When Perfect Isn't Good Enough
When Perfect Isn't Good Enough
When Perfect Isn't Good Enough
—MMA
For Carolyn
—RPS
Contents
Acknowledgments
INTRODUCTION
PART 1: UNDERSTANDING
PERFECTIONISM
CHAPTER 1: WHAT IS
PERFECTIONISM?
CHAPTER 2: THE IMPACT OF
PERFECTIONISM
CHAPTER 3: PERFECTIONISM
AND THOUGHTS
CHAPTER 4: PERFECTIONISM
AND BEHAVIOR
CHAPTER 5: MEASURING
YOUR PERFECTIONISM
CHAPTER 6: DEVELOPING A
PLAN FOR CHANGE
CHAPTER 7: CHANGING
PERFECTIONISTIC THOUGHTS
CHAPTER 8: CHANGING
PERFECTIONISTIC
BEHAVIORS
CHAPTER 9: ACCEPTING
IMPERFECTION
Obtaining a Journal
The exercises in this book require
you to answer specific questions and
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Understanding
Perfectionism
Chapter 1
What Is
Perfectionism?
Most of us are bombarded with de-
mands to improve our performance.
From the time we are born, we must
endure being evaluated and corrected
by different people in our lives. When
we first learn to talk, our parents cor-
rect our pronunciation. When we are
young, we are taught by others how to
walk, dress ourselves, hold our forks
properly, refrain from putting our el-
bows on the table, wash behind our
ears, and make our beds.
As we grow up, our behavior con-
tinues to be evaluated, criticized, cor-
rected, and rewarded. In school and
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Definitions of
Perfectionism
So, what is perfectionism, and how is
it different from a healthy desire to
achieve high standards? As a starting
point, let’s consider a dictionary
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Multidimensional Definitions of
Perfectionism
Recently, psychologists have be-
gun to define perfectionism as a mul-
tidimensional concept (Flett and He-
witt 2002). In other words, research-
ers increasingly view perfectionism as
consisting of several different com-
ponents or aspects. For example, Ca-
nadian psychologists Gordon Flett
and Paul Hewitt have identified three
main types of perfectionism: self-ori-
ented perfectionism, other-oriented
perfectionism, and socially prescribed
perfectionism.
Self-oriented perfectionism is a
tendency to have standards for your-
self that are unrealistically high and
impossible to attain. These standards
are self-imposed and tend to be asso-
ciated with self-criticism and an
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Appropriately High
Standards versus
Perfectionistic Beliefs
Most people have strong opinions
about how they should perform and
about how certain things should be
done. Although some standards are
helpful, other standards may not be.
For example, a person who has to
speak in front of groups may have the
belief: “It is important to do an excel-
lent job.” Is this a perfectionistic be-
lief or just an appropriate belief that
leads to improved performance in
public speaking situations? Unfortu-
nately, people are often not very good
at assessing the accuracy of their own
beliefs about their standards, because
most of us assume that our beliefs are
correct.
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Perfectionism as a
Personality Trait
Personality traits are stable charac-
teristics that make people who they
are. The term “stable” implies that
personality traits affect your behavior
across situations and over time. For
years, psychologists have debated
about the exact number of basic per-
sonality traits. Earlier, researchers
tended to view personality as being
comprised of many different person-
ality traits. The exact number of traits
differed from theory to theory,
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Areas Prone to
Perfectionism
Below are some of the common areas
in life in which unreasonably high
standards can lead to problems:
Writing
Writing can be difficult for some
people who are perfectionistic. Indi-
viduals who fear making mistakes
when writing may take a long time to
fill out forms, write letters, finish
term papers and exams, or complete
other written work. They may pro-
crastinate because the process of
writing feels like torture.
Speaking
People who are perfectionistic
with respect to speaking are often
very self-conscious about how they
speak and often worry about mispro-
nouncing words or saying things
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Physical Appearance
For some people, perfectionism is
focused on physical appearance. For
example, people may hold perfection-
istic standards about weight and body
image, hair loss, and even their cloth-
ing. For example, one person who
was seen in our clinic spent hours
getting dressed in the morning. She
would try on many different outfits,
searching for the one that looked
“just right.” As a result, she was usu-
ally late for work.
People can also hold perfectionist-
ic beliefs about the appearance of
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The Origins of
Perfectionism
Where does perfectionism come
from? Is it learned through your ex-
periences? Is it genetically inherited,
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Genetic Influences
Numerous research studies have
found that genetics plays a role in the
development of various personality
traits (Serretti et al. 2007), and recent
evidence suggests that perfectionism
is no exception (Tozzi et al. 2004). If
perfectionism is partly inherited, does
that mean that perfectionism cannot
be changed? Not at all. Genetics af-
fects just about every aspect of who
you are, including physical fitness,
academic ability, depression, anxiety,
and even your interests and hobbies.
Yet exercise can have an enormous ef-
fect on fitness level. Likewise, specific
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Have Contributed to
Your Perfectionism
Punishment
A second type of learning experi-
ence that can affect an individual’s
behavior is punishment. Punishment
involves receiving some sort of negat-
ive consequence following a behavior.
The overall effect of punishment is of-
ten to decrease the frequency of the
punished behavior. Criticism from
others is one form of punishment. For
example, a child who is often criti-
cized for doing things improperly
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Modeling
Modeling involves learning to be-
have in certain ways by observing
others. People can develop fears by
watching other people who are afraid.
People may start smoking, drinking
alcohol, or using drugs after watching
their peers use these substances.
There also appears to be a relation-
ship between watching violence on
television and engaging in violent be-
havior, and that observing violent be-
havior can lead to more violence
(Huesmann and Taylor 2006). All of
these are examples of modeling. If
people can learn these behaviors by
observing others, it is possible that
perfectionistic behaviors can develop
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The Impact of
Perfectionism
How Perfectionism
Affects Your Life
Perfectionism is a problem when it
leads to unhappiness or interferes
with functioning. Having excessively
high standards can affect almost any
area of life, including health, diet,
work, relationships, and interests. In
this section, we focus on some of the
main areas that are often impaired by
perfectionism: work, home and
school, relationships, and recreation.
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Perfectionism and
Psychological
Functioning
Perfectionism is associated with a
range of psychological problems, in-
cluding depression, generalized anxi-
ety and worry, social anxiety and
shyness, obsessive-compulsive prob-
lems, anger difficulties, and issues re-
lated to body image and eating. This
section discusses each of these poten-
tial problems that can arise from be-
ing overly perfectionistic.
Depression
Perfectionism is often a feature of
depression. Depressed mood can vary
in intensity from the normal periods
of sadness that everyone experiences
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Anger
Like anxiety, anger is a normal
emotion that sometimes occurs when
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Obsessive-Compulsive Behavior
Up to 80 percent of people in the
general population experience obses-
sions and compulsions from time to
time (Antony, Downie, and Swinson
1998). Obsessions are unwanted
thoughts, images, or urges that occur
repeatedly, despite efforts to resist
them. Examples may include
thoughts about being contaminated
by germs; images of hurting other
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obsessive-compulsive behavior in
more detail.
