Perfectionism: Mastery Gone Awry

Last week, I wrote about mastery - the feeling of competence or achievement that can be such a vital part of mental health. However, sometimes our desire for mastery goes awry, turning into perfectionism - compulsive efforts to reach impossibly high standards, while viewing anything short of perfection as failure. Perfectionism can involve standards we have for ourselves, standards we have for other people, or standards we believe others have for us.

While it's normal, and sometimes even helpful, to have high standards, these standards veer into perfectionism when they are excessive (i.e., unreachable), arbitrary, unnecessary, and rigid. High standards enhance functioning and help us be/do our best. Perfectionism, on the other hand, tends to interfere with performance and functioning in many areas of life. In fact, perfectionists are often paralyzed by their perfectionism: they either spend an inordinate amount of time on one task or activity trying to get it just right, or they don't even start a task or activity because they know they can't meet their own standards. Perfectionism takes a toll on relationships and self-esteem. It can produce anger and sadness, and is clinically linked to depression, OCD, other anxiety disorders, body dysmorphic disorder, and eating disorders.

The dysfunctions associated with perfectionism fall into two main categories: behaviors designed to help the person meet their excessively high standards, and behaviors aimed at avoiding situations that involve perfectionistic standards. The first category includes things like checking, repeating, correcting, organizing, etc. The second category includes difficulty making decisions, procrastination, and giving up too quickly. These behaviors are a burden for the perfectionist, and a source of annoyance to those around him/her.

Behind these behaviors lie a host of distorted thoughts, including filtering out positive feedback (to hone in on negative), black-and-white thinking (if I'm not perfect, I'm a failure), mind reading, comparisons, and lots and lots of "shoulds." Therefore, a major focus of intervention with perfectionists is correcting distorted thought patterns (using such CBT strategies as examining the evidence, identifying alternative (more realistic/helpful) thoughts, considering advantages/disadvantages of the thoughts, and hypothesis testing. Changing the thoughts will shift some of the perfectionistic behaviors, but these also may be addressed more directly through exposure exercises, where the person does the opposite of the perfectionistic behavior, and rides out the resulting anxiety until it lessens. This has to be repeated several times to create lasting change.

Basically, at its core, perfectionism reflects the fear that we're not "ok" - lovable, competent, acceptable, worthy, etc. These core beliefs take longer to change that thoughts or behaviors, but with the benefit of significantly improving quality of life. It really boils down to this: being perfect isn't worth it!

How do you see perfectionism's effects on people, and how do you help perfectionistic clients? Have you ever had a client who was perfectionistic about therapy itself?

(Based in part on When Perfect Isn't Good Enough)