Supporting Perfectionistic, High-Achieving Teens With Dr. Danielle Doucette

Dr. Danielle Doucette is the Chief Strategy Officer and Managing Partner at Midwest Counseling & Diagnostics, an organization that provides specialized behavioral therapies and psychological services in the Chicago area. As a licensed clinical psychologist and a Certified Eating Disorder Specialist (CEDS-S), Dr. Doucette is recognized for her expertise in exposure and response prevention for OCD, radically open dialectical behavior therapy (RO-DBT), and evidence-based treatments for anxiety, depression, and eating disorders. She is also involved in public health and has contributed to prominent publications on mental health topics.

Here’s a glimpse of what you’ll learn:

[02:27] Dr. Danielle Doucette talks about the hidden struggles of highly self-controlled, perfectionistic teens
[04:54] How rigidity and anxiety can signal overcontrolled behavior in teens
[06:49] The differences between undercontrolled and overcontrolled coping styles
[10:24] Why emotionally reserved teens may feel intensely lonely
[12:21] Ways self-injury shows up differently in overcontrolled adolescents
[16:54] How radically open dialect behavior therapy (RO-DBT) teaches flexibility and openness skills
[20:50] Practicing the “Big Three Plus One” for authentic social connection
[24:10] How facial expressions communicate authenticity and build relationships
[31:54] Why classes instead of groups help overcontrolled kids thrive and learn
[34:50] Inspiring success stories of teens building genuine connections and flexibility

In this episode…

Some teens seem to glide through adolescence with perfect grades, packed schedules, and spotless behavior. On the surface, everything looks fine — admirable, even. What happens when the traits that make a teen “successful” also keep them silently struggling, unable to share what’s really going on?

According to Dr. Danielle Doucette, a clinical psychologist specializing in behavioral therapies, many high-achieving teens aren’t acting out at all; they’re turning inward. She believes these teens often rely on extreme self-control, rigid routines, and emotional reserve to manage their anxiety. Drawing from her experience working with adolescents who fit this “overcontrolled” profile, Dr. Doucette explains that their perfectionism and strong academic or athletic performance can disguise deep loneliness, fear of vulnerability, and escalating internal distress. She emphasizes that helping these teens soften, open up, and connect with others can be life-changing, not because it alters who they are, but because it allows them to thrive rather than simply cope.

In this episode of The Coping Podcast, Dr. Leigh Weisz is joined by Dr. Danielle Doucette, Chief Strategy Officer and Managing Partner at Midwest Counseling & Diagnostics, to discuss how to support perfectionistic, high-achieving teens. They explore the hidden struggles of overcontrolled adolescents, the signs that often go unnoticed, and why traditional DBT doesn’t always meet their needs. Dr. Doucette also gives advice on practical skills teens can use to build more meaningful relationships.

Resources Mentioned in this episode

Quotable Moments:

“They might like hold back their feelings, they bottle things up inside and keep them inside.”
“Parents are typically surprised when they learn about the extent to which their teen is really struggling.”
“I can’t tell you how many times I’ve heard people say, yeah, I have friends.”
“That’s what makes it really hard for people to kind of know that something was going on.”
“Part of the reason is because they’re really living their life in a state of threat.”

Action Steps:

Learn to spot signs of overcontrol in teens: Recognizing perfectionism, rigidity, and emotional reserve early helps caregivers intervene before struggles intensify.
Encourage gradual vulnerability in safe relationships: Supporting teens in sharing small, authentic pieces of themselves builds confidence and strengthens meaningful connections.
Model and teach flexible thinking at home: Demonstrating adaptability helps teens loosen rigid patterns and handle unexpected changes with less distress.
Prioritize social connectedness as a core goal: Intentionally nurturing friendships and family bonds supports emotional wellbeing and reduces silent suffering in high-achieving teens.
Introduce evidence-based skills like the Big Three + One: Practicing concrete tools for signaling openness improves teens’ ability to form deeper, more rewarding relationships.

Sponsor for this episode…

This episode is brought to you by Coping Partners.

Coping Partners is a mental health practice dedicated to helping children, adolescents, and adults manage various challenges including anxiety, divorce, behavioral issues, relationship problems and much more in the Chicago suburbs.

Our practitioners are devoted to building on our clients’ strengths and bolstering weaknesses.

To gain insight and tools for getting unstuck check out our website at CopingPartners.com, email us at support@copingpartnersgroup.com.

Episode Transcript

Intro: 00:01

Welcome to The Coping Podcast, where we share strategies for coping with the stressors of life, especially the difficulties of parenting. And here is your host, Dr. Leigh Weisz.

