Albert Pignataro Albert Pignataro

Perfectionism: The Art of Never Being Satisfied

Perfectionism sounds admirable until you’re the one living inside it. On paper, it looks like high standards, discipline, and drive. In reality, it often feels more like anxiety in a three-piece suit. You get the thrill of accomplishment… for about twelve seconds. Then your brain politely asks, “Yes, but could it have been better?”

Spoiler: according to perfectionism, the answer is always yes.

What Is Perfectionism, Really?

Perfectionism isn’t just “wanting things done right.” It’s the chronic suspicion that you, personally, are never right enough. Unlike healthy ambition, perfectionism moves the finish line every time you reach it.

The Hidden Costs of Perfectionism

Perfectionism shows up in ways that drain your energy and relationships:

  • Work: Editing that email seventeen times, then hating yourself for wasting time.

  • Relationships: Holding yourself (and sometimes your partner) to impossible standards—then resenting everyone when reality doesn’t measure up.

  • Self-worth: Believing your value is basically a group project graded by strangers.

The result? Exhaustion, procrastination, anxiety, and a sense that no matter how much you do, it’s never enough.

Why Perfectionism Feels Impossible to Let Go

Perfectionism isn’t just a personality quirk—it’s often a survival strategy your nervous system learned early on. Maybe mistakes weren’t safe growing up, or approval felt conditional. Over time, “being flawless” got wired in as the only path to security. Which is why perfectionism doesn’t vanish with a pep talk—it’s more like an overzealous smoke alarm that goes off every time you try something new.

Therapy for Perfectionism: What Actually Helps

Therapy isn’t about forcing you to “embrace imperfection” by chanting affirmations in the mirror. It’s about loosening perfectionism’s grip so you can use your drive without burning out.

That might include:

  • Untangling from the inner critic (that voice that insists it’s “motivating” you but sounds more like a heckler).

  • Building self-trust so you don’t need every choice notarized by anxiety.

  • Redefining “good enough” in ways that let you actually finish things.

  • Balancing ambition with rest—because caffeine and cortisol aren’t long-term strategy.

Life Beyond Perfectionism

Imagine starting a project without a three-week spiral of overthinking. Or having a conversation without replaying every line like post-game footage. Or ending the day without perfectionism handing you a mental performance review.

That’s the difference: not killing your ambition, but freeing it from the cage of never enough.

Let’s Work on Perfectionism Together

If perfectionism has stopped being a “strength” and started running your life, therapy can help you break the cycle. Contact me to explore therapy for perfectionism and reclaim your time, energy, and peace of mind.

Read More
Albert Pignataro Albert Pignataro

Why AI Makes OCD Worse—And What Actually Helps

If you live with obsessive-compulsive disorder (OCD), you probably already know how easy it is to get stuck in your head. Maybe you spend hours replaying something you said years ago. Maybe you go down a mental rabbit hole trying to be sure you didn’t mess something up. Maybe you’ve even turned to tools like ChatGPT or Google in search of reassurance.

But as a therapist who specializes in OCD, I want to talk about why that backfires—and what actually helps.

I recently read a powerful article by writer and performer Amrou Al-Kadhi titled “Why AI and OCD Don’t Mix.” In it, they describe how their OCD—specifically Pure O, where the compulsions happen mostly in the mind—pulls them into endless mental spirals. They replay decisions. Revisit regrets. Analyze the past to death. And they found that ChatGPT, like so many AI tools, made it worse. It joined them in the spiral.

As they put it: “You ask ChatGPT for reassurance, it gives it to you.”

That’s exactly the problem.

What Is Pure O?

“Pure O” (short for purely obsessional OCD) is a subtype of OCD where the compulsions are mostly internal. Instead of visible rituals like handwashing or checking locks, the person tries to neutralize distressing thoughts through things like mental reviewing, reassurance-seeking, or avoidance.

The thoughts themselves might focus on morality, past mistakes, identity, or relationships—anything that hooks into the person’s deepest fears. The mental compulsions are often invisible from the outside, but the suffering is real—and intense.

How OCD Really Works (And Why It’s Not About the Content)

OCD isn’t just about being clean or organized. At its core, it’s a problem with the brain’s threat-detection system. A false alarm goes off—an intrusive thought, feeling, or image—and your system scrambles to feel safe again. That’s where compulsions come in. They’re attempts to make the anxiety stop.

For people with Pure O, that often means thinking harder, analyzing the situation, trying to find the “right” answer. But that overthinking is the compulsion—and it keeps the OCD loop going.

