Please note that this is an Archived article and may contain content that is out of date. The use of she/her/hers pronouns in some articles is not intended to be exclusionary. Eating disorders can affect people of all genders, ages, races, religions, ethnicities, sexual orientations, body shapes, and weights.

Author: Diane Starks, LCSW

Please note that this is an Archived article and may contain content that is out of date.

I once heard it said that when you reach the top of the pedestal, you will find there, a cage. What brings one to the top of a pedestal is some form of excellence. The cage is created by the demands of self and the expectations of others to maintain or excel in this acquired accomplishment. It is a common occurrence for people to place others on a pedestal, in response to their accomplishments or seeming perfection. As a society, we do this to great leaders, heroes, and performers. The problem is that people in the public eye often find themselves imprisoned on the pedestal, and feel caged by expectations of repeat performance. This puts enormous pressure on them to fit the “image” that is expected of them by society, or themselves. There are times when a girl is placed on a pedestal by loved ones. Parents, desiring to help a child grow in self-confidence and esteem, often provide opportunities for the child to excel. Then, as an attempt to reinforce the child’s positive feelings about self, they often praise them and may even “brag” about them to others. Most have honest intentions, to help the child, however, some do it to glorify themselves, by showing others what “great kids” they have produced. Sometimes parents may seek to fulfill their own unfulfilled wishes or dreams through their children. Though well-intentioned, this pursuit has the potential of creating and producing an unwanted result, and perfectionism may become the child’s approach to self-esteem. Self-esteem is a critical aspect of growing into a normal, healthy and happy adult. It begins its development in childhood, and is influenced by a wide variety of factors. Glenn R. Schiraldi, PhD, in his Self-Esteem Workbook (2001), identifies the foundations of self-esteem as: 1) unconditional human worth, 2) love, and 3) growing. He states, “While all three factors are essential in building self-esteem, the sequence is crucial. Self-esteem is based first on unconditional worth, then love, and then growing.” In other words, our self-esteem is healthy when built upon a rock, rather than upon the sand. The order of this development is vital to each child. Many try to start with the “growing,” without the basis of sensing their worth and love. This “cages” them by basing their worth on the opinions of others. As they seek excellence, gaining some external validation, they soon find that the demand for excellence escalates to a tiring endeavor that never produces the desired result. Their accomplishments are never enough, and their selfesteem deflates, because it is damaged by being based solely on external validation.

Research indicates that “perfectionism” can present itself in several ways. The striving to be perfect can be self-imposed, other-imposed, or socially prescribed. A high standard or goal can serve as the driving force for one’s achievement. Healthy perfectionism consists of allowing for mistakes or falling short of the desired goal, and can lead to excellence or achievement without damaging the self-esteem. The unhealthy type of perfectionism leads to self-degradation and beratement if the goal is not reached as planned. This becomes a vicious cycle, and can demand professional intervention to help reverse the depression and negative thinking patterns that ensue.

Sometimes perfectionism may be value-based, or out of religious teachings to be “perfect.” This might be a mis-perception, as it has been shown that the Hebrew and Greek translations of the word “perfect” indicate “finished” or “complete,” not to mean “flawless.” Children need to perceive that they are valued and cherished, just because they “are,” not because of their accomplishments. It is this base upon which self-esteem is built. Then added accomplishment and recognition serves to build upon that core sense of worth.

As professionals working with eating disorder clients, we often see these girls develop problems from the belief that their body must be perfect, oftentimes produced by media and cultural expectations. Body shape and size can become a critical piece of their esteem, so they focus on excellence, and develop a strong need for praise or approval from others. They develop a perception of “fat” that has an extremely negative connotation. In this negative thinking mode about themselves, they must be thin to be “okay. But no matter how thin they become, it is never enough. This attitude is often generalized to all areas of their life, and they desire perfectionism to prove to themselves that they are a worthwhile person. In most cases, this effort is not an attempt to feel superior to others, rather to merely feel equal.

This is an effort to build a self-esteem without the core, and their efforts fall short. Besides perfectionistic tendencies towards body shape and size, it is not uncommon to see them push themselves to a 4.0 GPA, or to win many awards and trophies, and recognition from outside sources. A problem with this unhealthy perfectionism is that as these girls continue to strive for more excellence, they recognize their flaws, and don’t feel they have ever reached that place of perfection, creating feelings of guilt and shame, regardless of the outward praise and recognition. This obsessive cycle leads to a downward spiral to guilt and hopelessness.