Dr. Leigh Weisz: 00:15

This is Dr. Leigh Weisz. I am the host of The Coping Podcast, where I feature top experts on topics like raising healthy children, parenting, and so much more. Past guests include Dr. Eli Liebowitz, therapist Ben Kessler, and many more. Just a quick disclaimer. The information provided is for educational and informational purposes only.

This is not intended to provide mental health treatment and does not constitute a client therapist relationship. The information provided is not a replacement for being assessed and evaluated by a licensed professional, and is not intended to replace mental health or medical advice. This episode is brought to you by Coping Partners. Coping Partners is a mental health practice in the Chicago suburbs dedicated to helping children, adolescents and adults. We help manage various challenges including anxiety, divorce, behavioral issues, relationship problems, and much more.

Check out more episodes of our podcast and our website at copingpartners.com, and you can contact us with any questions you have. Before we get into today’s topic, I wanted to introduce our guest, Dr. Danielle Doucette. Dr. Doucette is a licensed clinical psychologist and the chief strategy officer at Midwest Counseling and Diagnostics. Clinically, Dr. Doucette specializes in behavioral therapies, including exposure and response prevention for obsessive compulsive disorder, OCD, and radically open dialectical behavioral therapy. Our deep and evidence based treatment for anxiety, depression, and eating disorders.

She brings the core principles of our of openness and humility into both her therapeutic work and leadership approach. So thank you so much, Dr. Doucette for being here.

Dr. Danielle Doucette: 02:07

Thank you for having me.

Dr. Leigh Weisz: 02:08

Today we’re going to learn a little bit about a treatment modality that is specifically for a subset of teens who struggle in a less obvious way than the teens we typically identify as needing interventions. So, Dr. Doucette can you describe the teens that you’re concerned about who sometimes fly under the radar?

Dr. Danielle Doucette: 02:27

Yeah. So the a lot of the teens who were thinking about could be could who could benefit from radically open dialectical behavioral therapy, which I’m going to say roditi moving forward. Typically those who are really, really highly self-controlled, they might be emotionally reserved a little bit. They might kind of like which means they might like hold back their feelings. They bottle things up inside.

Keep them inside for a long time. Avoid sharing their emotions or just find it difficult being open and vulnerable with other people. They also tend to excel really well academically. And so because of that, they’re very perfectionistic. They’re hard working.

They usually get really great grades, excel in the sports that they’re doing. They’re really dedicated to the practice or studies of things. And however they kind of sometimes feel a little lonely or unsure about, like how to join or connect with other people. And so that’s where our team comes in to kind of work with these folks who sometimes fly under the radar, who, like I said, kind of just do really well in school. They’re like little.

They’re the kids in the class who raise their hand. They will make sure that they will know the answer, like 99.9% 9.9% sure they’ll get it right. And so because of that, too, they’re not usually targeted as someone who might be struggling. But inside these are the folks who have a lot of anxiety around things, and their anxiety is actually what helps them stay focused, organize, keep their to do lists, structure their day so that they can kind of get things done in an orderly fashion, for example.

Dr. Leigh Weisz: 04:15

So how do they get identified these kids and end up coming to see you or or even know that they’re overly controlled? You know what? What signs and symptoms do they usually present with?

Dr. Danielle Doucette: 04:27

That’s a great question. You know, in my work, for example, with young adults, when we kind of go back and look at and describe what their teenage years were like, what we kind of see is that they just kind of kept their struggles to themselves. And that’s what makes it really hard for people to kind of know that something was going on.

Dr. Leigh Weisz: 04:51

So internalizers kind of that term. Yeah.

Dr. Danielle Doucette: 04:54

Totally. Internalizers. And, you know, we see problems kind of show up in manifest in other ways. It could be with eating disorders. It could be especially restrictive eating disorders like anorexia.

And we’ll see a lot of this in terms of rigidity. I’ll get a lot of parents kind of contact me. And one of the things I will see repeatedly in emails about their teens, they just talk about rigid behaviors, getting upset if their structures are disrupted, getting upset if they can’t kind of do things as they had originally planned, needing to feel like they need to think ahead of the game for every single thing that they do, and then getting really upset if that doesn’t happen.

Dr. Leigh Weisz: 05:39

That makes sense. So, and does OCD kind of tip is that one of the ways it shows up? I know that’s part of your background too, that you treat OCD, eating disorders And I know that you work in r o DVT in the Arab world as well.