Perfectionism and
Thoughts
Research from around the world has
consistently found a relationship
between people’s emotions and their
beliefs, thoughts, expectations, and
interpretations. Negative thinking
seems to be related to experiences of
anxiety, anger, and sadness. Perfec-
tionism, which is often part of these
emotional states, is also associated
with these negative styles of thinking.
In this chapter, we will explain the
styles of thinking that contribute to
perfectionism; in later chapters, we
will discuss how changing these styles
of thinking can have a dramatic effect
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Automatic and
Unconscious
Perfectionistic Thoughts
People are often unaware of the
thoughts and interpretations that
lead to their intense reactions to situ-
ations. Often, these thoughts occur so
quickly and automatically that they
are outside of your conscious aware-
ness. In fact, there are many situ-
ations in which you process informa-
tion outside of your awareness. When
you walk, you don’t have to think,
“Right foot … left foot … right foot …
left foot.” Rather, you walk without
thinking about it. If there is a pole in
the way, you automatically walk
around it. In fact, a minute later, you
might forget that there was a pole to
be walked around.
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Trying to Confirm
Perfectionistic Beliefs
Everyone likes to be correct. There-
fore, people tend to seek out experi-
ences that confirm their beliefs. In
other words, people seek information
in a biased way, in an effort to sup-
port their assumptions, interpreta-
tions, and thoughts. They prefer to
spend time with people who think the
way they do. If they are politically act-
ive, they may go to rallies for their
own side—to hear what they already
believe. If they are active in their reli-
gion, they may seek out experiences
that bolster their religious beliefs (for
instance, attending services at a
church or some other place of wor-
ship) rather than seeking out experi-
ences that challenge their beliefs.
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Perfectionistic Thinking
Styles
People do not think like computers.
Computers use complex mathematic-
al formulas to process information
and solve problems. In contrast,
people often interpret their environ-
ments using what psychologists call
heuristics. A heuristic is a rule that
people use to make a decision or in-
terpret an event. For example, if an
individual sees an unleashed dog
while walking on the sidewalk, he or
she might rely on various stereotypes
about various dog breeds to help
guide the decision of whether to cross
the road and get away from the dog. If
the dog is from a large breed known
for biting, the individual might be
more likely to avoid the dog than if
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Filtering
Filtering is a tendency to select-
ively focus on and magnify negative
details at the expense of positive in-
formation, which is dismissed as less
important. Here are some examples
of filtering:
Ella receives a two-page perform-
ance evaluation at work that is very
positive overall, emphasizing that she
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Mind Reading
Mind reading involves assuming
that you know what other people are
thinking and that their thoughts
about you are negative. This style of
thinking is common in people who
are perfectionistic and may
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Probability Overestimations
Perfectionism is often associated
with a tendency to predict that negat-
ive events are more likely to occur
than they really are. We call these
predictions probability overestima-
tions. Here are some examples:
Alex is a straight-A student, yet
before every exam, he believes that he
is definitely not going to pass.
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Tunnel Vision
Tunnel vision is a cognitive style
in which people pay too much atten-
tion to detail and therefore miss the
big picture. This can also be thought
of as “missing the forest for the
trees.” Tunnel vision can slow people
down and get in the way of task com-
pletion. Following are a few examples
of tunnel vision:
Peter spent many hours reading
and taking hundreds of pages of notes
in preparation to complete his ten-
page paper on World War II.
Before making any new purchase,
no matter how small, David spends
many hours reading past issues of
Consumer Reports, talking to sales
people, and discussing his options
with friends.
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Interpersonal Sensitivity
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Catastrophic Thinking
Catastrophic thinking (also
known as catastrophizing) involves
incorrectly assuming that one could
not cope with a negative outcome if it
were to occur. This style of thinking
also includes predictions that particu-
lar events would be unmanageable if
they were to occur. Catastrophic
thinking is common in people who
are prone to experiencing problems
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• It would be unmanageable
to develop an illness that
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Should Statements
Should statements are arbitrary
rules for how things ought to be. If
others break these rules, a person
may feel angry or resentful. If indi-
viduals break their own rules, feelings
of guilt, sadness, inadequacy, or anxi-
ety often occur. Statements contain-
ing the words “should” or “must” are
often a sign that one is engaging in
this style of thinking. Following are a
few examples of “should” statements:
• My children should always
do what I tell them to do.
• If I send my husband to
pick up a new telephone, he
will probably get the wrong
one.
Inappropriate Social
Comparisons
One strategy that we all use to
evaluate our performance is to com-
pare ourselves to other people. Every-
one engages in social comparisons
from time to time in order to see how
they measure up compared to others
whom they perceive as similar to
them. For example, if you receive a
raise at work, you might be interested
in knowing whether other individuals
doing similar jobs received compar-
able raises. Following a test in school,
students often try to find out how
other people in the class performed
on the exam. Usually, people compare
themselves to others whom they per-
ceive to be similar or slightly better
than them in the dimension being
compared. So, following a term test,
average students are likely to
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Looking Ahead
In summary, identifying your perfec-
tionistic thoughts and understanding
the relationship between thinking
and perfectionism are important
steps in overcoming excessively high
standards. Later in the book, we will
discuss strategies for changing your
perfectionistic thoughts. First,
however, we will provide an overview
of the ways in which certain types of
behaviors can help to maintain your
perfectionism. As we explain in the
next chapter, perfectionistic thoughts
and behaviors are closely related in
that perfectionistic beliefs can lead to
perfectionistic behaviors and perfec-
tionistic behaviors can help to main-
tain perfectionistic beliefs. It is diffi-
cult to overcome perfectionism
without addressing both the thoughts
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Perfectionism and
Behavior
The Paradox of
Perfectionism
Joanne has great difficulty making
choices when shopping for clothes or
other items. She fears that if she only
buys one item, she’ll get home and
feel that she’s purchased the wrong
one. As a result, when faced with sev-
eral options, she tends to buy one of
each. For example, if she can’t decide
between six colors of a blouse, she
buys one in each color. Only by
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Appropriate Standards
vs. Perfectionistic
Behaviors
In order to perform effectively in the
world, it is important that people set
standards and work toward meeting
them. For example, most of us would
take the time to straighten a picture
that was hanging crooked on the
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Perfectionistic Styles of
Behaving
As we discussed before, the term
“perfectionism” means different
things to different people. No one
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Overcompensating
Because perfectionism is often as-
sociated with anxiety or discomfort
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Exercise 4.1
Overcompensating
Procrastination
Because perfection can almost
never be achieved, people who are
constantly aiming for perfection may
put off doing things for fear that they
will never meet their targets or goals.