Abuses of any kind also send a negative message to most young people who suffer them. Their perception of what the experience means about who they are is usually damaging to their self-worth. Many abused children believe that he or she caused the perpetrator to do the terrible action that was done. The victims often don’t see themselves as a victim, rather, a perpetrator who causes others to perpetrate. I believe that this comes from our societal tendency to blame victims for their experience, as a way to lessen our own feelings of vulnerability. That is why there is a high correlation between past child abuse and the subsequent development of an eating disorder, due to the devastating effect on the self-esteem of the child. Some eating disordered clients report a feeling of such low selfworth that they do not consider themselves even worthy of food. This came to light when I was working with a teenage girl who was a beautiful ballet dancer, with a bright smile, who finally admitted to me that she hated herself. She had very loving and supportive parents, and acknowledged their love and support. As I contemplated my own experiences with teachers and coaches as a youngster and as a parent, I remembered the negative feedback given about improving performance. I am sure that these people meant well, and wanted to help her to excel. However, some of the best and most compliant youngsters internalize this encouragement or criticism as a reflection of who they are as a person, and don’t attribute it just to their performance, as this young lady did. It is a common characteristic of eating disorder clients. Often, parents and other adults involved in a child’s life unknowingly promote this type of negative thinking in children. As parents, many feel that it is important for our children to find their talents and gifts, and so we try hard to help them develop them. This can give them a sense of accomplishment and confidence, and can enhance their self-esteem. It is common for coaches, directors, and teachers to focus on improvements that their young patrons need to make, rather than praising their successes. This becomes problematic when the youngster does not have an inner feeling that she is a worthwhile person, and so she perceives the feedback or criticism of their performance and internalizes and applies it to the “self,” developing the belief that she is not “good enough” as a person.

Sometimes a young woman does not perceive that she can achieve excellence in any area of her life, so she chooses to be the “thinnest” as an attempt to achieve a sense of personal power. Society usually rewards thinness with admiration, so she decides that she will excel in that way. This, she hopes, will bring validation. At first, the compliments and admiration do appear, and feed her need for validation. However, as previously explained, the void is not filled, and so she continues to lose more weight, until she is of the opinion that any fat whatsoever on her body means that she is not a good person. Thus begins the downward spiral as starvation symptoms set in, particularly damaging to the ability to reason and have insight, leading to being caged by her expectation that more of the same behavior will produce desired results. When it doesn’t, she perceives herself as a failure, and the already low self-esteem plummets into hopelessness and despair. This continued negative thinking pattern is devastating both to the victim as well as significant others, requiring professional help. What began as an effort to build a sense of esteem for oneself, ends up to be what robs them of any happiness in their life.

To prevent this unhealthy cycle of perfectionism, parents can help their children by making sure that they learn to value themselves and life itself. The following suggestions are some ways to help your children learn to value themselves:

1) Provide unconditional love and respect

Sit with your children, ask them about their feelings and thoughts about themselves and life. As you discipline, teach, rather than fuss at them. This can be difficult, but it works to create a close relationship. As much as possible and feasible, let the child make decisions and experience the consequences and show support and empathy as they learn difficult lessons.

2) Do activities with your child

Let them direct play with you. Compliment their successes, and encourage them to develop their talents. Let them explore their talents. Examine your own motives, and refrain from imposing your unfulfilled dreams for yourself on them.

3) Be aware of the type of people who work with your children

Pay attention to teachers, coaches, and instructors, and monitor whether they are making derogatory remarks that the child may internalize. If you find a great deal of criticism, beware of your child internalizing it. Try to involve your children with mentors who value the self-esteem of the children with whom they work.

4) Praise the child’s effort, not the grades they receive

As Edison stated, “I have not failed. I’ve just found 10,000 ways that won’t work.” Put successes and failures in the context of what works and doesn’t work, rather than right or wrong, or good vs. bad. Fred Astaire said, “The higher up you go, the more mistakes you are allowed. Right at the top, if you make enough of them, it’s considered to be your style”.

5) Remember, your child will most likely react to the world as you do

Your behavior is her most important teacher. If you react to the world in a loud and screaming manner, she most likely will also. If you are derogatory in remarks about yourself, and your body and looks, she will set her values based on her perception of yours.

6) Give children time to play and be playful as they grow up

Put a limit on how many lessons and structured activities you provide for them. Free play allows them to use their imagination and develops their personality, based on inner approval, rather than on outward reinforcements.

7) Be sure to send a message to the child of her intrinsic worth

Help her to develop her gifts and talents on that base of intrinsic worth. Help the child process any negative messages he or she may get from interactions with others, to prevent those messages from eroding the child’s sense of basic worth. Recently, as a therapist working with an eating disordered girl and her perfectionism, I have found that it is critical to slowly help her develop a deep sense of self-worth. This can be done by helping her to let go of the negative self-judgments that she is internalizing from her experiences and perceptions from the world outside of “self.” It is important to encourage her to develop her own set of personal values, from which she can develop integrity by strengthening them, and living congruent to them.

The key is that the core self-worth needs to be built on a rock, not on sand. She needs to learn to believe that she is acceptable just as she is, an imperfect person who makes mistakes, and able to gain the ability to learn from them. The unhealthy perfectionism is founded in a need for control, with the thought that the mastery or control will produce self-esteem. This is a false presumption, and does not give the wanted result. It is important that she learn to let go of the need for control, and to accept life and its challenges as a learning and growing field, whereby she can gain experience and wisdom. Striving for achievement and success can lead to great accomplishments, however, it can only be healthy if she only uses it for a drive to do things well, not connecting it to who she is. If its purpose is to give her a sense of worth, the efforts will fail, and put her in a cage, leading to the loss of esteem, and eventually hope.