Dr. Danielle Doucette: 05:54

Yeah, definitely. OCD does show up in some of these folks who are overcontrolled. However, for OCD we would really do exposure and response prevention. But if there’s those other problems that we were just talking about, then kind of either doing a combination of, you know, R and ERP would be really helpful for those teens. But we also know that OCD is really co-occurring with things like eating disorders and certain anxiety disorders.

So yeah.

Dr. Leigh Weisz: 06:21

Yeah, yeah. And so it sounds like, you know, again for for the parents listening, maybe you could explain the difference between the population that benefits from DBT, which we have talked about on the podcast. It seems like it comes up a lot with kids who have some emotional regulation problems. Right. So DBT and kind of who it helps versus the CBT and who that helps.

Dr. Danielle Doucette: 06:49

So to explain this, I’m going to have to go back a little bit. Okay. And you know, when we when the treatment developer and his team was looking at the research, what they found was that there was a pretty strong consensus that by around the age of 4 or 5 years old, we start to see one of two coping styles emerge in children that impact us into our teens and adulthood. Those two coping styles are called either under controlled or overcontrolled. So I’m going to talk about the under controlled kids.

And you can kind of think about like a 5 or 6 year old. So when we think about kids who are under controlled, they’re usually really loud, really excitable. They don’t think before they act at all. You know, if they see something they want, they just grab it right away. They might be the kids in the class who they’re not raising their hand.

They’re just going to call out an answer. They don’t care if it’s right or wrong. They might just say something just to get a laugh out of everybody else in the classroom. They don’t, you know. So those are some of the under control kids as adults, people who are under control.

You know, if they don’t feel like going to work, they just won’t show up. For example. And so those are typically the kids historically, that have been identified by teachers or other people in their lives around maybe having some issues with regulating their emotions, behavioral problems, things like that. And so for many, many years, we used standard dialectical behavior therapy, which is so it has a lot of empirical support to address some of those behaviors that we see the emotional dysregulation, the difficulty tolerating frustration or emotions, and a little bit more explosive at times with their emotions potentially. And so standard DVT was always applied to that population.

Dr. Leigh Weisz: 08:42

And I’m going to just insert my, you know, really cliff notes like just making sure DVT helps people who have big emotions, right? Overwhelming emotions. Yeah. To like.

Dr. Danielle Doucette: 08:53

Feeling.

Dr. Leigh Weisz: 08:54

Yeah. To kind of like bring it bring it in a little bit okay. Keep going.

Dr. Danielle Doucette: 08:58

Yeah. You know if they’re struggling. Yeah. And so because DVT had such a strong evidence base behind it, it was also being applied to kids who were presenting a little differently maybe a little bit more of like anxiety, those internalizers maybe a little social anxiety, maybe a little shy, quieter folks. And what we are seeing is that that standard DVT, it’s beneficial, but only to a certain degree.

And that’s really not targeting those problems that we see in those more overcontrolled kids. Kind of like I talked about before, those are the kids in the classroom who like if they raise their hand, they are 99.99% sure that they have the right answer and they’re risk takers.

Dr. Leigh Weisz: 09:44

Or rule followers.

Dr. Danielle Doucette: 09:45

Oh, they’re extremely risk averse. So they don’t want to get the answer wrong. And if they do get it wrong, they’re really, really hard on themselves. And they find it really hard to to even let that go. And they focus so much on, you know, the fact that they got something wrong, even though they probably got 99 other things.

Correct.

Dr. Leigh Weisz: 10:02

Right? Absolutely, absolutely. So in day to day life of a teen, it sounds like, again, some of the teens who are overcontrolled struggle with anxiety and rigidity. And you said sometimes they can be lonely. Can you say more about like what?

What makes them kind of more likely to be lonely in their lives?

Dr. Danielle Doucette: 10:24

Well, you know, what we’ve been talking about is them having difficulty sharing what’s really going on inside. And so if we don’t share what’s going on inside, which is a really vulnerable thing to do, by the way, it’s really hard. And it’s really it’s hard to connect to up people if we don’t know how to tolerate vulnerability, which is one of the things that we teach.

Dr. Leigh Weisz: 10:46

And that’s interesting because sometimes kids will be, like, so nervous to open up to a friend or someone and I’ll say, listen, it makes sense. If you just met someone and you’re sharing something really private, it makes sense that you’re nervous because you’re not sure if this is a safe person or not. And we’ll kind of have a candid conversation about how that that to me is like it’s protective, it’s smart. But if it’s your best friend in the world and and they’ve shown up for you time and time again and they open up to you and you know, you know that they’re a trusting person. When you open up to them, they actually feel like more connected to you, like they actually feel good and, you know, flattered in a way that you trust them.

And so it does deepen the connection. And so it’s interesting, like people are so nervous to open up, you know, even though it actually, like you said, does bring bring closeness to both parties.