By not starting things, perfectionists
don’t need to deal with the possibility
of doing a less-than-perfect job. In
some cases, perfectionism may lead
to complete avoidance of situations in
which an individual may not measure
up. Following are examples of
procrastination:
Because Michelle feels such in-
tense pressure to do well in all her
classes, she tends to take her school-
work very seriously. With each paper
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Exercise 4.6
Procrastination
Excessive Slowness
Perfectionism can sometimes lead
people to do things more slowly than
they would otherwise. Slowness is of-
ten related to some of the other beha-
viors discussed earlier. For example,
procrastination can cause people to
take longer before starting a particu-
lar project or activity. Also, people
who have difficulty making decisions
often take a long time to choose
among several options (things like
choosing what color to paint the liv-
ing room). Finally, people who check
excessively sometimes take longer to
complete tasks, particularly if they
continually check their performance
as they go along. Perfectionism can
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Failure to Delegate
Perfectionism is sometimes asso-
ciated with a tendency to mistrust
that others can do things properly.
Individuals who have trouble trusting
others may avoid delegating tasks to
people unless they are sure that the
other person will complete them per-
fectly. Here are a few examples illus-
trating a failure to delegate.
Louis insists on doing all of the
cooking and cleaning at home, des-
pite the fact that his wife and children
often offer to help. Although Louis
doesn’t enjoy these chores, he has
very strict beliefs about how things
should be done. He is therefore re-
luctant to let others help him, for fear
that the tasks won’t be done correctly
and his standards will not be met.
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Hoarding
For some people, perfectionism
can be associated with difficulty
throwing things away. For example,
people may hold on to old newspa-
pers, magazines, or pamphlets. Other
people may keep empty jars, pack-
ages, letters, broken appliances, or
other trivial items. In fact, people can
hoard almost anything. Hoarding is
not the same as having a collection of
some kind. Nor is it the same as keep-
ing things for sentimental value.
People who have problems with
hoarding often have their homes
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Exercise 4.11
Hoarding
Avoidance
Because perfectionistic standards
are often so difficult to meet, people
who strive to be perfect will some-
times avoid situations in which they
might feel compelled to meet these
impossible standards. We described
some specific examples of avoidance
earlier. These include failing to deleg-
ate tasks to others, procrastinating,
and giving up on tasks too quickly.
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Exercise 4.12
Avoidance
Strategies for
Overcoming
Perfectionism
Chapter 5
Measuring Your
Perfectionism
The Purpose of
Conducting an
Assessment
Before a psychologist, psychiatrist, or
other professional begins to help an
individual to deal with a particular
problem, there is typically a period of
assessment. Assessment involves col-
lecting information to better under-
stand the nature and severity of a
problem and to help develop the best
possible treatment plan. For example,
if a client visits a therapist seeking
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Identifying Problem
Areas
An important function of the initial
assessment phase is to describe the
features of your perfectionism and to
identify the main problem areas.
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Exercise 5.5
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The Effect of
Perfectionism on Others
It is important to assess the impact of
your perfectionism on those around
you. By doing this, you can improve
your interpersonal relationships by
reducing the strain that can be caused
by perfectionistic criticizing and dir-
ecting, as well as reducing your own
irritation and anger about the actions
of others that you would perform
differently.
Perfectionism and
Emotional Functioning
Your self-assessment should include
an examination of the ways in which
perfectionism affects you emotion-
ally. Sometimes perfectionism can
lead to feelings of depression if a per-
son finds that his or her high stand-
ards are never met (for example, a
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STYLES OF PERFECTIONISTIC
THINKING
List (from chapter 3) the styles of
perfectionistic thinking (all-or-noth-
ing thinking, filtering, and so on) that
are most problematic for you. Give an
example of each from your own life.
STYLES OF PERFECTIONISTIC
BEHAVIOR
List (from chapter 4) the styles of
perfectionistic behavior (overcom-
pensating, excessive checking, and so
on) that are most problematic for
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Measuring Improvement
and Change
In addition to helping you understand
the origins and nature of your perfec-
tionistic beliefs and behaviors, anoth-
er function of assessment is to meas-
ure changes in perfectionism over
time. Therapists sometimes ask their
clients to repeat the initial measures
(for example, questionnaires, diaries,
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Developing a Plan
for Change
Before beginning to use the strategies
for overcoming perfectionism, there
are several steps that should be taken
to prepare for change. In this chapter,
we will help you examine the costs
and benefits of becoming less perfect
so you can assess whether you really
are motivated to work on your perfec-
tionism at this time. We will also help
you identify specific goals for change,
so you can choose exercises that will
help you to reach those goals, and so
you can judge whether you are mak-
ing the improvements that you had
hoped to make.
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Exercise 6.1
Determining Benefits
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Identifying Goals
Before starting to overcome any prob-
lem, it’s important to define the prob-
lem and to identify goals. It’s not
enough to say that you want to “be-
come less perfectionistic.” The only
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The Importance of
Regular Practice
The strategies and exercises de-
scribed in the remainder of this book
will require regular practice. Ideally,
you should expect to conduct some
sort of practice almost every day. Al-
though some of these practices may
be quite brief, others may last up to
several hours. Exercises will include
such activities as completing diaries
each time you experience perfection-
istic thoughts, purposely making
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Obstacles to Becoming
Less Perfectionistic
In order to maximize your chances of
making positive changes as you start
the process of overcoming your per-
fectionism, it will be helpful to anti-
cipate any obstacles that might get in
the way of your success. By preparing
for possible roadblocks in advance,
you will be less likely to be affected by
these potential difficulties.
Changing
Perfectionistic
Thoughts
In chapter 3, we discussed the ways in
which beliefs, interpretations, and
predictions contribute to negative
emotions such as anxiety, depression,
and anger. We also discussed how
negative thoughts contribute to per-
fectionism. You may recall from earli-
er chapters that people don’t respond
to what is actually occurring around
them. Rather, they respond to their
interpretations of what is happening
around them. For example, if you fear
making mistakes at work, it’s not the
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Identifying Perfectionistic
Thoughts
Before your perfectionistic
thoughts can be changed, you must
first identify them. This can be diffi-
cult for two reasons. First, you may
incorrectly view your perfectionistic
thoughts as appropriate and accurate.
Second, you may be completely un-
aware of your perfectionistic assump-
tions—these thoughts may be so fa-
miliar and automatic that you don’t
even notice them.
It may be easier to identify times
when you are engaging in
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PERFECTIONISTIC THOUGHTS
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• My husband cannot be
counted on for anything.
ALTERNATIVE THOUGHTS
• It’s okay for my husband to
be late sometimes.
• Sometimes he does do
things when I would like
him to.
EVALUATING PERFECTIONISTIC
THOUGHTS AND ALTERNATIVE
THOUGHTS
• My expectation that my
husband always pick me up
on time only causes me to
get angry and frustrated. It
doesn’t seem to change the
situation at all.
PERFECTIONISTIC THOUGHTS
• I should always be enter-
taining and funny.
• If I am not entertaining,
people won’t like me.
ALTERNATIVE THOUGHTS
• It’s okay not to be enter-
taining all the time.
