Most people would consider having high standards a good thing but at times this is just part of the plot or in other words, part of a complex trap called ‘perfectionism‘. Striving for excellence might indicate that you have a solid work ethic, strength and ambition. But if and when achieving success (in any domain) is consistently associated with one’s value, self-worth and esteem, we risk falling into the trap of perfectionism.
High standards could indeed propel one towards the peak level of their potential. This is very common with professional athletes or musicians for example, who train long and hard to reach excellence in their respective sport or art. Clinical perfectionism could however develop when the individual believes that his/ her worth, value and appreciation by others, uniquely depends on achieving success all of the time and never failing a task. In parallel with that, standards are set so high that they often cannot be met, or are met with a great deal of difficulty. Perfectionists tend to believe that anything short of perfection cannot and should not be tolerated, and that even minor mistakes or imperfections will lead to one conclusion only: that they are not worthy or good enough individuals.
Generally speaking, we might believe that it is important to try to do the best that we can in one or more areas of life. However, most people also believe that making mistakes from time to time is reasonable and inevitable. Making a mistake does not mean they have failed entirely and this will ‘define’ them and ‘follow’ them forever. Perfectionism positions itself within this spectrum. Adults and even adolescents* with perfectionism tend to believe that they should never make mistakes and that making a mistake means they are a failure across the board, they are unworthy individuals, consistently disappointing others. Thinking like this makes perfectionists hypervigilant because of the prospect of making mistakes and as such, perfectionists experience constant states of hyperarousal, shame and defeat.
When exploring an individual’s early years it is easy to understand the origins of such attitudes to self and others. Perfectionism is encouraged in many families. Sometimes parents consciously or unconsciously set very high and very rigid standards. It can actually be very easy for any parent to fall in this trap given how much more competitive the world is. Demanding parents however would require top marks in school, medals in sports and flawless ballet recitals. Mistakes could be harshly punished. The punishment does not need to be physical; it is mostly emotional, it is severe and abusive. This may include neglect, public humiliation, downgrading accomplishments, name calling, yelling, shaming, the silent treatment, and/or indeed sometimes even physical aggression. The principle message conveyed to the child via words or behaviours is very clear: ‘failure is not acceptable and it will not be tolerated’. It is natural for children to have a strong need to impress adults and main caregivers in particular. This ‘need’ is a natural surviving instrument and therefore parents’ unhealthy expectations and demands are viewed as the norm which gives rise to fear of failure and perfectionist attitudes (within children). Reinforcing behaviours and assumptions about how to navigate through a competitive world would soon follow. Those will become embedded and programmed in one’s bio-psycho-social system and neuroaffective systems and as such, adolescents could struggle with symptoms of depression and low self-esteem and/or anxiety for years before treatment is sought and the correct diagnosis is identified.
This is in fact, exactly what makes perfectionism difficult to identify and treat. It has roots in an emotionally abusive and demanding environment and it crosses borders into the depression and trauma spectrum, chronic low self-esteem, OCD, eating disorders, even some personality disorders. Unfortunately a range of mental health pathologies rely on psychological rigidity and unrealistic self-imposed standards.
For the typical perfectionist adolescent or adult, trying to be perfect is a daily effort and it does not stop when leaving the school or the office. Martina is a well regarded and respected nurse manager who would consistently take additional responsibilities when on duty. She does not like to delegate, because ‘no one can deal with certain tasks as well as she does’. She is the ideal employee and therefore managers reward her by assigning more and more complex cases. This would lead to stress and burn out almost on a daily basis. When she gets tired, she would make mistakes which would not be tolerated since it confirms her worst fears that she is a failure, she is an embarrassment to her patients and colleagues.
Problems do not stop here. When she leaves work and arrives home, her equally high and rigid standards would continue to be applied and diligently enforced. With very clear daily instructions and (hour by hour) rules in place her expectations from her husband and their children to deliver everything on time and at a high standard (e.g. washing up, homework, etc.) are relentless and exhausting for all involved. This would lead to frequent arguments and further feelings of worthlessness, shame, embarrassment and failure.
If investigated carefully, subtle differences between the two case scenarios (i.e. the work situation vs. the home situation) may be observed. Although all behavioural responses and associated assumptions (i.e. beliefs) have a perpetuating role (or a role of maintenance which is, to reinforce the not good enough, failure or shame schemas), such elaborated cognitive strategies may be better understood as justifications or facilitating beliefs about why having high standards is important to the individual.
The diagram further below explains the reinforcing mechanism. For example, at work it is all about keeping everyone happy (in order to be appreciated and valued) which involves (in the NA-CBT formulation) a series of Compensatory, Avoidant or Surrendering strategies (like not allowing ‘weaker’ workers to work on certain tasks). At home it is all about ensuring that her children are successful and parents are appreciated, respected and valued for their efforts. This is also backed up by a series of compensatory, avoidant or surrendering strategies (excessive organising and list making, not compromising on the timing, etc.).
