Moonlight Sorrow (ca. 1856) by Victoria Adelaide Mary Louisa

One factor in creative block is that the threshold of self-consciousness about the desired manifestation of your ideas overrides your ability to take action and create those ideas. In other words, your idiosyncrasies are not embraced within, and so are implicitly suppressed by your superego, and that in turn inhibits your authentic expression, in both personality and art.

Many minds are not conducive to distinct artistic perspective but instead inclined elsewhere, such as social leadership, managerial competence, mechanical brilliance, or physical dexterity. Those all have their own inherent artistic aspects, and the potential depths and finesse that an individual can imbue their work with are the same as in art; a film can be shallow and contrived and a managerial strategy can be beautiful, comparable to an orchestra in the level of care, grace, and passion put into it. The human individual is to be appreciated for their uncovering of the potential stored in their biology, and the effort they expend to extract that potential into external space, where it then influences other individuals, altering their biology.

Viewing pathological self-consciousness as an incongruence between reality and imagined standards, as one manifestation of perfectionism, it begins to elucidate how perfectionism and stress work to cause physiological harm. A chronic state of perceived incongruence can only be stressful; if perfection is never attained, which it won’t because it doesn’t exist, an incurable agitation results; this is essentially self-induced learned helplessness.

Placing of too high a standard on oneself, and on the criteria of any practice, leads to perfectionism-paralysis, or avoidance behavior (Santanello and Gardner, 2007).

Perfectionism and neurotic self-criticism increase cortisol circulation by around 18% on average (Wirtz, et al., 2007). Chronic release of cortisol contributes to aging, obesity, depression, cancer and is predictive of later onset of chronic fatigue syndrome (Deary and Chalder, 2010; Kempke, et al., 2016), which can be caused by systemic mitochondrial dysfunction, where our cells become so desensitized to  cortisol that we hibernate in a low-energy hypometabolic state. 

A subtype manifestation is what our culture calls “burnout”, and the culture itself has contributed to the problem: perfectionism among millennials has steadily increased since the 1980s (Curran, 2019), and millennials are sicker than previous generations by both physical and psychiatric measure, with double-digit percentage increases in 8 of the top 10 medical conditions, including depression, psychosis, alcoholism, hypertension, Crohn’s, and diabetes II (BCBS, 2019). They’re also showing a lower life expectancy than the previous generation, Gen X, with a 40% increased mortality rate (BCBS, 2019). Despite having the lowest obesity rates in recent history, the young have become the old, owing in large part to stress-inflammatory degeneration.

Prolonged stress-induced adrenaline and noradrenaline synergize with cortisol, stimulating tumor progression and cancer cell proliferation (Lutgendorf, et al., 2003), although vitamin C was able to reverse stress-induced breast cancer in vivo and in vitro, by suppressing lactate and inhibiting the cancer stem-like cells (Cui, et al., 2019).

Adrenaline is also a mechanism by which cytokine-storm occurs during infections, including COVID-19, killing the patient by sepsis, so an increased sensitivity to adrenaline increases chance of death. That’s why alpha and beta-adrenergic blockers are sometimes given during both cancer (Yang and Eubank, 2013) and infection, and why alpha-blockers are being considered as a universal adjunctive treatment in COVID-19 patients with pneumonia.

Does perfectionism cause mitochondrial dysfunction or is the relationship epiphenomenal: does the same mediator contributing to mitochondrial dysfunction also steer the personality toward perfectionism? It seems to be different in each case, or generally it’s a positive feedback loop. This same question applies to perfectionism’s association with the aforementioned diseases, and with comorbid psychopathology, with which there is statistically significant association (Limburg and Egan, 2016). 

Given the probability that it depends on the individual, living as if both answers were true seems reasonable. If inherent physiological anomalies are contributing to high trait neuroticism or perfectionism, which are also predisposing one to illness, then a lack of psychobehavioral strategies to alleviate it will only exacerbate the pathology. The self-development process is one of troubleshooting and refining, where a richness of character arises from the variety of avenues explored and experimented with.

We know our mind and mitochondria communicate as a two-way street; same with our mind and guts, and our guts and mitochondria. The food and compounds we ingest shape our microbiome, which influences our mood and personality (Kim, et al., 2018; Johnson, 2020). The strains of bacteria in our microbiome modulate our insulin response, our ability to absorb nutrients (some synthesize nutrients themselves, for us), our neurotransmitters, hormones, skin and hair quality (Levkovich, et al., 2013), cognition, and aging. 

The quality of bacteria ranges from commensal (mutually beneficial relationship) to pathogenic (exploiting us to our detriment). The quality of our diets, lifestyles, how we think and act, our environment and relationships, all affect our gut’s bacterial quality (Karl, et al., 2018; David, et al., 2013).

We share our microbiota with the people we live with, even our pets (Song, et al., 2013). Our social connections influence us not only through direct interaction, but also downstream, as the bacterial strains of those around us acclimate into our guts, affecting our personalities via neurotransmission and hormonal environments.

Our habits, thoughts, and stressors affect our digestion and intestinal barrier. Distress of any kind can increase intestinal permeability, allowing bacterial endotoxin to translocate into our bloodstream, affecting every bodily system, including our minds. The brains of many neurological conditions have been found to contain accumulated bacterial metabolites that leaked through the intestinal barrier during digestion, then attacked the blood-brain barrier until that became leaky too (Riccio and Rossano, 2019).