Tools like ChatGPT can unintentionally reinforce that cycle. When you ask it to help you review a past event or reassure you that you’re not a bad person, it responds as if the fear is valid. That might feel comforting in the moment, but it strengthens the underlying belief that this thought needs to be resolved. It keeps the false alarm active.

What Actually Helps: ERP and IFS

Two of the most effective approaches for treating OCD are Exposure and Response Prevention (ERP) and Internal Family Systems (IFS). I integrate both into my work because they address different—but equally important—layers of the OCD system.

Exposure and Response Prevention (ERP)

ERP is the gold standard treatment for OCD. It involves gradually facing the thoughts or situations that trigger anxiety—without doing the usual compulsions. The idea isn’t to “get rid of” the thought. It’s to retrain your brain to stop treating that thought as dangerous in the first place.

If OCD says “You might have said something wrong,” ERP helps you sit with that thought without rereading messages or mentally dissecting the interaction. Over time, this breaks the link between discomfort and compulsive response.

Internal Family Systems (IFS)

IFS is a therapy model that views the mind as a system of parts—each with its own role, fear, and strategy. In OCD, protective parts often respond to the false alarm by launching into overthinking, avoidance, or perfectionism.

In my approach, I treat the OCD signal itself as a brain-based misfire, not a part—but I use IFS to help clients connect with the parts of them that try to manage or escape that signal. Instead of complying with the OCD, we build a different relationship to it—one that’s grounded, curious, and self-led.

AI Can’t Help You Heal. But Therapy Can.

As Al-Kadhi writes, “Sometimes, truly feeling something is the only thing we can do to recover.” That’s the paradox of OCD recovery: you don’t get better by finding the perfect answer—you get better by letting go of the need to have one.

AI tools like ChatGPT can simulate clarity, but they can’t teach you to tolerate uncertainty. They can’t help you grieve past regrets, feel your shame, or unhook from the inner protector that’s working overtime to keep you safe.

That kind of healing work happens in therapy—real, human therapy.

Ready to Work Differently With Your OCD?

If you're tired of getting stuck in thought loops, seeking reassurance from AI, or trying to outthink your anxiety, you’re not alone—and there’s a different way forward.

I offer therapy that blends ERP and IFS with an understanding of how OCD works on both a brain and emotional level. Whether you're dealing with Pure O, classic OCD, or something in between, we’ll work together to help you unhook from the false alarms and live with more clarity, calm, and choice.

Learn more about OCD therapy here, or get in touch if you're ready to begin.

Read More
Albert Pignataro Albert Pignataro

Why Your Brain Feels Stuck in Anxiety (Even When You Know You’re Safe)

If you’ve ever wondered why your brain won’t stop scanning for what could go wrong—even when you know you’re safe—you’re not alone. And you’re not broken.

Recent research in neuroscience is giving us a clearer picture of what’s actually happening in the brain during anxiety. One of the most useful explanations comes from a 2022 review by Kenwood, Kalin, and Barbas, which zooms in on the specific brain circuits involved in pathological anxiety and anxiety disorders.

This isn’t just academic theory—it helps explain what people with anxiety experience every day: intrusive worry, a sense of dread, difficulty calming down, and feeling like something bad is just around the corner.

Let’s break it down.

Your Brain’s Threat System: Built for Survival, Not Certainty

Anxiety is your brain’s way of preparing you for possible danger. The problem arises when that system becomes overactive—or when it fails to turn off after doing its job. In anxiety disorders, the brain keeps scanning for threat even when nothing is wrong.

The researchers point to a few key areas of the brain that are involved in this cycle:

  • Prefrontal Cortex (PFC): This area is responsible for planning, reasoning, and regulating emotion. When anxiety takes over, the PFC has trouble calming the system down.

  • Amygdala: This is your brain’s fear center. It tags things as dangerous—even when they’re not—and triggers a strong emotional reaction.

  • Anterior Cingulate Cortex (ACC): This part monitors for conflict or error. In anxiety, it can become hypersensitive, constantly flagging “problems” that aren’t real.

  • Striatum: Involved in habits and repetitive behavior, this area can keep you stuck in anxious loops.

Add to that the noradrenergic system, which floods the brain with arousal chemicals like norepinephrine, and you’ve got a full-body experience of anxiety that feels impossible to shut off.

Why This Matters

Understanding that anxiety is circuit-based—not just a personality flaw or lack of coping skills—can be a game-changer. It shifts the conversation away from "Why can't I calm down?" to "What is my brain trying to protect me from—and how can I work with it instead of against it?"

It also means that anxiety is not irrational. Your brain is trying to be helpful. It just gets stuck in overdrive.