The Pendulum-Effect Formulation
(NA-CBT by D Mirea)
Core Schema: NOT GOOD or PERFECT ENOUGH
OVERCOMPENSATION – AVOIDANCE – SURRENDERING
Overcompensation:
The heart of the problem: “I am not ready yet, this is not good enough!”
Overcompensation reflects your inability to internally say to yourself: ‘this will actually do’ or ‘this is good enough as it is’. To stop constantly shifting the goalposts or to refrain from aiming higher and higher and at the same time believing that it is not just realistic but also very-very important – to reach such high standards. Double checking or triple checking one’s work or several times, proof reading an email several times before sending it are examples of how working hours are extended and draining often leading to burn out.
The need to ‘control’ everything or ‘take control’ is yet another compensatory mechanism that facilitates perfectionism. Facilitating beliefs or justifications such as: ‘no one can do this as well as I can’ or ‘If I don’t do this, nobody else will..’ would inevitably lead to burn out, stress and eventually some type of failure – a sentiment that the perfectionist would like to avoid at all costs.
These attitudes or mindsets apply of course, to all areas of life whether personal, work or sports and therefore the language, behaviours and beliefs vary: having strong and rigid views or rules… being tough and correcting people or children when they make mistakes… commenting when other people are not being appropriate and directing them to more appropriate behaviours… arguing a point over and over again… not knowing when to stop, etc.
Avoidance:
Procrastinating: “I can work on this later, when I am ready and when I am better prepared!”
Since your worth, your value and even personal image depends on constantly reaching a specific standard, the process of completing a project becomes very important (i.e. an essay that you wrote for school or a project you have to complete at work); therefore preparation and feeling ready or ‘right’ to get started on it can be very important. Procrastination and putting plans off is almost always the answer.
Other types of avoidance include indecisiveness or avoiding tasks the perfectionist fears is outside their sphere of competence in spite of all the evidence (i.e. an over qualified psychotherapist still afraid to open up a practice).
Getting somebody else to attend in my place! Because I fear underperforming at the next meeting or social event – implicit knowledge that justifies avoidance.
Not asking for help! Avoid asking for help at all costs: because this will make me look weak and not good enough like a failure – implicit knowledge that justifies avoidance.
Surrendering:
Sabotaging Self-Confidence… Not celebrating one’s success! When achieving a goal (even at the required standard) this soon becomes a ‘box ticking exercise’ rather than a celebration. And over time celebrations (or celebrating achievements) would become completely absent from one’s life repertoire.
Giving up in shame or giving up too soon: “This is hopeless…” Measuring one’s performance against others that are on a much higher level (in their perception – in reality these specific ‘others’ may not be better off).
This is not the same as avoidance, it is much more about giving up something already started and thus giving into the schema that suggests you are a failure and worthless. Surrendering could also involve ‘drinking to unwind’ – important to point out, this is not an effective relaxation exercise but part of the giving up process (a secondary problem such as binge drinking would develop in some cases); acting out of character, not being able to accept or assume a fault, frequent episodes of anger directed towards the self or (incapable) others, etc.
Most perfectionists feel exhausted after repeated and very long episodes of intensive worry and fears of failing and not reaching the (self-imposed) ‘required’ standard. Therefore at some point, one throws in the towel and retires into a depressive state, a state of shame and guilt. Examples would be quitting a project very recently started or even doing something very-very slowly, not to miss important details and then giving up.
Treating yourself with Neuroaffective-CBT (NA-CBT)
This method was developed by Daniel Mirea in response to a growing subclinical population of undiagnosed affective disorders that fall under the umbrella of shame and self-disgust. Since the treatment of such phenomenon crosses the boundaries of a clear diagnostic criteria, the therapeutic approach has to be both comprehensive and strategic. It is my view that self-help in general and especially self-help manuals can only go so far without the guidance and support of a kind, generous and well prepared CBT therapist.
NA-CBT relies on a clearly prescribed toolkit that aims to disrupt all mechanisms that predispose, perpetuate and precipitate the fears of failing, the shame and disappointment with the self, that are at the core of perfectionism.
There is a difference between the healthy and helpful pursuit of excellence and the unhealthy and unhelpful striving for perfection (though at times there is a very fine line). Experiencing negative consequences of setting such demanding standards, yet continuing to go for them despite the huge costs would point towards clinical perfectionism. An initial step is recognizing that there is a problem which needs to be addressed. Understanding the nature of the problem, the costs and benefits that perfectionism brings to one’s life and also understanding how one has firstly developed and then kept falling in the trap of perfectionism over years, is just the first part of the changing process.
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* adolescents – the upper age limit is considered to be 24 according to neuroaffective case studies.
*** Training in Clinical Perfectionsim in West London on 20th May 2019. Details below
Neuroaffective-CBT 