Perfectionism Therapy in New York City

Perfectionism

Do you have excessively high standards? Do you experience extreme distress if you fail to meet these standards? Do you find satisfaction fleeting even when you achieve goals? Perfectionism is severe self punishment if one fails to adhere to extreme and rigid self imposed standards. Perceived failure over mistakes can leave the person with perfectionism feeling exhausted, worthless or worried. Often perfectionists believe that if they refrain from self-punishment they will be unsuccessful. Research has linked the trait of perfectionism with depression, anxiety and personality disorders.

There are three types of perfectionism that individuals may struggle with. These are referred to as self-oriented, social oriented and other oriented. Some people may exhibit aspects of all three subtypes.

3 Subtypes of Perfectionism

1. Self-Oriented Perfectionism: People with self-oriented perfectionism have excessively high standards regarding performance on tasks. If they may a mistake they can be extremely hyper- critical leading to depression. When working on a task they may also be extremely preoccupied with whether the outcome will meet their standards. This may contribute to difficulties concentrating, anxiety and procrastination. Often, even when a goal is met they typically minimize their accomplishment. For example, after obtaining a perfect score on an exam the perfectionist may diminish their grade. This may be done by labeling the exam as easy or unsophisticated.
2. Socially Oriented Perfectionists: Socially- oriented perfectionists believe others have excessively high standards and expectations of them. They fear others will be excessively critical or punitive if they do not meet their expectations. This pressure and tendency to over accommodate to others may leave them feeling resentful.
    
   Socially oriented perfectionists projected beliefs about others expectations may create a self-fulfilling prophecy. The more they accommodate to others and say “yes”, the more others will expect of them to do in the future. They do not set boundaries fearing disapproval and thus are often flooded with more requests. Social Oriented perfectionism is associated with severe depression because their value/self worth is often dependent on other people, which they cannot fully control.

 

3. Other Oriented Perfectionism: People with other oriented perfectionism have extremely high standards of others. They may be critical or harsh when others do not meet their expectations. Their tendency to feel disappointed in others may lead to interpersonal conflict or aggressive outbursts. Conversely, they may quietly withdraw if they feel disappointed that others do not meet their expectations. The high expectations of others may leave them chronically disappointed and frustrated. They may have difficulty connecting and forming intimate relationships.

How I Can Help with Perfectionism

I have spent an extensive amount of time researching, writing and working with patients with perfectionism. I am aware and address the many challenges perfectionists face when entering therapy. In general, perfectionists may be prone to terminating therapy prematurely. For example, a self-oriented perfectionist may interpret seeking help as though they are flawed and end the relationships quickly. Socially oriented perfectionists may want to please their therapist and thus not reveal thoughts and feelings and feel dissatisfied with the therapy process. By discussing the therapy relationship and monitoring thoughts and feelings throughout the process premature termination can be avoided. Through the therapy relationship perfectionists may also develop and internalize new coping skills to manage expectations. For example, new relationship experiences that occur in the therapy relationship (ex: expressing needs or being vulnerable) may generalize to other social settings. Other oriented perfectionists who can learn to accept the imperfections of their therapist can learn to possibly be more tolerant of others.

I also work with perfectionist patients on learning to manage anxiety regarding expectations and teach self-acceptance and compassion skills using mindfulness and Buddhist influenced interventions. I also help perfectionists identify and manage maladaptive cognitions and patterns that lead to distress. I help perfectionists develop more balanced thinking. I help teach self-oriented perfectionists how to set boundaries and say “no” to others. Many perfectionists, particularly self-oriented perfectionists are reluctant to let go of expectations fearing this will impair performance. Managing perfectionism however, does not necessarily mean desiring less, but changing one’s relationship and response to when expectations are not met.