EVALUATING PERFECTIONISTIC
THOUGHTS AND ALTERNATIVE
THOUGHTS
• Nobody is entertaining all
the time. Everyone has
awkward moments from
time to time.
PERFECTIONISTIC THOUGHTS
• ___________
• ___________
• ___________
ALTERNATIVE THOUGHTS
• ___________
• ___________
• ___________
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EVALUATING PERFECTIONISTIC
THOUGHTS AND ALTERNATIVE
THOUGHTS
• ___________
• ___________
• ___________
• ___________
• ___________
Education
One reason why people sometimes
maintain perfectionistic beliefs is a
lack of accurate information. Seeking
accurate information on a given topic
can help change perfectionistic or ri-
gid beliefs. Becoming educated is one
way of examining the evidence that
supports and refutes perfectionistic
beliefs.
For example, education can be a
helpful method of changing unrealist-
ic standards with respect to weight
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Hypothesis Testing
An excellent way to test the accur-
acy of your perfectionistic thoughts
and predictions is to carry out small
experiments, a process also known as
hypothesis testing. Carefully designed
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Changing
Perfectionistic
Behaviors
Why Change
Perfectionistic
Behaviors?
Perhaps the most effective method of
overcoming perfectionism is to
change the behaviors that help to
keep your perfectionistic beliefs, atti-
tudes, and predictions alive. If you
have a tendency to set very high
standards for yourself or others, you
probably use some of the behaviors
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Exposure-Based Strategies
For the past few decades, ther-
apies based on exposure have been
used to treat anxiety problems such
as social anxiety and obsessive-com-
pulsive disorder and, to some extent,
other problems such as depression
and eating disorders. Basically, ex-
posure involves confronting a feared
object or situation over and over
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Types of Exposure
There are different ways in which
exposure can be implemented. For
example, exposure can be conducted
live (also called in vivo exposure) or
in the imagination. Although we re-
commend live exposure whenever
possible, exposure in imagination
may be appropriate in cases where
live exposure is impractical, im-
possible, or too frightening. For ex-
ample, if you tend to be very
frightened of making mistakes during
presentations, we recommend first
that you try live exposure by giving
presentations and even making minor
mistakes that are unlikely to cause
any real harm (for example,
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Response Prevention
A second strategy for changing
perfectionistic behaviors is response
prevention. Response prevention in-
volves stopping yourself from enga-
ging in problematic perfectionistic
behaviors. This strategy is related to
exposure, in that it provides an op-
portunity to test out the accuracy of
your negative predictions (in fact, it
should be used along with exposure).
The main difference is that exposure
involves doing something anxiety
provoking (such as giving a presenta-
tion), and response prevention in-
volves preventing the behaviors that
you use to protect yourself from feel-
ing uncomfortable or to prevent bad
things from happening (for instance,
memorizing your presentation be-
forehand to ensure you don’t make
any mistakes). By preventing these
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Communication Training
A third strategy for changing per-
fectionistic behaviors is
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BE ASSERTIVE
Everyone encounters situations in
which the behavior of other people is
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LISTEN
An important part of any commu-
nication is listening to the other per-
son. Listening involves hearing what
the other person has to say and mak-
ing a genuine attempt to understand
his or her point of view. Perfection-
ism can get in the way of listening. If
you are overly critical of the other
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Prioritizing
Do you have difficulty getting
things done on time? Or, do you
spend so much time trying to get
everything done that you sacrifice
other important areas in your life? A
fourth strategy for changing perfec-
tionistic behaviors involves prioritiz-
ing. Prioritizing is important for indi-
viduals who always feel like they have
to get everything done right away. It
may also be helpful for people who
have problems deciding what to do
first (in case they make a “wrong” de-
cision). The process of prioritizing in-
volves three steps.
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Overcoming Procrastination
The final strategy for changing
perfectionistic behaviors is geared to-
ward overcoming procrastination.
People procrastinate for a variety of
reasons, including not enjoying the
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Accepting
Imperfection
The Costs of Control
Napoleon Hill, the American author
of the bestselling book, Think and
Grow Rich, was quoted as saying,
“Self-discipline begins with the mas-
tery of your thoughts. If you don’t
control what you think, you can’t con-
trol what you do” (1937). In The Pic-
ture of Dorian Gray, Irish playwright
and author Oscar Wilde had a similar
view, “I don’t want to be at the mercy
of my emotions. I want to use them,
to enjoy them, and to dominate them
(Wilde 2005).” Is it, in fact, true that
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• Overcompensating
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New Acceptance-Based
Treatments
In recent years, a number of new
treatments have been developed that
teach people to accept their negative
feelings and experiences, rather than
trying to change them. For example,
psychologist Jon Kabat-Zinn has pro-
moted the use of a meditation-based
treatment called mindfulness-based
stress reduction for dealing with
chronic pain, stress, anxiety, and oth-
er negative experiences (Kabat-Zinn
1990, 1994). This treatment involves
learning to be aware of your thoughts
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Mindfulness
You may assume that meditation
and other mindfulness-based
strategies are necessarily weird, “new
age,” spiritual, or religious in nature.
In fact, mindfulness is not necessarily
about spirituality or about getting in
touch with a higher power, and there
is nothing weird or strange about it.
Rather, mindfulness is simply a spe-
cific kind of attending. Kabat-Zinn
(1994, 4) defines mindfulness as
“paying attention, in a particular way:
on purpose, in the present moment,
nonjudgmentally.” Bishop et al. re-
cently proposed a similar definition
in which two components were high-
lighted: (1) awareness of one’s imme-
diate experience in the present mo-
ment, and (2) allowing one’s atten-
tion to be accepting, non-judging, and
compassionate (2004). Although
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What Avoiding
Pain Cost the Emper-
or Moth
MAKING A COMMITMENT TO
CHANGE
The second component of ACT in-
volves thinking about what really
matters to you and making a
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Acceptance and
Perfectionism
In summary, acceptance-based
strategies for perfectionism have two
goals. The first is to become more ac-
cepting of your own thoughts, feel-
ings, and experiences, as well as be-
coming more accepting of others. The
second is to begin to recognize that
although your perfectionism may tell
you that things need to be a certain
way, there are many situations in
which you have a choice about how to
behave. You can choose to behave in a
way that is consistent with your most
deeply held core values, or you can
continue to behave like a perfection-
ist. Now is as good a time as any to
start living the life you want to be
living.
Part 3
Working with
Specific Problems
and Perfectionism
Chapter 10
Perfectionism and
Depression
The Nature of
Depression
You have probably experienced a
period of sadness or depression fol-
lowing a significant loss in your life.
