Srini Pillay, M.D.

by Charles Platkin, PhD

Location: Cambridge, MA

Position: Assistant Clinical Professor, Harvard Medical School; former Director of the Outpatient Anxiety Disorders Program at McLean Hospital; CEO of NeuroBusiness Group

Birthday: October 26

Hometown: Durban, South Africa

Favorite Movie: Raging Bull, Miller’s Crossing, M Butterfly

Last book read: My own: “Life Unlocked: 7 Revolutionary Lessons to Overcome Fear”; aside from that I most recently read a short book on the history of Louis Vuitton and re-read “The Yoga Sutras of Patanjali”


Diet Detective: Thanks for the interview. You have a new book coming out called Life Unlocked: 7 Revolutionary Lessons to Overcome Fear, what led you to writing a book about overcoming fear?

Srini Pillay, M.D: I can’t honestly say that I know how all the various factors converged. At a personal level, I have always been aware of how fears help and hinder my own life goals. Also, growing up in South Africa and being filled with oftentimes divergent and contrary desires often gave rise to fears that I wanted to understand better. At a professional level, I have been the Director of the Outpatient Anxiety Disorders Program at McLean Hospital (Harvard’s largest psychiatric hospital) and the Director of the Panic Disorders Research Program in the Brain Imaging Center at McLean Hospital as well. I have studied anxiety and fear at many levels, and have a private practice that focuses on helping people with this. Even prior to my residency in psychiatry, I studied the neurochemistry of anxiety. I think that the personal and professional factors came together to inspire this book. I have been doing this work for close to twenty years now.

Diet Detective: In all your years studying fear, what is the most common misconception?

Srini Pillay, M.D: The most common misconception is that fear has to be consciously registered for it to be impactful in a multitude of ways. Fear can register in the unconscious (what people commonly refer to the subconscious) entirely outside of awareness. In fact, if you show people with certain forms of blindness (e.g. cortical blindness) pictures of a fearful face, they will be able to detect this. Thus, to imagine that fear is affecting your behavior and choices only when you know it is there is a misconception.

Diet Detective: Why would anyone fear success? It doesn’t seem logical that a person would work so hard to achieve a goal, and then thwart his or her own efforts to achieve that goal?

Srini Pillay, M.D: It is in fact often not logical to thwart one’s own goal, but the majority of brain process works outside of the “logic” spectrum. The unconscious brain is instrumental in our decision-making. When we hold fears of success unconsciously, this can thwart our greatest dreams. People may have many reasons for fearing success (see below). Sometimes other factors also play into this. For example, many people feel guilty about exceeding their siblings or parents, value being loved and fear being resented or envied. It is important to note that these fears may be conscious or entirely outside of awareness.

Diet Detective: How does the fear of success specifically impact an individual’s goal?

Srini Pillay, M.D: When people fear success, the often make up reasons for why they cannot pursue their goals. Sometimes this fear and anxiety is so strong they can make themselves physically sick over this. Conscious and unconscious fear can also inadvertently affect the thinking brain, thereby leading to diminished productivity, procrastination, and living an “almost” life.

Diet Detective: What are the theories/reasons why a person would sabotage his or her own success?

Srini Pillay, M.D: There are many reasons that people fear success. Some of these reasons include:

  • The loneliness of success: When you are successful, you often are in your “corner office” or alone trying to focus on being successful. Also, success often involves going deep inside yourself, and when we do this, we sometimes feel “cut off” from the external world. The anticipation of this loneliness can be frightening.
  • The disorientation of success: When people are successful they are often alone at the head of the pack with nobody to follow. As a result, there is no “guiding light” except for the “guiding light” within. This absence of an external guiding light can be frightening.
  • The responsibility of success: Being successful involves being commitment, time management and meeting your goals. This responsibility can be frightening.
  • Fear of the unknown: Success often involves unknown consequences and surprises. There may also be unknown commitments. This large unknown is what frightens many people, often unconsciously.
  • Fear of not being able to maintain the success: People are often afraid of growing expectations one they become successful and maintaining the goal may not be easy. A one time champion may not be able to be the champion forever and the resulting anticipatory fear can deter this champion.
  • Fear of losing one’s drive: People often fear that their real “life force” comes from the chase and not the attainment of their goals. As a result, they avoid attaining their goals for fear of losing a driving force.
  • Fear of giving in to opportunistic people: Many people fear that when they are successful, people will come crawling out of the woodwork to prey on their success. This is frightening to them.
  • Fear of losing one’s identity: Success changes people, and people often fear change.

Diet Detective: How do procrastination, perfectionism, imposter phenomenon, not feeling worthy of success, and overcommitting interfere with one’s ability to reach a goal?

Srini Pillay, M.D: Procrastination delays the time to reach the goal, and may in fact operate to prevent reaching one’s goal. In rare instances procrastination may cause a motivating anxiety that can help goal accomplishment.

Perfectionism (as opposed to exercising one’s mastery) can impede reaching one’s goal because it creates a distracting internal dialogue. Also, perfectionism often leads to self criticism and this can decrease one’s motivation to be successful.

“The impostor syndrome” occurs when people question whether they deserve their success. They fear that their success may have occurred by a chance occurrence rather than any real talent that they possess. When this is not true, in part because the person cannot recall the unconscious elements of his success path, this can be very disruptive and fear-inducing, often launching people into chaotic thinking and feeling and preventing future success.

