The Enemy of the Good

By | NESCA Notes 2020

By Jason McCormick, Psy.D.
Pediatric Neuropsychologist

As a neuropsychologist who has primarily focused on assessment of middle school, high school and college students, I have worked with many children, adolescents and young adults plagued with perfectionism. On the surface level, perfectionism is defined as a refusal to accept any standard short of perfection. Digging deeper, at the roots of perfection are fears of making mistakes, fears of being judged, and, ultimately, fears of being inadequate.

By definition, students with perfectionism hold impossibly high standards, which can severely undermine productivity and can lead to high levels of emotional distress. The adage, perfection is the enemy of the good, “perfectly” describes these students’ challenges. Students with perfectionism often run into “blank-screen syndrome,” presenting with such a harsh self-censor that they shoot down their own good ideas before they have a chance to develop them. Further, with the additional time needed to “gild the lily,” students often end up blowing past paper deadlines, thus undermining their grades.

Complicating treatment, many students – even those with recognition of their impossibly high standards – view a call to work on ameliorating their perfectionism as an intolerable directive to lower their standards or even as an affront to their intelligence and ability levels. Thus, despite the emotional distress and work production challenges perfectionism causes, many students with perfectionism present with insufficient motivation to change.

In response, treatment needs to begin with helping these students appreciate the negative impact perfectionism can have on their mental health, and, from a more mercenary standpoint, on their grades. Further, it will be important for these students to be able to broaden their definition of success beyond mere quality to include a balance of quality and efficiency. An A paper turned in two weeks late might earn a B, C or even (depending on the philosophy of the teacher or professor) a failing grade, due to its tardiness.

After securing some buy-in, work with a therapist or therapeutic tutor, with background in cognitive-behavioral therapy, is often needed to move the needle on perfectionism. More specifically, the use of exposure and response prevention (ERP) can be effective. Typically used to treat obsessive-compulsive disorder (OCD) and phobias, ERP involves exposing an individual to their feared stimulus (e.g., heights, snakes and in this case sub-perfect work) and not allowing for the avoidant response (in this case, over-reviewing/over-thinking behaviors that are used to avoid the possibility of mistakes). For instance, an ERP assignment might involve a student setting a reasonable time limit to complete a given task and having the student pass in that work, no matter what final state it is in. Over time, such work can help a student progress toward their ultimate goal of producing “the good enough paper.”

To be clear, this progress does not happen overnight, and it can feel difficult and mentally painful. However, it is important work, as learning to strike a reasonable balance between quality and efficiency is a critical element of the “hidden curriculum,” needed for success in college and the workforce.


About the Author:

Dr. Jason McCormick is a senior clinician at NESCA, sees children, adolescents and young adults with a variety of presenting issues, including Attention Deficit Hyperactivity Disorder (AD/HD), dyslexia and non-verbal learning disability. He has expertise in Asperger’s Disorder and has volunteered at the Asperger’s Association of New England (AANE). Dr. McCormick mainly sees individuals ranging from age 10 through the college years, and he has a particular interest in the often difficult transition between high school and college. As part of his work with older students, Dr. McCormick is very familiar with the documentation requirements of standardized testing boards. He also holds an advisory and consultative role with a prestigious local university, assisting in the provision of appropriate academic accommodations to their students with learning disabilities and other issues complicating their education.


To book a consultation with Dr. McCormick or one of our many other expert neuropsychologists, complete NESCA’s online intake form.


Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.


Exercise Before Medication: How consistent workouts can change your life

By | NESCA Notes 2019

By Billy Demiri, CPT
Certified Personal Trainer

Recently I came across an article that highlights what I have believed to be true since I first started exercising regularly myself…a healthy body will foster a healthy mind. The study shows that “lifting weights helps lift depression; cardiovascular activities reduce the effects of anxiety; and any type of movement improves mental health.” Throughout the study, patients were led in a structured exercise program for 60 minutes four times a week. An astounding 95 percent reported feeling better, and 91.8 percent were very pleased with their bodies during each session. With those kinds of results, exercise should be at the forefront of treating mental health issues before psychiatric drugs.

When I started working as a personal trainer and coach, I saw the positive effects that consistent exercise had on all of my clients. Here at NESCA, I have the privilege of working with some amazing kids and young adults—all dealing with different disabilities/mental illness from Autism Spectrum Disorder (ASD), Anxiety, Depression, Obsessive-Compulsive Disorder (OCD), Muscular Dystrophy, and Attention Deficit Disorder (ADD) or Attention-Deficit Hyperactivity Disorder (ADHD). My goal has always been to make exercise fun and challenging, while also trying to identify goals that drive each individual to want to make exercise a regular part of their lifestyle.

Using a variety of equipment, we work on agility, conditioning, strength, coordination and overall better movement mechanics. After six years of being a personal trainer, and working at NESCA the past year, I couldn’t agree more with the findings of the article. I continue to see firsthand that consistent exercise can unlock everyone’s full potential and, in turn, create a lot of joy and self-worth.

Over the past year, it has been spectacular to see each person progress from session to session—not just physically but mentally. One of my clients was struggling with staying on task and had a hard time completing one exercise at a time before he got frustrated and needed a break. Each session we kept on progressing, and one exercise turned into two, then three, until we built up to doing four-move circuits. Yes, he built up strength and endurance over time, but more Importantly, he gained confidence in himself. He learned that what he originally thought was daunting was actually easy and very doable. Then  he went one step further and wanted to make it even harder. It was amazing seeing his mood change from not wanting to do any exercise to smiling and celebrating after beating his previous time in a four-move circuit. By staying consistent with exercise and seeing himself improve each week, I could see noticeable changes in his self-esteem, on-task behavior and overall mood during workouts—not to mention that he also developed better movement patterns and gained strength, endurance and overall better health.

Based on my experiences, prescribing exercise before medication is a worthwhile approach to continue to look at. Each person needs to be looked at individually, and more research needs to be done to ensure the safety of the patient and others without medication, however it’s clear through research and my own experiences that exercise has positive impact on our overall well-being. It will take some time to change the norm of prescribing patterns, but we are heading in the right direction.


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About the Author:

Certified Personal Trainer Billy Demiri offers Personal and Social Coaching (PSC) at NESCA. Billy has several fitness certifications including: NSCA-CPT (National Strength Condition Association- Certified Personal Trainer) Certified and Autism Fit Certified.


To book sessions with Billy Demiri, complete NESCA’s online intake form and note that you are interested in Personal & Social Coaching.


Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.