Some children show signs of perfectionism from early on. Young children might become frustrated and rip up their drawing if it’s not quite right. Older children might avoid or refuse to do homework because they’re afraid to make a mistake.

Perfectionism can lead to children feeling overwhelmed, angry and frustrated, or sad and withdrawn.

And yet perfectionism isn’t considered all bad in our society. Being called a “perfectionist” can be a compliment – code for being a great worker or student, someone who strives to do their best and makes sure all jobs are done well.

These seemingly polarised views reflect the complex nature of perfectionism.

What is perfectionism?

Researchers often separate perfectionism into two parts:

1. perfectionistic strivings: being determined to meet goals and achieve highly
2. perfectionistic concerns: worry about being able to meet high standards, and self-criticism about performance.

While perfectionistic strivings can be positive and lead to high achievement, perfectionistic concerns can lead to a higher chance of children developing eating disorders or anxiety and depression, and having lower academic achievement.

Children and adolescents may experience perfectionism in relation to school work, sport, performance in art or music, or in relation to their own body.

Signs of perfectionistic concerns in children and adolescents may include:

• children being highly critical of themselves
• their reactions to mistakes seeming to be an overreaction
• intense preoccupation and worry over their standards and goals and/or procrastination
• significant change in performance, for example, lower academic results
• irritability and negative emotions, stress and feelings of worthlessness
• social problems with peers and friends, such as bullying and alienating themselves from peers.

A range of genetic, biological and environmental factors influence perfectionism in children. And as a parent, our role is important. While research evidence suggests we can’t successfully increase positive perfectionistic strivings in our children, harsh or controlling parenting can increase negative perfectionistic concerns in children.

Parents who are perfectionistic themselves can also model this to their children.

So, how can we walk the line between supporting our child’s interests and helping them to achieve their potential, without pressuring them and increasing the risk of negative outcomes?

Give them space to grow

A great metaphor is the gardener versus the carpenter described by psychology professor Alison Gopnik.

Instead of trying to build and shape our children by controlling them and their environment (like a carpenter), parents can embrace the spirit of the gardener – providing lots of space for children to grow in their own direction, and nourishing them with love, respect and trust.

We can’t control who they become, so it’s better to sit back, enjoy the ride, and look forward to watching the person they grow into.

However, there is still plenty we can do as parents if our child is showing signs of perfectionism. We can role model to our children how to set realistic goals and be flexible when things change or go wrong, help our children manage stress and negative emotions, and create healthy balance in our family daily routine.

Set realistic goals

People with perfectionistic tendencies will often set unattainable goals. We can support the development of flexibility and realistic goal setting by asking curious questions, for example, “what would you need to do to get one small step closer to this goal?” Identifying upper and lower limits for goals is also helpful.

If your child is fixed on a high score at school, for example, set that as the “upper limit” and then support them to identify a “lower limit” they would find acceptable, even if they are less happy with the outcome.

This strategy may take time and practice to widen the gap between the two, but is useful to create flexibility over time.

If a goal is performance-based and the outcome cannot be guaranteed (for example, a sporting competition), encourage your child to set a personal goal they have more control over.

We can also have conversations about perfectionism from early on, and explain that everyone makes mistakes. In fact, it’s great to model this to our children – talking about our own mistakes and feelings, to show them that we ourselves are not perfect.

Talk aloud practices can help children to see that we “walk the walk”. For example, if you burn dinner you could reflect:

I’m disappointed because I put time and effort into that and it didn’t turn out as I expected. But we all make mistakes. I don’t get things right every time.

Manage stress and negative emotions

Some children and adolescents have a natural tendency towards perfectionism. Rather than trying to control their behaviour, we can provide gentle, loving support.

When our child or adolescent becomes frustrated, angry, sad or overwhelmed, we support them best by helping them to name, express and validate all of their emotions.

Parents may fear that acknowledging their child’s negative emotions will make the emotions worse, but the opposite is true.

Creating healthy balance

The building blocks of healthy child development are strong loving family relationships, good nutrition, creative play and plenty of physical activity, sleep and rest.

Perfectionism is associated with rigidity, and thinking that there is only one correct way to succeed. We can instead encourage flexibility and creativity in children.

Children’s brains grow through play. There is strong research evidence showing that creative, child-led play is associated with higher emotion regulation skills, and a range of cognitive skills, including problem-solving, memory, planning, flexibility and decision-making.

Play isn’t just for young children either – there’s evidence that explorative, creative play of any kind also benefits adolescents and adults.

There is also evidence that getting active outdoors in nature can promote children’s coping skills, emotion regulation and cognitive development.

Elizabeth Westrupp, Associate Professor in Psychology, Deakin University; Gabriella King, Associate Research Fellow, Deakin University, and Jade Sheen, Associate Professor, School of Psychology, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Medicinal cannabis use has increased rapidly in recent years in Australia. Since access pathways were expanded in 2016, more than 700,000 prescription approvals have been issued.