Dr. Danielle Doucette: 11:37

It does. I can’t tell you how many times I’ve heard people say, yeah, I have friends. I have friends, you know, in my sport that I do or, you know, in school, especially in this class. And then after talking about it, they end up saying something like, but they don’t really know me. And this is where, again, parents and friends are typically surprised when they learn about the extent to which their teen is really struggling, maybe with anxiety or depression or even self-injury, because that presents differently in overcontrolled in the overcontrolled population as well.

Dr. Leigh Weisz: 12:15

Wow. Wow. How would that present in an overcontrolled teen, for example? Yeah.

Dr. Danielle Doucette: 12:21

So for people who are under controlled, they will and they engage in some kind of, you know, non-suicidal self-injury. It’s usually very impulsive and they’re not really always great at hiding it. Whereas when we think about our folks who are overcontrolled, they tend to be more planful. So they kind of plan out. It’s a little bit more rigid.

It’s a lot more secretive. So it’s a little bit more hidden. It’s not kind of out there for everyone to see. And you know, even when I worked in like partial hospitalization program for teens. Right.

It was it was. That’s what I saw. The kids who are under control, you see their injuries. They don’t really care about others seeing it. But the over controls, they hide it and they hide it really, really well.

So much so that just it’s I’m I’m they like are suffering silently so much and they just.

Dr. Leigh Weisz: 13:18

Keep doing this for attention in other words.

Dr. Danielle Doucette: 13:21

Yeah. Yeah. They’re doing it to help them usually, you know, regulate themselves and manage or for punishment potentially. So it’s a little bit more hidden. And that’s why I say like, you know, parents are always so surprised that, like, I had no idea is something I’ve heard over the years.

Dr. Leigh Weisz: 13:41

Yeah, it sounds like these kiddos are not the ones, you know, reaching out for help. And raising their hand and saying, I’m struggling. Help me. You know, they’re really they’re really trying to keep it all together.

Dr. Danielle Doucette: 13:50

And when they are struggling, what do they do? They control more. They work harder. They push themselves to limits, to extreme limits at times. And so that’s what we see.

And those are some of the signs. Like are they pushing themselves too hard. Are they kind of taking healthy eating too far. Are they working out and doing their training for their sport? So much so to the cost.

You know, the the cost of, you know, missing dinner with their family or not like doing other things that they maybe once enjoyed.

Dr. Leigh Weisz: 14:20

Yeah, yeah. No, it sounds like everything is much more extreme than, than a healthy, you know, individual. Yeah, absolutely. So and and how does it show up? It sounds like you’re showing.

You’re telling us a little bit more how it shows up in the, I would say in the school setting in terms of the academics like there, you know, never going to get an A minus, they’re going to like, you know, study 110 times harder than everyone else for their finals. How does it show up at home? Like what might a parent see at the dinner table? Or, you know, what might they see that might be a sign like, oh, I better worry about her a little bit more than I am.

Dr. Danielle Doucette: 14:57

Yeah, that’s really tough. One thing to pay attention to, I think, is when teens are kind of saying everything is fine. And, you know, parents, they have some good instincts. And so really inquiring a little bit more about that I think can be really helpful. But or observing their relationships with their friends too.

Are they really engaging with their peers or are they so focused on other things like academics or sport? support is usually that kind of falls by the wayside a little bit.

Dr. Leigh Weisz: 15:34

Yeah. So the relationships it sounds like is is one of your red flags. Like if the relationships really don’t feel deep, they feel superficial. And their focus is really much more on the achievement and the individual, you know, pursuits.

Dr. Danielle Doucette: 15:49

And we might not see a lot of vulnerability even with their parents, which to some degree developmentally might be appropriate. But when a parent feels like they don’t know.

Dr. Leigh Weisz: 15:59

What’s going on.

Dr. Danielle Doucette: 15:59

Really what their kid is feeling, what’s going on, that’s a good sign.

Dr. Leigh Weisz: 16:03

That makes sense. Not a good sign, but a good a good signal. Yeah, yeah, yeah. So I, you know, we want to know a little bit more about these aro DBT classes that you teach. Yeah.

So I think because this is a new for most of us, if you can first just describe in a really simplistic way how these classes work. Yeah. And then I would love to hear a bit about an example of a team that you’ve worked with, kind of like what was going on before, and maybe how they were able to shift after these classes and kind of like what we what’s a reasonable progress because they’re not going to all of a sudden become uninhibited, loud, right. They’re not going to change their personality.

Dr. Danielle Doucette: 16:48

But yeah.

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