Milestones Quarterly Luncheon was a chance for recovery professionals to get together and enjoy an afternoon networking, enjoying great food and listening to leaders in the field of dual diagnosis. Milestones was honored to host Dr. Timothy G. Benson of McLean Center at Fernside, a Harvard affiliate, as our keynote speaker. Dr. Benson spoke on treating the high achiever (notes below):

 

Treating The High Achiever: Success, Stress and Addiction

Dr. Timothy G. Benson, McLean Center at Fernside, a Harvard Affiliate

Achievement is the cornerstone of our society. From birth we are socialized to strive for excellence in academics, athletics and in the professional world. For some, this pursuit derives from a healthy place and leads to a sense of fulfillment. For others the pursuit has spawned out of a place of pain and fear. Regardless of the etiology of their motivation “high achievers”, individuals who have received a significant degree of acclaim in their chosen field of expertise, can often find themselves embedded in stressful environments or circumstances that may make them vulnerable to developing mental health problems. If unaddressed these problems can have devastating consequences.

In some cases high achievement comes at a significant cost. For instance, over identification with one’s achievement can lead to a distortion of values and allow for particular susceptibilities during periods of transition. Changes in status, income responsibility have the potential to expose underlying insecurities that destabilize one’s sense of self and safety.

 Regarding mental health treatment, the mindset of the high achiever can be a significant barrier. The tenets of working harder, having a myopic focus and demanding immediate results serves to promote professional success. However, these ideals can be counterproductive in a treatment/recovery process that encourages one to surrender, be vulnerable and patient. Engaging the patient in the treatment process is the first crucial step. The divide between the achievement and treatment cultures can be bridged through strength-based approaches which offer a non-threatening entry into treatment. For example, the concept of resilience has been used to engage patients in a collaborative process that works to expand self concept, increase awareness, improve self-regulation and coping mechanisms,while enhancing support networks.

Upon entering treatment issues around perfectionism and the “impostor syndrome” often surface. While being flexible clinicians must also be aware perpetuating what has been described as the “VIP syndrome”. The VIP syndrome is the phenomena in which generally poorer care given to a person of particular influence because of deviations from the standard of care. These deviations may include: denial of alcohol or substance abuse by caregivers, short-circuiting routine procedures to avoid inconveniencing the patient; overlooking psychiatric issues to avoid insulting the patient; and feelings of shame and fear going uncomforted.

In summary, high achievers may have unique circumstances that impact recognition and treatment of mental health issues. Periods of transition can increase their vulnerabilities as well as offer an opportunity to engage in treatment. Furthermore, the use of strength based approaches may serve to enhance our ability to detect and treat those high achievers who are most at risk.

References:

Block, AJ., “Beware of VIP Syndrome” Chest 1993

Clance,P. Imes, S “The Imposter Phenomenon in High Achieving Women: Dynamics and Therapeutic Intervention” Psychotherapy Theory, Research and Practice Volume 15, #3, Fall 1978

Groves, et al., “Celebrity Patients, VIP’s and Potentiates” J Clin Psychiatry 2002 Jones, G and Spooner, K “Coaching High Achievers” Consulting Psychology Journal: Practice and Research, Vol. 58, No. 1, 40–50

Shafran, R., & Mansell, W. Perfectionism and psychopathology: a review of research and treatment. Clinical Psychology Review, 21, 879–905.