Stressing out?  How about using the 80/20 rule? 

 It’s only human nature to have high expectations for how we want life to look like day to day and what we want to accomplish.  In a word: perfection.  But life has a way of getting in the way of our intentions.  Nobody knows that better than someone who is living with a chronic condition.

A question for you: Have you taken a look at your expectations lately?  Starting with what you are expecting yourself to accomplish?

My clients often talk to me about how their lives aren’t measuring up to their expectations.  They feel let down by others, not getting enough of what they need.  They feel that they are letting others down by not being able to give enough.  Or they feel they have let themselves down by not doing enough.

Here are a couple of examples:

A client I’ll call Joe is balancing a full-time job, part-time college, and the responsibilities that go along with a chronic condition.  In his case, a bleeding disorder.  To say that he pushes himself hard to be the best person he can be is an understatement.  He recently told me about an experience he had that brought home to him how trying to do everything can lead to stress.

“I had a rough week at work, and I had a test to study for over the weekend.  On Friday night, a friend called and said she was inviting a few friends over to help her set up her and her roommate set up their new apartment.  She told me how she really wanted me to be there.

“Again, I had a lot to do and I also needed to get some rest.  But I said yes anyway.”

“How did that turn out for you?” I asked.

“I spent the day with her and her friends, and I was exhausted that evening.  I also banged my knee helping her move a couch, which I shouldn’t have been doing, and ended up with a bleed.  Along with a lot of stress.  So I did pretty badly on my test.”

A client I’ll call Connie is a mother of a child with a chronic condition.  Asthma.  She told me about her own struggles with attempting to be perfect.

“I have a full-time job.  I am a single parent.  On Friday night, my son had a flare-up of symptoms that took us to the emergency room.  He was fine but it was a hard night and a late night, to say the least.

“I got a call arly Saturday morning from my mom.  She told me that she and one of her sisters were planning to stop by during the afternoon.  She laughed and told me she had bragged to my aunt about my amazing chocolate chip cookies.”

“Nothing like additional pressure,” I said.

“Exactly,” she answered.  “So I rushed around to make sure the bathroom and the living room were spotless and got the cookies in the oven.  I was so stressed.  I don’t know how I managed to keep my smile on while they were here.  Needless to say, I collapsed after they left.”

Are my clients’ experiences anything like yours?


Self-Expectations… Self-Criticism… Stress…

Sure, it’s only human to expect to always perform at your best.  To think you need to always be available to other people.  As well as to have high expectations of how others should feel or act towards you.  Especially people who are close to you, friends and family, or the healthcare professionals that you work with.

One of the most frustrating things about living with a chronic condition is adjusting to the constant challenges to maintain your own self-care, or watching over (AKA enforcing) the self-care of a child with a chronic condition.  A whole boatload of responsibilities and demands, none of which you asked for.  Along with the need to rely more on others to do their part, assuming you let anyone else help out (more of that later).

Here’s what I’ve learned from my clients, as well as in my own experience with friends and family dealing with chronic conditions: Expecting 100% can be a set-up for a letdown.

Behind the science and technology of healthcare are humans.  And humans aren’t perfect.  Healthcare professionals aren’t always so responsive.  Delays are going to happen, along with the restrictions and inconveniences of managed care.

Yes, you’re human.  With good days and bad days, good intentions, and your own limitations.

Your family members are also human.  And that means they aren’t always so supportive, because they aren’t able to or don’t know how to, or just won’t.  Or because you won’t let them.

So, here’s an idea to consider:

Given that we are dealing with imperfect beings, what if, instead of expecting perfection, you expected imperfection?  What if you started to ask yourself what parts of your life need to be functioning at 100%, and where you might begin to loosen up on your expectations?  Averaging out your expectations to, let’s say, around 80%?

Adjusting your expectations for yourself, and the people around you, to a more realistic 80 instead of 100 percent would mean allowing for the human factor in yourself and others.  It might also mean a whole lot less disappointment. Not to mention a whole lot less stress.

And what if you embraced this idea so much that you instituted a new rule at your house?  The 80/20 rule.  With you and your family all adjusting expectations for themselves and each other accordingly.

