When Straight A’s Come with High Stress: EMDR Therapy for Teen Perfectionism inCarlsbad, CA

When I think back to high school and even middle school, I remember feeling a need to prove

myself, to get it right, to not disappoint anyone—I see so much of that same energy in the teens

I work with now. I’ve worked with many high-achieving teens over the years—the ones who

always get their homework in early, study late into the night, and seem to carry the weight of the

world on their shoulders. And while their report cards might be filled with A’s, their nervous

systems are often signaling something else: exhaustion, anxiety, and pressure that feels

overwhelming.

As a Licensed Marriage and Family Therapist based in Carlsbad, CA, I specialize in helping

teens who look like they have it all together on the outside but are quietly overwhelmed on the

inside. One of the most effective tools I use in my practice is EMDR therapy (Eye Movement

Desensitization and Reprocessing). It's been a game-changer for many of my clients struggling

with perfectionism.

Perfectionism Isn’t Just Ambition

It’s easy to mistake perfectionism for motivation or discipline. But true perfectionism isn’t about

wanting to do well—it’s about feeling like you have to do well in order to be good enough. It can

come with intense self-criticism, fear of failure, and a constant thought loop of "what if I mess

up?" These teens are often the ones who:

● Rewrite their papers multiple times to make them "perfect"

● Feel physically sick before exams

● Avoid activities they’re not instantly good at

● Cry over a B+

● Push themselves to the point of burnout

Underneath all this effort is often a deeper belief: If I don’t do everything perfectly, I’m not okay.

Where Does Perfectionism Come From?

Perfectionism in teens can stem from a mix of personality traits, family dynamics, school culture,

or early experiences. Sometimes it comes from subtle messages like "You always do so well!"

or "You're the smart one in the family." Other times, it’s a response to more distressing events

like a tough divorce, bullying, or moments where a teen felt unsafe, unseen, or out of control.

What I’ve seen again and again is that perfectionism isn’t just about academics. It’s often rooted

in anxiety and unprocessed emotions. That’s why EMDR can be such a powerful approach.

How EMDR Helps Perfectionistic Teens

EMDR therapy helps the brain process the distressing experiences that often sit beneath

perfectionism. The therapy uses bilateral stimulation (like eye movements, tapping, or sound) to

help the brain reprocess stuck memories, shifting how those experiences are stored and felt in

the present.

Let’s say a teen once got scolded in front of their class for making a mistake. Even if it

happened years ago, their brain might still replay that moment as if it’s happening now. They’ll

do everything to avoid that feeling again—even if it means working themselves to exhaustion.

With EMDR, we can target the memory of that moment, along with the belief that grew from it ("I

can’t mess up," or "I’m a failure"). Through processing, that belief shifts to something more

grounded and supportive, like "It’s okay to make mistakes," or "I can trust myself even when

things aren’t perfect."

What EMDR Therapy Looks Like

EMDR is structured, but it’s also flexible. Sessions typically involve:

1. Building trust and safety: We never dive into difficult material before a teen feels

ready.

2. Identifying the roots: We explore early memories or moments that might have planted

the seeds of perfectionism.

3. Reprocessing: Using bilateral stimulation, we help the brain move through stuck

emotions and beliefs.

4. Installing positive beliefs: We reinforce new, empowering ways of thinking and feeling.

Many teens appreciate that EMDR doesn’t require them to talk endlessly. They can stay more

internal and still experience deep change.

Supporting Your Teen in Carlsbad, CA

If you live in Carlsbad or North County San Diego, you know that the academic and

extracurricular culture here can be intense. Teens are often juggling AP classes, sports,

volunteer work, and social pressure. When teens are constantly expected to excel, it’s no

surprise that perfectionism takes hold.

If your teen seems like they’re doing well but are clearly under high stress, they might benefit

from EMDR therapy. It can help them release the pressure, reconnect with themselves, and

rediscover joy in the things they love.

Straight A’s shouldn’t come at the cost of your teen’s well-being. If your high-achieving child is

overwhelmed, anxious, or pushing themselves to unhealthy limits, EMDR therapy could be the

support they need.

I work with teens in Carlsbad and across California via telehealth, helping them move beyond

perfectionism and toward a more balanced, empowered life.

About the Author: A Licensed Marriage & Family Therapist Trained in EMDR Therapy

​Katherine Madsen is a therapist who specializes in helping teens and adults heal from trauma and reconnect with their whole selves. Drawing from her personal experiences with trauma and healing, she offers a compassionate, non-judgmental space for clients to explore their challenges.

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Can EMDR Help with Anxiety? Exploring Carlsbad EMDR Therapy for Anxiety and Stress Relief