Sarah: Diagnosed with diabetes as a young child, Sarah had treated herself with insulin as long as she could remember. The disease had never affected her life to any great extent. She was now thirty-two years old and trained as a lawyer.
During the past year, Sarah's doctor had noticed some changes in her eyes that were early complications of diabetes. After some discussion with her doctors, she had decided to have a pancreas transplant. Their expectation was that this surgery would decrease the seriousness of future eye complications. Following surgery, Sarah recovered as expected. Her new pancreas functioned well and she steadily needed less and less insulin. She now felt reassured those sight problems would not interfere with her life or work.
Unfortunately, Sarah developed some side effects from the anti-rejection drugs. While not severe, they bothered her greatly. She talked with her doctor, but he said that there was little that he could do. It was possible that the side effects would decrease over time. Sarah had known before surgery that she might have some of these side effects afterwards. But it wasn't important to her then. All that had mattered to her was saving her vision. But that was then. Now, she began to think, "Why did I have this transplant anyway? I feel worse now than before the surgery."
For several weeks, the side effects persisted. Over and again, Sarah would check out how she felt, hoping to notice some change, some relief. Concerns about how she felt were a constant distraction. Even at work, she couldn't concentrate well. At night, preoccupation with her health kept her alert. At doctors' appointments, Sarah always asked if there was not something that they could do. It was obvious that she was beginning to frustrate them. Eventually, a nurse said to Sarah that her side effects were similar to those of an average recipient. They were less severe in fact, than many that were far less distressed than she.
Sarah believed that she was not performing her best at work. But her supervisor often commented that she was the hardest worker in the law office. When her firm offered a course in management training, Sarah's supervisor suggested that she enroll.
Included in the course was a talk on perfectionism. Sarah immediately recognized the pattern in her. She was always impatient. Everything in her life had to be in order. If she was not striving to achieve high standards, her confidence suffered. This applied to her health as well. She had to feel perfectly well physically or health concerns would occupy her mind. To reassure or distract herself was almost impossible. It occurred to her that perfectionist tendencies had contributed to her preoccupation with the side effects. When present, she found it hard to think of anything else. If she didn't feel perfectly well, she worried, even after the transplant staff reassured her that she was not ill or in any danger. In her mind, she was not perfectly well and that worried her.
After this insight, Sarah asked further about perfectionism. The course instructor recommended some books on stress and stress management. Sarah didn't stop asking the doctors if they could do something about her side effects. She wasn't going to give up trying. But meanwhile, she shifted her own energies to better learn how to tolerate the side effects and to otherwise deal with her worry. Now Sarah had a direction in which to work.