The vast majority of medicinal cannabis products on the market have not been registered on the Australian Register of Therapeutic Goods. But medical practitioners can apply to the Therapeutic Goods Administration (TGA) for approval to prescribe them to patients.

Data shows the three most common conditions for which scripts are approved are chronic pain, anxiety and sleep disorders.

Although many patients report benefits, professional bodies and regulators have raised concerns about whether prescribing is outpacing the evidence.

So what does the evidence actually say? Does medicinal cannabis work for the conditions for which it’s most commonly prescribed?

Medicinal cannabis for pain

Medicinal cannabis refers to cannabis products that are legally prescribed to treat a medical condition. This can be the plant itself, or natural compounds extracted from the plant. Some compounds similar to or the same as those found in cannabis (for example, dronabinol and nabilone) are made in a lab.

Two of the most common compounds in the plant are THC (tetrahydrocannabinol) and CBD (cannabidiol), known as cannabinoids.

These are commonly found at various concentrations in medicinal cannabis products which come in forms including oils, capsules, dried flower (used in a vaporiser), sprays and gummies.

Chronic pain is the most common reason for medicinal cannabis use. But as we’ve written in a previous article, research shows only modest benefits, with limited improvements in pain and physical functioning.

The TGA says there’s limited evidence medicinal cannabis provides clinically significant pain relief for many conditions, and should only be tried if other standard therapies haven’t helped.

Does medicinal cannabis work for anxiety?

Beside chronic pain, a growing number of people are now turning to medicinal cannabis for anxiety.

Multiple reviews have examined whether it works for this purpose and have come to similar conclusions. For THC-based products the evidence is mixed, with some patients finding relief, while others report their symptoms are worse.

There is emerging evidence for CBD, however it’s too soon to recommend medical cannabis as a first-line treatment for anxiety. So far, studies of CBD in anxiety have been small, only measured effects under experimental conditions designed to induce stress, had no comparison group, or only tested a one-off dose. Because of these limitations, the studies can’t tell us if CBD is effective for ongoing anxiety management.

A recent review found CBD had positive effects on anxiety, but these effects were seen in studies deemed to have problems with their methods, and not in studies that were more rigorously designed and conducted.

Similarly, a small Australian study (with no control group) demonstrated positive effects of CBD in young people with anxiety who had already tried other treatments. However, the authors stated more rigorous trials were still needed.

What’s more, there are recent case reports of acute psychosis arising from medicinal cannabis use. Taken together with the ambiguous evidence, the role for cannabinoids for anxiety remains far from clear.

How about sleep disorders?

The evidence for cannabis in the treatment of sleep disorders and insomnia is perhaps even more limited, with neither CBD or THC having shown clear benefits reducing the number of awakenings or time spent awake during the night, or improved sleep quality. That said, some people do report they have fewer symptoms of insomnia when using medicinal cannabis.

Similar to anxiety, many of the studies have major weaknesses in their study design which make it difficult to draw strong conclusions. There are also few studies that compare medicinal cannabis to proven treatments for sleep disorders and insomnia. This makes it hard to make recommendations for treatment based on the current research evidence.

THC can make you drowsy, and in the short term, may help people fall asleep, or feel like they’re getting more sleep. But there are some important downsides to consider, too.

For example, if you take medicinal cannabis regularly to fall asleep your body can get used to it, making it harder to fall asleep without it. In the long term, medicinal cannabis can also affect the amounts of light and deep sleep a person will have, which can result in poorer sleep quality.

There is good evidence for some conditions

Some of the strongest evidence for medicinal cannabis products are for rare forms of epilepsy that don’t respond to existing treatments, and for treating symptoms associated with multiple sclerosis.

The only TGA-approved medicinal cannabis products are for these conditions.

There’s also evidence medicinal cannabis can help with chemotherapy-induced nausea and vomiting. Though as newer medications with fewer side effects are now available, medicinal cannabis products are not considered first-line treatments.

Risks and side effects

Common side effects with THC in the short term include drowsiness, anxiety, dry mouth, nausea, vomiting and appetite changes. For some people, these effects reduce over time.

Some people with preexisting health conditions such as schizophrenia, psychosis or heart conditions may be more prone to experiencing side effects.

An estimated one in four people using medical cannabis meet the criteria for dependence (known as cannabis use disorder). In the longer term, dependence appears more common with medical use, particularly when combined with non-medical use.

If you are suffering with anxiety, sleep problems or chronic pain, and are wondering what treatments might be most effective for you, speak to your regular GP.

Suzanne Nielsen, Professor and Deputy Director, Monash Addiction Research Centre, Monash University and Myfanwy Graham, NHMRC Postgraduate Scholar and Fulbright Alumna in Public Health Policy, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.