-Joseph Sacks, LCSW
A perfectionist is someone who deep down inside feels terrible about himself and tries to redeem himself from that poor self-image by achieving a perfect performance or by accomplishing truly amazing things. He feels that if he can finally get things just right, then and only then will he be a worthwhile person, but if he achieves any less than perfect he remains with feelings of being a failure. However in considering how to treat perfectionism in young people, we must remember that this goal is an illusion that never succeeds, since even the most perfect performance cannot cure low self-esteem. No matter how great his achievement, he notices that it does not relieve his poor feelings of self-worth, and concludes that only higher levels of perfection must be achieved to redeem himself. This mechanism involves severe self-imposed pressure and self-criticism and can generate significant anxiety since because consistent perfection is practically impossible, he is terribly anxious over his likely perceived failure. It can cause depression as he feels helpless and hopeless to ever achieve perfection and redeem himself from his low self-esteem, and he gives up and falls into a depression. It can cause obsessive-compulsive disorder as he drives himself endlessly to get every detail perfect. It can even generate back pain, migraines and a whole host of psychosomatic illnesses as his mind creates these physical illnesses to distract him from overwhelming feelings of worthlessness.
How does a young person get this way?
To answer this question we have to go back to the most important thing in any person’s life, his early relationship with his parents. A perfectionist is usually someone who was born with a sensitive temperament and raised by loving, well-intentioned parents who unfortunately made some common errors such as being overcritical, showing lack of approval or showing love only conditionally. When the child does something wrong many parents reason that they’re helping out their child by calling attention to their errors so that they will improve and correct themselves, but unfortunately criticism, even so-called constructive criticism if administered on a regular basis is devastating to a child’s self-esteem. He feels that he just can’t get things right and that he is defective, and he forms a plan in order to rescue himself from these unpleasant feelings. He resolves to accomplish amazing things, to achieve near perfection and then and only then will he be a beyond the reach of the criticism of his parents.
In addition, if the parents display love and approval of the child only when he performs well he learns to think, “My value depends on my performance. I must have a superior performance otherwise I am worthless.”
Marital conflict or abandonment partially by one parent can also generate the condition, as the child thinks, “If I could just be perfect, mommy and daddy wouldn’t fight or break up. If I could just do amazing things he would see my value, pay attention to me and love me.”
Therefore if the patient is still young we need to educate the parents about providing an extremely non-critical, approving and accepting attitude towards their child.
How do we treat perfectionism in young people?
In therapy we will have a young person understand the whole maladaptive thought process how it got that way, how it is futile and how perfect performance will never restore his self-worth. Rather he needs to develop the habit of shooting for decent performance, for moderate goals, that less than perfect is also good. This takes considerable time and review as the habit of striving towards perfection is extremely strong. However the patient will begin to experience the profound beauty, joy and satisfaction of a mundane, average accomplishment. Yes one of the greatest pillars of mental health for everyone is appreciating the value of moderate, average, halfway decent performance. Since by definition most of what people accomplish in life falls in that range we need to learn to embrace it and celebrate it. Such appreciation will indeed create true self-esteem as the person will see true value in the many ordinary things he does. Furthermore the patient must avoid self-criticism at all costs! Developing an attitude of self-acceptance is accomplished by understanding that considering the difficulties he went through in childhood, he is actually doing fantastic! In addition in therapy the patient needs to gain a conscious awareness of his authentic feelings, his emotional life. This further create self-esteem as the person thinks, “I perceive my feelings, thoughts, needs, desires and values as real and worthy.” Furthermore the patient needs to mourn and grieve the unfortunate events in his childhood that led to his condition. This way the drive towards perfection is reduced and replaced with moderate, reasonable, healthy goals and the accompanying anxiety, depression and mental health issues also subside.
Never underestimate the power of this great work. In months it can bring tremendous relief.