Perhaps it was following the breakup
of a relationship, death of someone
close to you, loss of a job, or inability
to achieve some goal. For most
people, losses such as these tend to
trigger periods of sadness, depres-
sion, or grieving. Most people also ex-
perience sadness from time to time,
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DEPENDENCY
Dependency is the perception of
needing help and support from other
people. When people are feeling sad,
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SELF-CRITICISM
Self-criticism is a tendency to ex-
aggerate one’s faults. A number of re-
searchers have demonstrated a phe-
nomenon known as state-dependent
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INEFFICACY
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Clinical Depression
Researchers and clinicians in the
mental health field have identified a
number of specific problems (collect-
ively known as mood disorders) that
are defined in part by the presence of
depression. In this chapter, we limit
our discussion to two of these dis-
orders that are most often associated
with perfectionism. These are major
depressive disorder and dysthymic
disorder.
DYSTHYMIC DISORDER
People with dysthymic disorder
experience sadness and depression
over a longer period, and usually at a
milder level relative to people with
major depressive disorder. Technic-
ally, to receive a diagnosis of dys-
thymic disorder, a person must ex-
perience a period of two years or
longer in which he or she feels sad or
depressed most of the day, on most
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Causes of Depression
If you have had significant problems
with depression, you may have had
one professional or another tell you
that your depression is caused by a
chemical imbalance in your brain,
problems in the way your parents
brought you up, genetics, or any
number of other factors. Despite the
many different theories that have
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Biological Factors
Depression is very much influ-
enced by our biology, including our
genetic makeup, brain chemistry, and
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GENETICS
A number of studies have demon-
strated that depression runs in famil-
ies (Sullivan, Neale, and Kendler
2000). For example, averaging across
studies, a person is up to three times
more likely to suffer from major de-
pressive disorder if he or she has a
parent who suffers from the problem
than if there is no depression in the
immediate family. Of course, the fact
that depression runs in families does
not, in and of itself, mean that de-
pression is inherited genetically. It
could be that depression is learned
from growing up in a home with other
people who are depressed. To demon-
strate a genetic basis for a problem
such as depression, scientists must
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NEUROTRANSMITTERS
Many studies have examined the
relationship between neurotransmit-
ter levels and depression (Stahl
2008). Neurotransmitters are chem-
icals in the brain that are responsible
for sending messages from one nerve
cell to another. In general, the neuro-
transmitter model of depression that
has obtained the most support sug-
gests that depression is associated
with low levels of serotonin and/or
norepinephrine. Neurotransmitter
models of depression are based in
part on the fact that medications that
raise levels of these substances seem
to improve depression. In addition,
there is other evidence supporting a
role for these transmitters in
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Psychological Factors
Many studies have shown that
psychological factors are important in
the development and maintenance of
depression. For example, various life
stresses (for example, physical or
sexual abuse, divorce, unemploy-
ment) may put certain people at risk
for depression. Also, a person’s style
of thinking can increase his or her
chances of feeling depressed. One of
the most influential psychological
theories of depression describes how
thinking contributes to feeling de-
pressed. This model, proposed by Dr.
Aaron Beck and colleagues (1979), is
known as the cognitive theory of de-
pression. Beck proposed that depres-
sion is associated with a tendency to
think negatively about the self (for in-
stance, “I never seem to achieve any-
thing I set out to do”), the world (for
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Perfectionism and
Depression
Recall from chapter 1 the three types
of perfectionism: self-oriented perfec-
tionism (a tendency to set unreason-
ably high standards for one’s own
behavior), other-oriented perfection-
ism (a tendency to demand that oth-
ers meet your unrealistically high
standards), and socially prescribed
perfectionism (the belief that others
have impossible standards, and that
you must meet these standards in or-
der to win their approval).
Researchers have examined the
relationship between these types of
perfectionism and the symptoms of
depression and have reported a num-
ber of interesting findings:
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• Self-oriented perfectionism
increases the risk that a de-
pressed individual will con-
tinue to feel depressed a
year later if the person is
under high levels of stress
related to his or her work or
school, but not if stress is
more focused on his or her
relationships (Enns and
Cox 2005).
• Perfectionism appears to be
related to other specific
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Treatments for
Depression that Are
Supported by Research
Depression can be effectively treated
using a number of approaches. In this
section, we discuss three of these, in-
cluding cognitive behavioral therapy,
interpersonal psychotherapy, and
medications.
Interpersonal Psychotherapy
for Depression (IPT)
Interpersonal psychotherapy for
depression (IPT) is one of the few
psychological treatments other than
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Antidepressant Medications
Below is a partial list of medica-
tions that have been shown to be use-
ful for treating clinical depression. As
you can see, the list is quite long.
These drugs are organized with re-
spect to their effects on particular
neurotransmitter (brain chemical)
systems that are believed to be in-
volved in depression, such as the ones
that involve serotonin, norepineph-
rine, and dopamine. We have in-
cluded both the generic name as well
as the brand name (in parentheses)
for each medication.
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Electroconvulsive Therapy
Electroconvulsive therapy (ECT)
is often administered after all other
treatments for depression have been
attempted and failed, unless the per-
son is very seriously ill, in which case
it may be recommended as an initial
treatment. ECT is still very controver-
sial and is often discussed in a negat-
ive light by the media. Today, ECT is
very different than the way it has
been portrayed in movies such as One
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How to Change
Perfectionistic Thinking
and Behavior in
Depression
For a detailed review of all the
strategies for overcoming perfection-
ism, see chapters 7 through 9. In this
section, we will highlight some of the
techniques that may be helpful for
you if you suffer from depressed
mood or if you tend to feel down
when your expectations are not met.
Changing Perfectionistic
Thoughts that Contribute to
Depression
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Changing Perfectionistic
Behaviors that
Contribute to Depression
A number of strategies may be helpful
for dealing with perfectionistic beha-
viors that are associated with depres-
sion. Exposure exercises designed to
disprove perfectionistic beliefs can re-
duce the intensity of these beliefs. Ex-
posure can help reduce depression in
other ways as well. Often, when
people are feeling depressed, they
tend to become socially withdrawn
and uninterested in their usual hob-
bies and activities. Therefore, they be-
gin to avoid doing things because they
believe that they are unlikely to enjoy
themselves. The net result of the
avoidance, however, is to decrease the
person’s enjoyment of life, thereby
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Perfectionism and
Anger
Like sadness and fear, anger is a uni-
versal emotion that is experienced by
everyone. Despite the fact that all
people feel anger from time to time,
most people don’t enjoy feeling angry,
and they may even feel embarrassed
about expressing anger in front of
others. The experience of anger is of-
ten associated with other feelings,
such as irritation, disappointment,
rage, or a feeling of hatred and dislike
toward another person, a situation, or
even yourself.
When feeling angry, you may also
experience a desire to be aggressive
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Restraint
Restraint involves some force
blocking your desired actions in a
particular situation. Restraint can be
physical or psychological in nature.
Physical restraint involves actually
holding a person down in order to
prevent him or her from doing
something or going somewhere. Stud-
ies show that even infants as young as
four months old respond with anger
when their arms are restrained
(Sternberg and Campos 1990). Psy-
chological restraint involves being
prevented from doing something by
some social or psychological force
(for example, having to follow
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Interruption of Goal-Oriented
Behavior
Interruption of goal-oriented be-
havior is very similar to restraint, in
that a person is prevented from
reaching a particular goal. An ex-
ample is feeling angry when you are
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Aversive Stimulation
Aversive stimulation involves be-
ing exposed to an unpleasant stimu-
lus, such as extreme cold or heat, in-
tense pain, a loud noise, a nasty odor,
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When Is Anger a
Problem?
