Signs Your High-Achieving Child May Be Struggling: How Play Therapy Supports Internalizing Behaviors

The Hidden Struggles of High-Achieving Kids: Understanding Internalizing Behaviors

When adults think about children who might benefit from therapy, externalizing behaviors often come to mind—aggression, defiance, or frequent discipline issues. But what’s often overlooked are internalizing behaviors: emotional struggles that are turned inward and can be much harder to detect.

These kids often appear “perfect” on the outside. Teachers might describe them as quiet, well-behaved, or high-achieving. They succeed academically, participate in activities, maintain friendships—and yet, they may be silently struggling with anxiety, perfectionism, or self-criticism. Because they aren’t acting out, their distress often goes unnoticed.

What Are Internalizing Behaviors?

Internalizing behaviors involve emotions and challenges that a child directs inward. They’re typically more subtle than behaviors that disrupt classrooms or family dynamics, but they can be just as painful—and harmful—over time.

Here are common signs of internalizing behaviors, especially in high-achieving children:

  • Perfectionism and fear of failure

  • Low tolerance for mistakes, mess, or disorganization

  • Negative self-talk, especially after small errors or perceived shortcomings

  • Limited emotional expression, always appearing calm or “fine”

  • Avoidance of risk-taking or emotionally uncomfortable situations

  • Frequent somatic complaints, such as headaches or stomachaches

  • Rigid thinking, difficulty coping with change or uncertainty

  • Trouble sleeping or recurring nightmares

  • Masking behaviors, especially at school or in public

  • People-pleasing tendencies at the expense of authenticity

Why Internalizing Behaviors Often Go Unnoticed

High-achieving kids often meet or exceed expectations, which can make emotional distress harder to identify. Their ability to “hold it together” masks the deeper struggles they might be experiencing—especially if adults aren’t attuned to the signs of internalized anxiety, pressure, or self-doubt.

These children may not raise alarms, but they often experience:

  • Chronic stress

  • Emotional suppression

  • Identity confusion (i.e., believing they are only valuable when achieving)

How Play Therapy Helps High-Achieving Children

Play therapy offers a safe, non-judgmental space where high-achieving kids can:

  • Make mistakes without fear

  • Engage in messy, unstructured activities

  • Explore emotions they typically suppress

  • Challenge perfectionism and rigid thinking

  • Reconnect with their authentic selves

  • Learn that they are valuable just for being themselves—not for what they achieve

In sessions, we focus on creating emotional flexibility, self-compassion, and self-regulation. Therapy helps kids understand that discomfort, mistakes, and imperfection are part of being human—and that their feelings are welcome and manageable.

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Recognizing Childhood Anxiety: Symptoms, Behaviors, and How Play Therapy Can Help

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Understanding the 4 Core Threats to a Child’s Nervous System: Insights from Synergetic Play Therapy