Performance Addiction: Our Secret Obsession: Guest Post by: Arthur P. Ciaramicoli, Ed.D., Ph.D

I remember the first evening I met with 44-year-old Mary in consultation. She entered the waiting room with hesitation and an obvious degree of discomfort. A few minutes into the interview she told me she could not get over her husband leaving her for a young colleague four years ago.

I don’t love him anymore, I just feel so inferior. He is a CEO of a successful company, graduated from an Ivy League school, always attracts women. He is charming, bright and handsome.

As we talked further she told me her husband had frequent affairs, always increasing her feelings of inadequacy. She practically raised their three children alone yet said little about her role as a mother. She went to college to become a teacher, and emphasized it was “just a state school.” She has tried to date since her divorce but insightfully indicated she thought her lack of confidence drove men away. When I asked what gave her such feelings, she talked about her short height, her mediocre education and her meager financial stature.

Fact vs. Fiction

Early in life we write a story about ourselves, a novel if you will. It is most often a fictitious story that is being reflected back to us from those close to us – as if we were looking at ourselves in a mirror. We are evolving and learning along the way – who we are, or more importantly, who others think we are. If the mirrors you are looking into give you an inaccurate view of yourself you begin to form a fictitious idea of your capabilities and worth.

Mary grew up with an alcoholic father who spent little time with his two daughters, but nevertheless had very high expectations on how they should perform in school and athletics. Mary’s mother had a kind heart but was quite overweight. She was often on the diet of the month, frequently calling herself fat – an idea that was reinforced by her perfectionistic husband. As a result of this environment Mary developed a critical self-voice, which supported a deep belief that she was not good enough.

Performance Addiction (PA): the belief that perfecting appearance and achieving status will secure love and respect.

This common syndrome sets the stage for what I call Performance Addiction (PA): the belief that perfecting appearance and achieving status will secure love and respect. It is an irrational belief system learned from early familial experiences and reinforced by our material and appearance driven society. I recognized this disorder as I worked with people like Mary who are intelligent, compassionate, caring and attractive, yet their internal story tells them they are inferior, unattractive and unimpressive. These individuals are what I call scoreboard watchers. They are constantly evaluating how well they sound, look and appear. They idealize others, as Mary did with her husband because of his good looks and financial success, totally missing the fact that his character is quite poor and unimpressive.

They are trying desperately to look better and achieve more to have a taste of the love and respect they have longed for since early childhood.

People who suffer from PA tend to value status over character and achievement over relationships. They are often seen as preoccupied people who are always on the move, in their minds or in reality. They are trying desperately to look better and achieve more to have a taste of the love and respect they have longed for since early childhood. Our society rewards attractive people and those who perform on high levels. Once a person has bought into the unending quest of Performance Addiction they can’t relax, let go, and let life take its mysterious course. When their efforts fail, they decide to try harder, move faster, and are willing to make more sacrifices while compromising their health. This behavior pattern is the nature of an addiction.

Mary is an attractive, bright, affable woman who has needed to uncover her true worth by being open to the fact that she has been misguided in her pursuits for love and acceptance. Rather than constantly trying to correct what is wrong with her she needed to uncover what has been right about her all along. Her natural goodness had been under cover as a result of the lack of empathy she endured early in life and later in her marriage.

Changing Your Story

In order for Mary to change her story she joined one of my group therapy sessions where members are committed to providing truthful, tactful feedback with the goal of everyone changing their story from fiction to non-fiction. You cannot change your story alone; human beings are all too subjective to do so. When we have the courage to let ourselves be known by rational people who have the capacity to provide us with a realistic appraisal we begin to see the truth about others and ourselves. It is very hard to deny feedback that comes from 10 group members who have known you for some time and all agree on a certain perception of your personality.

Over a period of months Mary has been able to understand the distortions she formed of herself. Growing up in an alcoholic home with a mother who suffered from an eating disorder left her feeling alone. Without the empathy of her parents she feel into an obsession with appearance and performance. She discovered the one way to consistently garner their attention. As a result she couldn’t resist the appeal of her husband’s resume. Her familiarity with excessive alcohol consumption made her minimize the impact of her husband’s drinking, and of his demeaning way of relating to her.

Children of alcoholics often find it difficult to understand why they would choose the very type of person that has caused them such misery.

It is human nature to return to the scene of the crime; we have a degree of familiarity with what we have experienced. Our minds tell us to run away from certain individuals. Nevertheless our hearts drive us forward to see if we can re-write the story by finally gaining the love and respect from those who are incapable of giving it, recreating our familial dynamic.

Today, after several months of individual and group therapy, Mary realizes that net worth does not equal self worth and perfecting appearance does not bring love and respect but in fact creates addictive behavior.

Changing a distorted story and the negative self-voice it creates in the most impressionable times in life is very difficult but certainly possible. Always remember that anything learned can be un-learned with patience and perseverance. I have seen many miraculous transformations occur with the support of empathic, open-minded people who are committed to helping each other reach the common goal of true happiness and health.


Arthur P. Ciaramicoli, Ed.D., Ph.D., is a licensed clinical psychologist who has been treating clients for more than 35 years. He is a member of the American Psychological Association and the Massachusetts Psychological Association. Currently in private practice, Dr. Ciaramicoli has been on the faculty of Harvard Medical School for several years, lecturer for the American Cancer Society, Chief Psychologist at Metrowest Medical Center, and Director of the Metrowest Counseling Center and of the Alternative Medicine division of Metrowest Wellness Center in Framingham, Massachusetts.

Dr. Ciaramicoli is currently in full time private practice and is the Chief Medical Officer for He has produced an Anti-Anxiety App with Soundmindz that has been downloaded by over 25,000 users and rated by Frontline as one of the most effective and usable anxiety apps available. He has also recently released an Anti-Depression and Mental Health app for Soundmindz.

Dr. Ciaramicoli is the author of The Curse of the Capable: The Hidden Challenges to a Balanced, Healthy, High Achieving Life, Performance Addiction: The Dangerous New Syndrome and How to Stop It from Ruining Your Life and The Power of Empathy: A Practical Guide to Creating Intimacy, Self-Understanding, and Lasting Love, which is now published in 7 languages, and just released in China. His first book, Treatment of Abuse and Addiction, A Holistic Approach was selected as Book of the Month by The Psychotherapy Book News. He is also the coauthor of Beyond the Influence: Understanding and Defeating Alcoholism.

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