Chronic problems with anger can
contribute to high blood pressure,
heart disease, excess stomach acid,
and other physical problems.
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The Development of
Anger
The experience and expression of an-
ger is mediated by a complex interac-
tion among various biological and
psychological factors. As we men-
tioned earlier, there is evidence that
the capacity to express anger is
present from infancy. In addition,
many animals are capable of express-
ing anger, often in ways that are very
similar to the expression of anger in
humans. From a biological perspect-
ive, the limbic system (including the
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Changing Perfectionistic
Thoughts and Behaviors
that Contribute to Anger
Chapters 7, 8, and 9 contain many
different strategies that are useful for
combating the thoughts and behavi-
ors that are associated with perfec-
tionism, including those that contrib-
ute to anger. You may wish to review
these chapters. The remaining sec-
tions of this chapter highlight a num-
ber of strategies that are especially
helpful for dealing with anger.
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Perfectionism and
Social Anxiety
The Nature of Social
Anxiety
If you’ve ever felt uncomfortable in
the presence of another person or
nervous about making a negative im-
pression on other people, you’ve ex-
perienced social anxiety. Most people
experience anxiety or fear in certain
social situations, at least some of the
time. Perhaps you have felt uneasy in
a situation where you were the center
of attention (for example, getting
married, acting in a play, or giving a
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• Participating in meetings at
work, answering questions
in class, and so on
SOCIAL-INTERACTION SITUATIONS
THAT SOMETIMES TRIGGER
ANXIETY
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• Being assertive
• Initiating casual
conversations
• Maintaining casual
conversations
Biological Factors
Twin studies that have attempted
to separate out the effects of learning
and genetics have yielded inconsist-
ent results, with some studies show-
ing that genetics plays a moderate
role in the development of social
anxiety disorder and other studies
finding a relatively small genetic con-
tribution. Nevertheless, two personal-
ity traits that are associated with so-
cial anxiety have been shown to be
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Psychological Factors
Although a person’s biology plays
a role in the development and main-
tenance of social anxiety, psycholo-
gical factors are also very important.
A psychologist by the name of S.
Rachman (1976) identified three dif-
ferent pathways to developing fear:
traumatic conditioning, which in-
volves experiencing some negative
event that triggers the fear (for ex-
ample, being teased after a class
presentation may induce a fear of
public speaking); observational
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• People find me
unattractive.
Changing Perfectionistic
Thoughts and Behaviors
in Social Anxiety
In this section, we discuss strategies
for challenging anxiety-provoking
thoughts and changing anxiety beha-
viors associated with social anxiety.
For a more detailed discussion of
strategies for overcoming social
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Challenging Perfectionistic
Thoughts
Rather than assuming that your
perfectionistic thoughts are true, it is
important to treat your beliefs as pos-
sibilities or guesses. Unless you are
able to accept the possibility that your
standards for performance are too
high, it will be difficult to shift your
expectations to be more realistic.
Chapter 7 describes methods of chan-
ging your perfectionistic thoughts.
Several of these strategies are likely to
be helpful for dealing with your anxi-
ety in social situations, including ex-
amining the evidence supporting your
thoughts, changing perspectives,
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Changing Perfectionistic
Behaviors
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Perfectionism and
Worry
Everyone worries from time to time,
particularly about events over which
they have little control. We all endure
daily stresses that affect our jobs,
school performance, relationships,
and other areas of our lives. In these
circumstances, it’s common to worry
about possible negative outcomes.
Just like sadness, anger, and other
emotional states, worry is a normal
part of life. However, worry can be-
come a problem when it interferes
with functioning (for example, mak-
ing it difficult to concentrate or
sleep), causes a lot of distress, or
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What Is Worry?
Worry involves running over some
possible future event in your mind
over and over again. Worry is a natur-
al response to feeling anxiety, appre-
hension, foreboding, or uneasiness.
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Generalized Anxiety
Disorder
Although most people are able to put
their worries aside when necessary,
some people have difficulty turning
their worries off. In a condition called
generalized anxiety disorder (GAD),
worry is experienced as difficult to
control, and it occurs at an intensity
and frequency that leads to signific-
ant interference in people’s lives.
Among people with GAD, worry is ex-
cessive, unrealistic, or out of propor-
tion to the actual threat. In addition,
the worry is present most days and
lasts for an extended period of time.
In fact, many people with GAD report
that their worry has been a problem
for as long as they can remember.
Along with the worry, people with
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Relaxation Training
Chronic worry can be lessened by
learning to relax. Several relaxation
methods are available. Progressive
muscle relaxation involves learning
to relax the muscles of the body to de-
crease feelings of tension, stress, and
anxiety. A second method, known as
imagery, involves learning to imagine
particular scenes that are soothing.
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Challenging Anxiety-Provoking
Thoughts
One way of combating anxiety is
to challenge the thoughts, beliefs, and
predictions that contribute to your
anxiety. Chapter 7 provides a detailed
description of these strategies, and in
this section we describe how to apply
these strategies to GAD and excessive
worry.
ANXIETY-PROVOKING THOUGHTS
• I am going to fail the exam.
SHIFTING PERSPECTIVES
It is often easier to solve another
person’s worries than your own.
Therefore, a helpful strategy for deal-
ing with your own worries is to ima-
gine that you are giving suggestions
to a close friend or relative who has
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HYPOTHESIS TESTING
If you tend to make unrealistic
predictions about negative things that
might happen, testing the validity of
your predictions using mini-experi-
ments can be a helpful way of challen-
ging your anxious thoughts. Before
conducting the experiment, make one
or more explicit predictions regarding
the outcome. Then, conduct the
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Problem-Solving Training
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Perfectionism and
Obsessive-Compulsive
Behavior
There are two psychological problems
that include obsessive-compulsive be-
havior as a core feature. The first is
obsessive-compulsive disorder
(OCD), which is an anxiety disorder
associated with persistent disturbing
thoughts (obsessions) and repetitive
behaviors aimed at decreasing the
discomfort caused by these thoughts
(compulsions). Many people dia-
gnosed with OCD have perfectionistic
standards for certain activities. The
second problem, called obsessive-
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Obsessive-Compulsive
Disorder
Obsessions and compulsions, the core
features of OCD, may not be what you
think they are. In this section, we
start by defining each of these terms.
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What Is an Obsession?
To most people, the word “obses-
sion” refers to any persistent thought,
desire, or drive that controls a per-
son’s behavior. Die-hard fans of a
music group or celebrity are often
said to be obsessed with their idols. A
doctor who works around the clock to
discover a cure for a serious disease
may be considered obsessed with his
or her work. Even people who love a
particular food so much that they eat
little else are often said to be obsessed
with that food. In contrast to this
common use of the word “obsession,”
mental health professionals have a
very specific meaning for this term
that is somewhat different.