How It Shows Up in Different Disorders

This circuit model helps explain why anxiety looks different in different people:

  • In Generalized Anxiety Disorder, the worry never stops. The brain’s error-checking systems are always active.

  • In Social Anxiety, the amygdala lights up in response to perceived judgment or disapproval.

  • In Panic Disorder, the brain misreads internal sensations as dangerous, creating false alarms.

  • In OCD, the threat system misfires and the brain sends repeated error signals, leading to compulsions.

Each version of anxiety has its own flavor—but they often share the same underlying circuit dysfunctions.

What Helps: Working with the System, Not Against It

Treatments that work tend to do one (or more) of the following:

  • Calm the alarm: through medication, exercise, sleep, or breath work

  • Retrain the response: using therapies like CBT, ERP (for OCD), or somatic work

  • Increase awareness and flexibility: using approaches like mindfulness, Internal Family Systems (IFS), or ACT

These strategies don’t “fix” the brain because it’s not broken—they help reorganize the system so it can respond more appropriately to real life, not just imagined danger.

Bottom Line:

Anxiety is not just mental—it’s biological, relational, and systemic. And when you understand the brain’s role, it becomes easier to stop blaming yourself and start working with your system in a more compassionate, effective way.

The alarm is real—but so is your ability to respond differently.

Let’s connect:

If your mind’s been running fire drills for threats that never arrive, there’s probably a reason—and a way through. Therapy isn’t about shutting down the alarm; it’s about learning how to hear it differently. If that sounds like a relief, let’s talk.

Read More
Albert Pignataro Albert Pignataro

Yes, I Give Advice Sometimes. No, I'm Not Going to Tell You What to Do.

Let’s get this out of the way: therapy isn’t just me staring at you silently while you spiral and wondering how that makes you feel. If that’s what you’re expecting, I get it. That image has been baked into pop culture for decades. But it’s not how I work—and honestly, it’s not how most therapy works.

People often come into therapy both craving and fearing advice. They say things like, “Just tell me what to do,” usually with a mix of desperation and sarcasm. And I get it. Life’s big decisions are messy, and it would be a relief to hand the wheel to someone else for a minute. But here’s the thing: even if I did tell you what to do, that wouldn’t be real help. It would just be outsourcing your uncertainty. And that never sticks.

Telling someone what to do is usually a failing strategy. It bypasses their own internal compass and undermines the process of genuine ownership. If the action doesn’t come from within, it rarely leads to lasting change. You don’t tap into your inner wisdom. You don’t build trust in your own decision-making. And frankly, people famously resist being told what to do—even when they think they want it. They either reject it outright or abandon it later, because it never truly felt like theirs.

That said, I’m not one of those therapists who withholds thoughts like a human Magic 8-Ball stuck on “Reply hazy, try again.” I’m collaborative, direct, and I’ll absolutely share my perspective. Sometimes I suggest a new way to frame something. Sometimes I point out a pattern you might not see. And yeah, sometimes I offer ideas for what you might try next.

But you’re still in the driver’s seat. My job is to help you hear yourself more clearly, not to drown out your instincts with mine. When you ask for advice, what you’re often really asking is: “Am I missing something?” or “Is this a terrible idea?” or “Can you help me trust myself more?” And to that, the answer is yes. That’s the work.

Good therapy isn’t about handing over your choices to someone with a clipboard. It’s about building the kind of clarity, resilience, and self-trust that makes those choices more manageable. Along the way, I’ll offer my thoughts when they’re useful, I’ll challenge you when it helps, and I’ll stay quiet when that’s what lets something deeper emerge.

So yes, I give advice sometimes. But no, I won’t tell you what to do. That’s not my job. My job is to help you figure out what you want to do—and to get better at actually doing it.

Curious what this kind of work could look like for you? Reach out and let’s see if we’re a good fit.

Read More
Albert Pignataro Albert Pignataro

How Do I Know If Therapy Is Working?

One of the most common questions people have (but rarely say out loud) is: “Is this actually helping me, or am I just forking over all my money to this therapist, talking in circles?”

It’s a fair question. Therapy progress doesn’t always look like a lightbulb moment or a Hollywood breakthrough. Sometimes, it’s quieter. It’s the subtle shift from feeling stuck and reactive to noticing what’s really happening inside — and realizing you have more choice than you thought.

What Real Progress Looks Like

Some signs therapy is actually working:

  • You catch yourself responding differently to things that used to set you off.

  • You’re more curious than critical about your own thoughts and feelings.

  • You don’t shove things down as much — you’re able to sit with what’s real without spiraling.

