Perfectly Imperfect:

Perfectionism and Global High Intensity Activation

People come to therapy for all sorts of reasons. Over the years, I’ve developed a bit of a niche working with high-achieving, productive individuals who, from the outside, not only appear to be functioning, but in many cases, seem to be thriving. The problem isn’t what they haven’t achieved. The problem is how their achievements haven’t changed the way they feel, or how they continue to live as if they’ve achieved nothing at all.

Often, this person is perfectionistic, successful, likable, driven. But despite the life they’ve created, they struggle to feel genuine satisfaction or safety. They perform well under pressure but have a hard time relaxing on vacation. Why is that?

In somatic psychotherapy, we might think of this pattern as Global High Intensity Activation (GHIA). While not the only profile within this category, this particular character structure shows up frequently in my New York City practice.

What is Global High Intensity Activation (GHIA)?

GHIA refers to a nervous system state characterized by sustained high levels of sympathetic charge, fight-or-flight energy. For these individuals, the nervous system has adapted to function under constant pressure. When they begin to downregulate into a more parasympathetic (rest-and-digest) state, they often either spring back into activation or collapse entirely. There is very little capacity to stay in a regulated, settled state.

This high-output state becomes the norm. It feels like safety. Stillness and rest feel like danger.

How Do We Work with GHIA?

We work slowly, which, of course, is difficult for someone who has learned to move fast. By gently introducing brief moments of settling and then pendulating (swinging back) to the familiar state of activation, we gradually expand the client’s window of tolerance. Over time, this allows the system to experience greater safety and flexibility.

Eventually, they can feel more resourced and enjoy being inside their lives, not just pushing their lives forward.

The Myth of Perfectionism

Clients with GHIA often hit an intellectual barrier in this work. High achievement and productivity are not only socially rewarded, they’re internalized as core aspects of identity. On a deeper level, though, these clients associate vigilance with safety. So when the body begins to settle, the vigilant part of the system reemerges.

They might say: "But I don’t want to rest. I don’t want to be mediocre. I want to strive for excellence."

Healing the nervous system doesn’t mean we stop striving toward meaningful goals. It means we can do so with more presence, more enjoyment, and less depletion. It means we have access to our full selves, not just the part that knows how to push.

If You’re Reading This and Thinking, “I Don’t Want to Rest”

You might fall into this category. Don’t worry—you’re in good company.

The truth is: if we don’t learn how to feel safe within ourselves, we eventually burn out. It might look like autoimmune illness, insomnia, inflammation, or digestive issues. And eventually, the strategy stops working, you lose the ability to push through.

You don’t have to give up your ambition. But imagine what it might feel like to live in a system that doesn’t constantly feel like it’s under threat. You might even discover that rest, ease, and presence are not enemies of achievement, but allies.

Thinking about trying therapy? Book a free consultation today to see if it’s right for you.