstein, 2000).

It is important to note that there are no current studies examining whether there is a link between depression, NYC and perfectionism. However, in my practice I see the connection often and it prompted me to write a book on perfectionism. Future research should examine this area.

Below are Tips On Managing Perfectionism in NYC:

  1. Avoid Black and White Thinking: This type of thinking is extreme and puts experiences into broad categories as either good or bad. There is no middle ground or grey area. For example, the perfectionist who make a mistake may view themselves as total failure. A more realistic, balanced perspective would be to avoid globally defining yourself by a situation. A mistake does not define who you are in totality. Making a mistake does not mean you are incompetent. Every successful person makes mistakes.
  2. Learn from the competition: In New York City there is extreme competition. Competition helps you grow and expand if you react to it in an adaptive fashion and can push you to work harder. When competing it is important to accept losses and learn from them. What did your competition do correctly? What can you learn from them? How can you improve on what they are doing? Failure can be your best teacher if you refrain from ruminating, withdrawing or staying stuck in the defeat you experienced.
  3. Decide: Eventually, it is important to take action when faced with choices. Consistently doing nothing typically leads to stagnation and depression. When deciding, go with the information you have and do what appears logical and feels correct. Try not to dwell on the option not chosen. This interferes with you enjoying where you are. It is also important to keep in mind it is not uncommon to idealize people or alternative situations from a far. Only close up do flaws become more apparent.
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  5. Accept: If you can’t change something then accepting it may be the best option New York is chaotic and that is out of your control. However, you can change your relationship to the chaos. Remind yourself that the irritants you are experiencing will eventually pass (ex: noise, smells etc). Also take advantage of the serene aspects the City has to offer such as Central Park, the Highline (off peak hours) or a stroll by the Hudson River.

Overall, NYC can be a great place if you develop a healthy relationship with it, but just like anywhere else it’s not perfect.

References:
Bergman, J.A., Nyland, E.J. & Lawrence, B.R. (2007). Correlates with perfectionism and the utility of a dual process model. Personality and Individual Differences, 43 389–399.
Dunkley, M.D. & Blankstein, K.R. (2000). Self-critical perfectionism, coping hassles and current distress: A structural equation model approach. Cognitive Therapy & Research, 24, 713-730.
Glaeser, E.L,Gottlieb, D.J. & Ziv, O. (2014). Unhappy Cities. The National Bureau of Economic Research. Paper No 20291
Iyengar, S. & Lepper, M. (2000). When choice Is demotivating: Can one desire too much of a good thing? Journal of Personality and Social Psychology, 79, 995-1006.