An obsession is defined as a recur-
rent and persistent thought, image, or
impulse that is experienced as
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What Is a Compulsion?
Compulsions are behaviors that
are repeated over and over again in
response to an obsession or according
to rigidly applied rules. Compulsions
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What Is OCD?
For most people in the general
population, intrusive thoughts and
compulsive behaviors don’t cause sig-
nificant problems. For example, you
may avoid certain situations because
of concerns about contamination (for
example, eating a candy that has
fallen on the floor, sitting on a public
toilet seat) or you may check your
locks and appliances a couple of
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Causes of OCD
As is the case for all psychological
problems, the causes of OCD are
complex and involve both biological
and psychological processes.
BIOLOGICAL FACTORS
Three different lines of research
support a role for biological factors in
the cause and maintenance of OCD.
First, there is indirect evidence of
altered functioning in the brain neur-
otransmitter called serotonin. For ex-
ample, medications that increase
levels of serotonin in the brain appear
to be effective for many people who
suffer from OCD, whereas most med-
ications that affect other brain
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PSYCHOLOGICAL FACTORS
A person’s learning experiences
and beliefs also influence the onset
and course of OCD. From a cognitive
perspective, OCD is not so much a
problem with obsessions as it is with
people’s interpretation of their obses-
sions. Remember that most people
experience thoughts that are obses-
sional in nature from time to time.
The difference between people who
experience the occasional obsessional
thought without being bothered by it
and those who become very
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Treatment of OCD
Two general treatment ap-
proaches have been shown in con-
trolled studies to be effective for help-
ing people who suffer from OCD:
medications and cognitive behavioral
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Obsessive-Compulsive
Personality Disorder
The second type of problem discussed
in this chapter is obsessive-compuls-
ive personality disorder, or OCPD.
This problem shares a number of fea-
tures with OCD and can occur in
people with OCD. However, OCPD
and OCD are viewed as different
conditions.
What is OCPD?
The hallmark of OCPD is an ex-
cessive concern with order, organiza-
tion, rules, lists, and trivial details.
People with OCPD are often perfec-
tionistic to the point of not getting
anything done. For example, they
may spend so much time making lists
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Research on OCPD
Compared to OCD, very little re-
search has been conducted with
people suffering from OCPD. There-
fore, we know very little about the
causes of this problem and almost no
controlled studies have tested the ef-
fects of specific treatments for OCPD.
In fact, we do not even have reliable
data on the prevalence of this dis-
order. Despite the lack of adequate
research, it is likely that both biolo-
gical and psychological factors con-
tribute to OCPD. The limited literat-
ure available on treatment suggests
that the cognitive and behavioral
strategies discussed in chapters 7 and
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Overcoming
Perfectionism Associated
with Obsessive-
Compulsive Behavior
Strategies for dealing with obsessive-
compulsive behavior include re-
sponse prevention and exposure, each
of which is discussed in this section.
Response Prevention
As we mentioned earlier, exposure
to feared situations combined with
prevention of compulsive rituals is
the key to overcoming obsessions and
compulsions. This approach is likely
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obsession—or performing
the rituals—that this proves
that the ritual really doesn’t
help. By focusing on your
successes when you’re not
performing the rituals, you
will be better able to see
that your desire to perform
the ritual is driven by anxi-
ety rather than by genuine
necessity.
Exposure Exercises
After you have successfully res-
isted performing your compulsive
rituals for a few days, the next step is
to begin exposure to situations that
you find anxiety provoking or uncom-
fortable. Exposure may be conducted
gradually. That is, you can begin with
easier situations and work your way
up to more challenging situations.
Chapter 8 is worth reviewing be-
cause it discusses in detail exactly
how to conduct your exposure prac-
tices. However, the main principles to
keep in mind include: continue your
exposure practice session until your
anxiety or discomfort has decreased
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Using Cognitive
Strategies to Change
Obsessional Beliefs
In chapter 7, we described a number
of techniques that are useful for chan-
ging perfectionistic thoughts. The
techniques that are most likely to be
effective for changing thoughts that
are associated with OCD and OCPD
include: evaluating the evidence for
your beliefs, learning to compromise,
taking another person’s perspective,
hypothesis testing, looking at the big
picture, using coping statements, and
learning to tolerate uncertainty (see
chapter 7 for detailed descriptions).
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dinner. On weekends, I
spend up to six hours a day
cleaning. Each day, I try to
wash the floors, vacuum my
carpets, dust the entire
apartment, and clean inside
and under the stove and
fridge. On weekends, I do
bigger jobs like cleaning the
windows and cleaning out
the fireplace.
Therapist: Do your friends spend as
much time cleaning as you
do?
Meg: No. In fact, when I visit friends
there are often dishes in the
sink and sometimes the
floors are quite dirty.
Therapist: What do you think of
friends who have homes that
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Perfectionism,
Dieting, and Body
Image
Dieting and Body Image
Concerns in Western
Culture
Anyone influenced by Western cul-
ture is likely aware that they live in a
society that is preoccupied with ap-
pearance. Thin is in, and people go to
great lengths to attain the thin beauty
ideal. This culture equates thinness
with beauty, and furthermore, associ-
ates thinness with all sorts of positive
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Perfectionistic Thoughts
Related to Eating and
Weight
Researchers have consistently shown
that a person’s beliefs about dieting
and weight have an enormous impact
on eating-related problems, including
tendencies to be underweight; engage
in binge eating; or engage in various
purging behaviors such as self-in-
duced vomiting, laxative abuse, and
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• Poor complexion
Perfectionistic Behaviors
that Contribute to
Body-Image Problems
Almost everyone likes to look their
best. Because it feels good to be com-
plimented on one’s physical appear-
ance, most people try to look good.
However, people who are overly con-
cerned about their physical appear-
ance tend to rely too often on
strategies for improving or masking
perceived physical flaws. In addition,
they tend to engage in behaviors that
maintain their unrealistic standards
by preventing them from disproving
their perfectionistic beliefs. Chapter 4
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• Cosmetic surgery
Psychological Problems
Associated with a
Distorted Body Image
A number of psychological disorders
are associated with distorted attitudes
and perceptions regarding body
shape and physical appearance. These
include the eating disorders anorexia
nervosa and bulimia nervosa, as well
as body dysmorphic disorder, which
is a condition associated with body-
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Anorexia Nervosa
Anorexia nervosa is diagnosed
when a person refuses to maintain a
weight that is at least 85 percent of
that expected for the individual’s
height and age (American Psychiatric
Association 2000). In addition,
people with this condition have an in-
tense fear of becoming fat, even
though they are actually underweight.
