04 OF 06 SPECIALTIES
It never quite feels like enough
The win lands and the bar moves. You check again, redo what was already fine, and wait for the other shoe, or for someone to finally see that you’re not as solid as you look. Telehealth across New York State.
Prepared for every meeting.
Up until 1am fixing something no one else would notice.
Never misses a deadline.
The next thing is already waiting before this one lands.
Always has it handled.
Exhausted. Still going.
What it looks like from the outside
- Prepared for every meeting.
- Never misses a deadline.
- Always has it handled.
What it costs
- Up until 1am fixing something no one else would notice.
- The next thing is already waiting before this one lands.
- Exhausted. Still going.
01 WHAT IT ACTUALLY LOOKS LIKE
Perfectionism isn't about high standards. It's about what happens when you don't meet them.
You don't need a lecture about high standards. You need relief from the hum underneath, the constant scan for what you missed, what you should have said, what will expose you if you stop moving. It looks like success on the outside. On the inside it can feel like you're always one mistake from being found out.
This isn't about trying harder.
You check the email again, replay the meeting, redo work that was already fine, and the finish line still moves. The promotion, the degree, the thing you thought would finally quiet the voice. It doesn't. That doesn't mean you're ungrateful. It means the standard in your head wasn't built to let you land.
Most people who come to me for this don't say “perfectionism” first. They say things like:
- “I’ll spend four hours on an email that should take ten minutes.”
- “I can’t start anything unless I’m sure I can do it right.”
- “I got the promotion and within a week I was already stressed about the next thing.”
- “Everyone thinks I’m crushing it. I feel like I’m one mistake away from being exposed.”
- “I can’t sit on the couch without a list in my head of everything I should be doing.”
- “I replayed a two-minute interaction from the meeting for three days straight.”
Some of this is perfectionism. Some of it is adjacent: imposter syndrome, chronic self-monitoring, the kind of overthinking your nervous system taught itself a long time ago. We figure out which is which. Then we figure out what's underneath. For some people, that adjacent piece is ADHD that never got named — perfectionism built, one habit at a time, on top of it. If that's sounding familiar, the late-diagnosed ADHD page goes into that specific pattern.
There's a version of New York that runs on credentials, optimization, and quietly checking what your peer group is doing. The promotion. The startup. The body, somehow, while also working 60 hours. Perfectionism here doesn't have to manufacture pressure — it's ambient. The work isn't opting out of comparison. It's noticing what it costs you, and what's underneath the bar you keep raising on yourself.
“Overthinking isn't a character flaw. It's a strategy that kept you safe once, and it's running out of rope.”
03 HOW WE'D ACTUALLY WORK ON THIS
Slower than your brain wants to go.
The first thing we'd do is figure out what your specific version of this is actually doing, what the voice in your head sounds like, whose voice it is, what it's been protecting you from. Not in a worksheet way. In a “let's look at what happened when you turned in that project last Tuesday” way.
From there we'd work on a few layers at once: the nervous system piece (so turning something in stops feeling like physical danger), the cognitive piece (so you can tell the difference between high standards and fear wearing a suit), and what's underneath (so your worth stops being something you have to earn back every morning).
I'm direct without being harsh, and I'll push back when the perfectionism tries to run the session too. You won't have to perform in here. You won't have to get therapy right. You'll get to be a person who's allowed to be a work in progress, which, for a lot of my clients, is something they haven't had much practice at.
04 WHAT YOU MIGHT NOTICE
You leave a reply unread overnight. It doesn’t ruin your sleep.
You turn something in without reading it a fifth time.
The goalpost moves. You notice it happening. That’s new.
You stop earning the right to rest. You just rest.
“I sent a deck I knew wasn't perfect and I didn't redo it on the train. My boss said it was great. I'm honestly still kind of mad about it being great.”
Client, 36 · Perfectionism · 17 months
Testimonials shared with permission. Identifying details changed.
These often come together:
05STARTING
If this sounds like the right fit,let's talk.
Nothing you say has to be perfect. This is the one place that’s off the table.
You send a note.
Takes a minute. Tell me what’s bringing you in, or just say “hi, I want to talk.” No intake form, no questionnaire.
We do a 15-min call.
No cost, no commitment. We see if it’s a fit. If it’s not, I’ll help you find someone it is.
We book a first session.
Evenings and weekends available. Telehealth from anywhere in New York State.
Or email Angela@nystateofmindtherapy.com
Free 15-minute consult, no pressure. Private pay $160/session. Most major insurance plans accepted including Aetna, Cigna, Optum, United, BCBS, and Oxford.