Ready to give the 80/20 rule a chance?  Here are ideas for how to loosen up your grip and giving yourself, and others, some breathing room.


Focus your energy on what needs to be in place to take the best care of yourself and your child.  Taking care of your health is priority number one – medication, diet, rest, and anything else you need to do to manage your condition.  As well as the health of your child with a chronic condition.  So if you’re looking for a starting place, this is one aspect of your life where striving for 100% makes sense.  After all, your self-care is the cornerstone of your life.

Take a look at your priorities.  Assuming you aren’t superwoman/man, maintaining 100% self-care and care for your children may require making some adjustments in the other areas of your life.  80 out of 100 doesn’t mean have to mean an across the board cut, but doing some reallocating to take the pressure off yourself.  This might mean taking a look at your to-do list, the one you’ve written down or the one you keep in your head, and making some decisions on what needs to be at the top and what needs to be at the bottom, what can be postponed.  Think of it this way: When everything you have to do is fighting for top priority, you turn your mind into a battleground.  How’s that for stress?

Say no to the go go go.  Let’s start with your family.  Sure you want to give 100% to your family.  But parents often tell me that they run themselves ragged with work around the house, trying to participate in community or school activities, being constantly available for extended family events, while also trying to have real quality time with their children.  If that’s you, then it might be time to look at where you can tighten up and where you can lighten up.  For example, Joe could have just said to his friend, “Sorry, but I need to sit this one out.”

Watch out for that four letter word: NEED.  What do you “need” to commit to?  Something that you really want to do or something that you feel like you should do?  Do you need to go to that meeting or commit to that weekend activity?  If you look at your commitments from the 80/20 perspective, you might find that good enough, and not perfect, can leave you with more balance in your life.  Less stress.  Here’s a way to look at what’s needed and what’s not.  At the risk of repeating myself: Maintaining your optimal health and the health of your children definitely falls into the need category, and therefore front and center in that 80% of your life that gets your best effort.  No, no slacking there.  However…

Say yes to a little mess.  Could your house be a little less spotless, with the laundry waiting an extra day, the lawn waiting a few days?  80 out of 100 might mean a less than perfect house, but also give you more time to spend enjoying your family.  While taking better care of yourself by getting a little more rest and a little less stress?  And what if you asked other family members to help out, giving up some of your control and giving them a chance to give you a hand?  Is there an aunt or uncle or a grandparent who would jump at the chance to come over and help out for an afternoon?  For example, could Connie have asked her mom to pick up some cookies on the way to her house?  Or to postpone her visit until Sunday?

Lighten up, for crying out loud.  And while we’re on the topic, are you demanding 100 out of 100 from the people around you?  Keep in mind that expectations for other people can lead to disappointment.  Other people aren’t always going to act the way we think they should, or hope they would.  Everybody has days when they aren’t on their A-game, when they don’t feel good, when they aren’t so supportive.  Instead of expecting the people of your life to be at 100, how about cutting them some slack, too?  Given that you are dealing with human beings here, 80 out of 100 isn’t so bad.  Patience helps.

And what about you?  Try going a little easier on yourself.  When you hear that voice of self-criticism start to zero in on what you should have don’t and didn’t, or do perfectly, remind yourself of the 80/20 rule.  Give yourself credit for doing the best you can.

Speaking of should… Every time the word “should” creeps into your self-talk, ask yourself: “Who says?”  Asking this question is a way to assess when the need to be perfect – and to live up to unrealistic expectations for yourself and others – is interfering with your well-being.  In other words, stop “should-ing” all over yourself.   (With the holidays on their way, you might want to build the “Who says?” test into your daily routine.)

Loosen up on that tight grip.  Show some compassion toward yourself, and it will be a lot easier to show compassion toward others.  Think 80/20!  If you’re taking better care of yourself, you have that much more to give to others, and to give it joyfully and not out of exhaustion.  And remember, we are all in this together.


Gary McClain, MS, PhD, LMHC, CEAP, is a psychotherapist, patient advocate, and author in New York City, who specializes in working with individuals diagnosed with chronic and catastrophic medical conditions, their caregivers, and professionals. He often works with couples who are living with a chronic condition.  He maintains a website,