Individuals with anorexia nervosa
also have distorted beliefs regarding
their body shape, including denial
that they are underweight or a tend-
ency for their self-esteem to be almost
entirely tied to their weight. To be
diagnosed with this disorder, women
must have stopped menstruating for
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TREATMENT OF ANOREXIA
NERVOSA
Although findings from treatment
studies have been mixed, most ex-
perts believe that medications are rel-
atively ineffective for treating anorex-
ia nervosa. Instead, nonmedical treat-
ments are typically used (Wilson and
Fairburn 2007). The first stage of
treatment involves helping the person
to gain weight. If the person is
severely underweight, this stage may
occur on an inpatient basis so that
possible medical complications can
be managed.
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Bulimia Nervosa
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Overcoming
Perfectionistic Thinking
and Behavior in
Body-Image Problems
Chapters 7 through 9 describe a num-
ber of strategies that are helpful for
changing perfectionistic beliefs and
behaviors. In this section, we high-
light several of these techniques, as
well as a few other ideas for dealing
with perfectionism in the context of
problems related to being overly con-
cerned with your physical
appearance.
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Education
Education is an important tool for
combating distorted beliefs about di-
eting, body image, and related topics.
Unfortunately, there is a lot of bad in-
formation out there. The media con-
stantly presents a distorted view of
the ideal body shape. Magazines, tele-
vision, and movies often suggest new
diet and exercise plans, show off un-
derweight models and celebrities, and
generally send out the message that it
is extremely important to be thin and
attractive. To combat this potentially
harmful message, it’s important that
you check out the facts regarding diet,
exercise, weight, and health.
For example, there is growing
evidence that, to a large extent, body
weight is determined by genetics.
With healthy eating and moderate
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Challenging Perfectionistic
Beliefs
Rather than assuming that your
perfectionistic beliefs are true, it is
important to test the validity of your
beliefs by examining the evidence.
The following therapy vignette
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Changing Social-Comparison
Habits
Perfectionism often leads to the
habit of comparing oneself to other
people who are seen as better in par-
ticular dimensions. For example, if
you are overly concerned about being
overweight (even though you are at a
healthy weight), you may tend to
compare yourself to people who are
underweight. Or, you may compare
your current weight to your weight in
the past, at a time when you were
strictly dieting and therefore likely
below your natural, healthy weight.
These types of comparisons serve to
maintain your perfectionistic
thoughts. If you are overly concerned
about your weight, you need only
consider the body type you may have
inherited from your family (collect in-
formation about your parents and
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What Next?
Chapter 16
Preventing
Perfectionism
from Returning
Evaluating Your
Progress
At the end of chapter 5, we mentioned
that the process of assessing your per-
fectionism should be an ongoing one.
Now that you have worked through
this book, the next step is to evaluate
the current status of your perfection-
ism. One way of doing this is to re-
turn to the issues raised in the
chapter on assessment (chapter 5)
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STRESS
Stress puts people at risk for
whatever problems they are prone to
experience. For example, people who
tend to get headaches are more likely
to get them during or following peri-
ods of stress. People who tend to ex-
perience depression, panic attacks, or
drinking too much alcohol often
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Conclusion
We hope this book introduced you to
new skills that will help you to deal
more effectively with your perfection-
ism and with the situations where it
tends to get triggered. The more you
practice these skills, the more im-
provement you will see. Best of luck
as you continue to let go of the rules
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Self-Help Readings
Burns, D. D. 1980. The perfection-
ist’s script for self-defeat. Psychology
Today November, 34–57.
Basco, M. R. 1999. Never Good
Enough: How to Use Perfectionism
to Your Advantage without Letting It
Ruin Your Life. New York:
Touchstone.
Video Resources
Antony, M. M. 2008. Cognitive
Behavioral Therapy for Perfection-
ism Over Time. DVD. Washington,
DC: American Psychological
Association.
Cognitive Behavioral
Therapy
Self-Help Readings
Burns, D. D. 1999. The Feeling
Good Handbook, Rev. ed. New York:
Plume.
Butler, G. and T. Hope. 2007.
Managing Your Mind: The Mental
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Communication Training
Self-Help Readings
Christensen, A. & N. S. Jacobson.
2000. Reconcilable Differences. New
York: Guilford Press.
Davis, M., K. Paleg and P. Fan-
ning. 2004. The Messages Work-
book: Powerful Strategies for
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Procrastination
Self-Help Readings
Burka, J. B. and L. M. Yuen. 1983.
Procrastination: Why You Do It and
What to Do About It. Reading, MA:
Addison-Wesley.
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Depression
Self-Help Readings
Addis, M. E. and C. R. Martell.
2004. Overcoming Depression One
Step at a Time: The New Behavioral
Activation Approach to Getting Your
Life Back. Oakland, CA: New
Harbinger Publications.
Bieling, P. J. and M. M. Antony.
2003. Ending the Depression Cycle:
A Step-by-Step Guide for Preventing
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Anger
Self-Help Readings
Eifert, G. H., M. McKay, and J. P.
Forsyth. 2005. ACT on Life, Not on
Anger: The New Acceptance and
Commitment Therapy Guide for
Problem Anger. Oakland, CA: New
Harbinger Publications.
McKay, M., P. D. Rogers, and J.
McKay. 2003. When Anger Hurts:
Quieting the Storm Within, 2nd ed.
Oakland, CA: New Harbinger
Publications.
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Self-Help Readings
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Self-Help Readings
Antony, M. M. 2004. 10 Simple
Solutions to Shyness: How to Over-
come Shyness, Social Anxiety, and
Fear of Public Speaking. Oakland,
CA: New Harbinger Publications.
Antony, M. M. and R. P. Swinson.
2008. The Shyness and Social Anxi-
ety Workbook: Proven, Step-by-Step
Techniques for Overcoming Your
Fear. 2nd ed. Oakland, CA: New
Harbinger Publications.
Hope, D. A., R. G. Heimberg, H.
R. Juster, and C. L. Turk. 2000.
Managing Social Anxiety. New York:
Oxford University Press.
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Video Resources
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Obsessive-Compulsive
Disorder
Self-Help Readings
Foa, E. B. and R. Wilson. 2001.
Stop Obsessing! How to Overcome
Your Obsessions and Compulsions,
rev ed. New York: Bantam Books.
Grayson, J. 2004. Freedom from
Obsessive-Compulsive Disorder: A
Personalized Recovery Program for
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Video Resources
Antony, M. M. 2007. Obsessive-
Compulsive Behavior. DVD. Wash-
ington, DC: American Psychological
Association.
Wilson, R. R. 2005. Obsessive-
Compulsive Disorder. DVD.
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Self-Help Readings
Cash. T. F. 2008. The Body Image
Workbook: An 8-Step Program for
Learning to Like Your Looks. 2nd ed.
Oakland, CA: New Harbinger
Publications.
Claiborn, J. and C. Pedrick. 2002.
The BDD Workbook: Overcome Body
Dysmorphic Disorder and End Body
Image Obsessions. Oakland, CA: New
Harbinger Publications.
Heffner, M. and G. H. Eifert.
2004. The Anorexia Workbook: How
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