  • You notice you feel less trapped, less alone inside your own head.

  • You trust yourself a bit more — your boundaries, your needs, your gut sense.

Sometimes progress is obvious — like when you feel lighter or more at ease in places that used to feel tight. Other times, it shows up when you handle a familiar trigger in a new way and think, “Huh. That was different.”

When It Feels Slow (and That’s Still Working)

You might feel worse before you feel better — that’s normal. You’re digging into old patterns, naming things you’ve avoided, and trying new ways of being. That’s real work — and sometimes real work is uncomfortable.

Good therapy isn’t about the therapist (me) fixing you. It’s about the therapist (me) helping you fix yourself — by understanding how you work, so you’re not just fighting your own mind on autopilot. It’s about creating more choice, more space, and more connection to what you actually want — and, most importantly, holding you accountable to take the actions that make your wants and needs real.

Insight alone isn’t enough. It’s insight plus action. This is what I can offer you.

If you’re wondering whether therapy could really do that for you, you don’t have to figure that out alone.
Reach out here — let’s see if we’re a good fit, together.

Read More
Albert Pignataro Albert Pignataro

Why Do I Seem ‘Fine’ on the Outside But Feel Like Sh*t on the Inside?

You’ve got your life together — or at least that’s how it looks. You’re responsible, thoughtful, maybe even the one other people lean on. You keep the job, the family, the day-to-day running. You’re “fine.”

But when you’re alone with your thoughts? There’s that quiet truth: “I feel like sh*t inside.” Restless. Numb. Overwhelmed. Like something’s off but you can’t quite name it — and you feel guilty for feeling that way at all.

Why “Fine” Isn’t Fine

A lot of high-functioning, self-aware adults get stuck here. You feel like you should be able to think your way out of it — push harder, fix it, move on. But anxiety, burnout, and old protective patterns don’t work that way. They don’t care how smart or capable you are — they just keep you circling the same thoughts.

These patterns made sense once:

  • Staying busy to avoid feelings that were too big to handle.

  • Pushing for perfection to feel worthy.

  • Putting everyone else first to feel needed.

  • Overthinking every choice to avoid the “wrong” move.

At some point, those strategies helped you survive. Now? They keep you stuck in your head, disconnected from your gut, and exhausted.

What Therapy Actually Does

Therapy isn’t about telling you what’s wrong with you. It’s about seeing what those old protective moves really are — survival strategies that just don’t fit your life anymore. Together, we slow down enough to notice what’s happening in your mind and body when that hum of stuckness shows up. We get curious instead of shutting it down.

When you do that, you create space to choose — instead of running on autopilot. You learn to trust your own signals again. It’s not about becoming someone else. It’s about becoming more you — with less friction and more ease.

If you’re tired of looking “fine” and feeling like sh*t, you don’t have to do it alone.

Reach out here — let’s see what’s really under the surface and how to shift the sh*t away.

Read More
Albert Pignataro Albert Pignataro

IFS, OCD, and You: A Different Way to See Obsessive Patterns

If you live with obsessive thoughts, you know how relentless they can be. And if you’ve tried to control or silence them, you probably know — that fight often makes them louder.

I want to share a perspective that’s been meaningful for me, both professionally and personally.
This isn’t the only way to look at OCD — but through my own lived experience and clinical work, it’s the model I’ve found most effective.

Here’s the idea:

OCD isn’t a “part” of you — it’s more like a hypersensitive threat-detection system baked into your neurobiology. It’s an alarm that gets stuck in the ON position, scanning for danger and spinning out intrusive thoughts to try to keep you safe.

The problem is, the alarm rarely matches reality. And instead of helping, your parts — the protective voices and impulses inside you — misinterpret these false alarms as emergencies. So they pile on with strategies: compulsions, avoidance, checking, self-criticism, all in the name of “keeping you safe.”

This is where IFS comes in.

IFS (Internal Family Systems, or parts work) helps you see these reactive parts with more compassion — not as bad habits to crush, but as overworked protectors responding to a faulty alarm.

When you build a new relationship with these parts:

  • You stop getting hijacked by shame or panic when the intrusive thoughts come.

  • Your protectors can soften and trust that you’re actually OK — even if the alarm is still beeping in the background.

  • You spend less energy fighting yourself and more energy living your life.

I share this model because it’s helped me and many of my clients move from fear and control to curiosity and choice.

It’s not magic — but it can feel like a relief when you realize you’re not “broken” or “crazy.” You’re just running an overprotective system that you can learn to work with.

If any of this resonates, you’re not alone — and you don’t have to untangle it by yourself.

Let’s talk.

Read More