Not feeling worthy of success make people feel like impostors too, and this deep, often unconscious, feeling may shape a person’s identity so much so that they may feel as though success betrays their real selves.

Overcommitting makes fear escalate and increases distraction. It is also a purposeful way of applying one’s self to the major tasks at hand and unconsciously proves to people who fear success that they cannot achieve what they want to. It leads to a panic stricken person who is afraid of disappointing people and ends up doing this anyway. This negative result worsens motivation and clarity of thinking impeding one’s path toward one’s goal.

Diet Detective: What’s the difference between fear of success and fear of failure — how does it manifest itself in terms of weight control?

Srini Pillay, M.D: Fear of success is the brain’s story for why a goal should not be reached. Fear of failure is just another kind of brain story that can have the same effect. The brain makes up stories to capture the fear so as to feel more in control of what would otherwise be free-floating anxiety without a brain story or narrative. When people fear success, they are often much less aware of this than when they fear failure. Also, fear of success is often related to the fear of being envied or resented whereas the fear of failure is related to the fear of being judged. Fear of success is also related to fears of excess or greed whereas the fear of failure is related to a fear of “not having enough.” When it comes to weight control, people fear that when they change their bodies, they may have to deal with more people being attracted to them, and when this threatens an existing relationship, this can be very intimidating. In the same situation, people feel that if they fail at weight control, they may fear being considered “losers” for even trying. If someone is successful at losing weight, they may look better (fear of envy), feel more vital and want to be engaged in different activities (fear of having to acquire a new set of friends and losing the old friends), and have greater self-confidence (fear of having to face the fact that they have short-changed themselves their entire lives). These and other changes can be intimidating.

Diet Detective: Are certain individuals more susceptible to fear of success issues than others?

Srini Pillay, M.D: Yes. People who are vulnerable to any of the factors mentioned above are more vulnerable to fears of success. Often, superstitious people (“My luck may run out at any time”), people who care a lot about what other people think of them (“Why do people look at me that way? Why are people ignoring me now that I have this promotion? Why do my friends call less?”), and people who cannot tolerate the tension of a process and must always be at the goal are people who are susceptible to fears of success.

Diet Detective: How do you know that you fear success and/or failure? Are there signs?

Srini Pillay, M.D: The following are signs that fear of failure and success may play a role in attaining your goals: (1)You are a procrastinator; (2)You are always down on yourself; (3)You avoid successful people; (4)You are outwardly “fine” but experience internal turmoil; (5)You are unable to concentrate or attend at work; (5)You always stop short of your goal or slow down when you are almost there; (6)You low-ball your goals; (7)You feel no permission to “dream” or “not be realistic” on occasion; (8)You feel cynical about life and people; (9)You feel burned out.

Diet Detective: Are there suggestions for someone to avoid sabotaging his or her life (i.e. weight loss goals)?

Srini Pillay, M.D: (1)Go slow and start with small goals; (2)Try to lose weight with a friend or loved one from whom you can get feedback and motivation; (3)Have frequent check-ins with yourself; (4)Set realistic goals; (5)Examine your underlying fears and history: Are you especially sensitive to resentment? How would your life change if you lost weight? What might you lose? Have you included your partner in this decision and talked about this? (6)Set rewards frequently — intermittent food rewards are important as is rest from being goal driven; (7)Examine your goals in context — remember, this is your life and you have to balance “work” and “fun” as much as you can. Incorporate as much play as you can in your workout routine; (8)Examine the role of food in your life: Is it serving an emotional function? Does it help to cover up some other misery that you are not addressing? (9)Meditation: This can help self-acceptance and decrease the distracting internal criticisms that prevent you from reaching your goals; (10)Focus on the solution rather than only the problem; (11)Take adequate precautions: Stretch when working out; prevent injuries; pay attention to the slightest physical discomfort-you may be trying to sabotage your own goals by having a pseudo-legitimate injury.

Now a few personal questions.

Diet Detective: What’s always in your fridge?

Srini Pillay, M.D: Skim milk, Smart Balance and butter (the latter for occasional splurges), multiple spicy condiments, many vegetables, frequently the preferred cut of meat for the week, good white wine, selection of cheeses, eggs, and yogurt.

Diet Detective: What was your last meal?

Srini Pillay, M.D: Protein shake and egg-whites with wheat toast for breakfast. (A little misleading as I shared an appetizer of chorizo and cheese last night, and then had blackened chicken with beans and rice at a Mexican restaurant.)

Diet Detective: What’s your favorite “junk food?”

Srini Pillay, M.D: Bratwurst, kielbasa, Coca-Cola, and Snickers. (Do martinis count?)

Diet Detective: What was your worst summer job?

Srini Pillay, M.D: None. I really enjoyed the few I had.

Diet Detective: As a child what did you want to be?

Srini Pillay, M.D: Many, many things and wondered how I could do it all. I wanted to be a doctor, inventor, actor, music composer, writer, dancer, mathematician, and literature professor. Mostly, I wanted to have the continuous permission to be curious and unbounded by rigorous definitions.

Diet Detective: Where do you get your ideas?

Srini Pillay, M.D: Who knows? I think that they are a combination of translating internal unconscious narratives and interacting with people in conversation. The origin of ideas is a fascinating question.

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