Endotoxin and inflammation decrease the ability to think clearly, and increase impulsivity and irritability (Gassen, et al., 2019). Activation of the immune system leads to the release of the inflammatory cytokines interleukin-6 and tumor necrosis factor-alpha, which leads to heightened neural sensitivity of the anterior insula, causing excessive interoceptive awareness (e.g. overthinking and rumination), impaired concentration, increased sensitivity to social rejection, and intensified negative emotions (Harrison, et al., 2009; Slavich, et al., 2010). This discomfort in turn causes impulsive behaviors or addictions, which, even though they may be temporarily comforting, act as physiological stressors that further perpetuate inflammation and endotoxin-mediated immune activation. Alcohol powerfully inflames the intestine, liver, and brain, as do, to lesser extents, high free-fructose diets, industrial vegetable and seed oils, heavy metals, pesticides, many pharmaceuticals, and psychosocial stress (Punder and Pruimboom, 2015).

There is the romantic popular archetype of the tortured artist, whose tragedy and pain are necessary muses for their beautiful creations. Francis Bacon and Vincent Van Gogh come to mind; the former lived in a chaos of binge-drinking and hangover haze all the while painting beautiful nightmares, and the latter engaged in psychotic self-mutilation and suicide, the profound visions of his paintings being one of the only reliefs life granted him. But just as real is the tranquil artist who is able to balance motivation and passion with mindfulness and self-care. There is David Lynch, who has meditated 40 minutes per day since 1973, and creates art in perpetual childlike joy and has never lost his belief in the power of positivity.

“I like to think that van Gogh would have been even more prolific and even greater if he wasn’t so restricted by the things tormenting him. I don’t think it was pain that made him so great—I think his painting brought him whatever happiness he had.”
—David Lynch, Catching the Big Fish, pg. 94

Ray Peat, the science philosopher and painter, is apparently so happy at 84 that he believes anything less than euphoria indicates bad health.

“If you are far from the euphoric condition then it means you’re basically degenerating structurally, aging, deteriorating, and maintaining the euphoric state is therapeutic […] Everything that doesn’t cause injury and does cause energy or stability is going to lead you towards a greater stability.”
Ray Peat, Generative Energy #33 (22:50)

Procrastination and perfectionism can also be seen as a conditioned response of rebellion against authority figures and their prescribed behaviors imposed upon us in subservient roles, as the child, student, or employee. In Freud’s view, many of us introject the authoritarian prescriptions modeled to us, obligations that elicit groans from our very soul, and so tyrannize and patronize ourselves even into adulthood, having become our own authoritarian dominator; a pseudo-pathological super-ego. 

What can be done to mitigate psychophysiological distress, to protect our minds from this vicious circle, while preserving and amplifying creative energy? Learning and applying the principles affecting cognition and emotion and their interplay through a biopsychosocial model. The same principles that apply to fitness and nutrition apply to our creative health and they all synergize for our benefit or downfall.

There is evidence that mindfulness can substantially improve perfectionistic tendencies (Flett, et al., 2020). In a study of 255 musicians, the musicians that meditated at least weekly had lower performance anxiety regardless of their trait mindfulness scores (Diaz, 2018).

Heart rate variability (HRV) is a biomarker of our nervous system’s flexibility; low HRV tends to occur in illness, even depression, while high HRV is associated with fitness and wellbeing. Meditation can significantly enhance HRV in just a few minutes. One study found that perfectionists who meditated for 10 minutes failed to experience this benefit, but non-perfectionists doing the same meditation had a great increase in HRV (Azam, et al., 2015). The perfectionist temperament is unable to relax because they are hypercritical even of their ability to relax

A subsequent meditation study with 120 perfectionist college students found that their HRV did become marginally higher only when they specifically performed a non-judgement mindfulness for 10 minutes; general mindfulness and progressive muscle relaxation were comparative failures (Koerton, et al., 2019).

When you approach a problem one way, you’re presented with a set of seemingly preferable solutions and necessarily blinded from others. It’s only when we learn to adjust and discern, contextually and adaptively, that we understand that what is most valuable in one scenario is detrimental or futile in another, and that previously unforeseen options exist when new knowledge is applied to existing problems. Single-cause ideologues and other dogmatists can’t access that perspective, and perfectionism is a self-imposed dogmatism-of-process.

Since distress kills, and since distressing ourselves is a prolonged form of self-poisoning, we can work to care for ourselves in the way of a true friend as opposed to a disciplinarian. What is best for a perfectionist or procrastinator is not tyranny or endurance of excruciation, but instead a remodeling of the entire process in everything we’ve accumulated thus far. The radical zen approach, as a reaction to tyranny, may prove just as impotent. Finding a balance in between, where initially minor actions beget exponentially increasing results that prove our decisions hold weight, is a useful place to begin; behavioral activation therapy, developing microhabits, improving your protocols as opposed to goals, or starting by doing it badly. Cultivating self-compassion in the face of these challenges may be the most crucial thing.

Further reading

Man and Woman Contemplating the Moon (ca. 1824) by Caspar David Friedrich

Works Cited

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