Psychotherapy Articles

Psychotherapy Articles

We used to think things would only get easier after graduate school. To even be considered for doctoral study required perfection: astronomical GRE scores, great field experiences, and evidence of research potential. The pace only picked up during graduate training. We now needed to earn top grades in each and every domain of psychology, become self-aware of our blindspots and insecurities, secure great externships and practica with sufficient client contact hours, slog through the dissertation process, and still be pleasant and brilliant and memorable enough to impress our professors and supervisors to write great references for us. All this was for the opportunity to maybe, possibly, please match for predoctoral internship! The demands of perfectionism were not shed with those heavy velvet robes at graduation.

Our doctoral degree entitled us to the responsibilities of finding a postdoc, sitting for the EPPP, and obtaining a license. Then we needed to maybe, possibly, please land a job or open a practice. As early career psychologists, working with clients and students brings new anxieties: Are we competent and expert enough to be helpful, are we following our training closely enough, and are they going to come back? We look enviously at our mid and later career psychology colleagues and imagine that once we reach their stage in the profession the need for perfection will cease.

However, as psychologists, early career or not, we have learned several things that help us understand the process of becoming a psychologist. First, past behavior is the best predictor of future behavior. Because we showed an earlier disposition toward perfectionism, it is most likely that our mid and later career will be tinged with this same perfectionistic style (and our relaxed-looking colleagues probably are still swimming upstream just like us). From our observation, psychology as a field seems to be populated with perfectionists.

The profession of psychology, in its training and its practice, has the tendency to select for perfectionists, to amplify existing perfectionist traits among its members, or to exert a chronic level of stress that exhorts its members toward perfectionism. One of us (KSM) teases our doctoral students when learning about personality disorders that most good psych graduate students will have Obsessive-Compulsive Personality Disorder. Perhaps we should be careful about reinforcing this pressure toward perfection, but regardless, perfection seems to be part of the profession.

Second, we know more about the trait and experience of perfectionism, not just from personal anecdote, but from the psychology literature. Perfectionism is not a unidimensional construct distinguishing psychologists from non-psychologists. Instead, the conceptualization of perfectionism has changed from being unidimensional to multidimensional (Burns, 1980; Hewitt & Flett, 1991), encompassing factors like the high standards we internalize for ourselves and others and the degree of functionality found in how we relate to those standards. One way of measuring the facets of perfectionism, including both its positive and negative attributes, is the Almost Perfect Scale-Revised (APS-R; Slaney et al., 1996).

In the APS-R, the Discrepancy subscale measures the perceived difference between the standards one has set for one’s own behavior and actual performance (Slaney & Ashby, 1996). The other two subscales are High Standards, which measures the standards one sets for performance, and Order, which measures the tendency to value a sense of order and organization. Based on the three subscales of the APS-R, three types of perfectionists have been classified: maladaptive perfectionists (high Discrepancy, Standards, and Order scores), adaptive perfectionists (high Standards and Order scores, but low Discrepancy scores), non-perfectionists (lower Standards and Order scores and moderate Discrepancy scores). Research consistently indicates that maladaptive perfectionists have lower self-esteem, more depressive symptoms, and more anxiety (Rice, Ashby, & Slaney, 1998; Suddarth & Slaney, 2001; Rice & Slaney, 2002) because these individuals do not feel as though they can meet their personal standards, which then become debilitating.

In contrast, adaptive perfectionists also espouse high standards, however, they are not self-defeated by their expectations. Instead their high standards are used as a motivational tool. A fourth type of other-oriented perfectionist has been documented, involving lower Standards but higher Discrepancy scores (Nakano, 2009; Wang, Slaney, & Rice, 2007; Wang, 2012), and research on the possible existence of this group is beginning. Other-oriented perfectionists may take on the expectations of their family and important social institutions (as opposed to generating their own high standards). These individuals, as with non-perfectionists, tend to exhibit more average levels of self-esteem and depressive symptoms. Clearly there are variations in the types of perfectionism experienced by psychologists.

Finally, how our perfectionism plays out within our identity as psychologists is perhaps moderated by our other multicultural identifications. Overall, Asian Americans tend to report higher scores on several negative dimensions of perfectionism when compared to Caucasian Americans and African Americans (Castro & Rice, 2003; Chang, 1998). African Americans might experience more types of certain perfectionism (e.g., expectations from family) than might Caucasian individuals, but not for all types of perfectionism (e.g., criticism from family; Castro & Rice, 2003). Maladaptive perfectionism in minority individuals may be related to earlier development on scales of racial identity (Elion et al., 2012). Other-oriented perfectionism (high Discrepancy but lower Standards) is not often found among Caucasian or African American samples (e.g., Elion et al., 2012; Grzegorek, Slaney, Franze, & Rice, 2004; Rice & Richardson, 2014; Wang, 2012) and may be exclusive to Asian individuals (for a discussion, see Wang, 2012; for an exception, see Wang, Puri, Slaney, Methikalam, & Chadha, 2012).

As an example, in Asian Indian culture an individual has an obligation to excel and live up to the standards of the family/community. Asian Indians are expected to bring honor and esteem to the family, through achievements at the cost of their own personal sacrifices and freedom (Durvasula & Mylvaganam, 1994; Sandhu, 1997). Thus, Asian Indians might feel more pressure to excel and strive for perfectionism because it is expected from the family. Interestingly, however, few gender differences have been observed in the experience and expression of perfectionism (e.g., Grzegorek et al., 2004). This may be due to a true similarity between men and women or that our instruments and methods are not well equipped to detect the standards on which men and women might differ. For instance, items are often describing high standards generically, but it may be that men hold more perfectionistic beliefs about agentic concerns (work, aging, competency) and women more about interpersonal concerns (relationship quality, appearance).

How might these cultural identities and values intersect with our career as psychologists and the demands of our field, especially at our emergence into our profession? We provide some vignettes here of times we have caught ourselves being perfectionistic with ourselves, our clients, and our students, and offer some comparisons of our experiences.

BM: As an early career professor I have high expectations for myself and my students’ experiences in the classrooms. I can spend days or sometimes more prepping for a lecture. For example, it takes a while thinking of interactive exercises, thought-provoking films, and discussion questions. Ultimately, as a new faculty member I want my students to leave my courses feeling energized and well-trained in the course material. If students don’t understand material, as evidenced by exams or papers, I wonder how I might have been unsuccessful as a professor. On the contrary, if students do grasp material I don’t delight in it and actually don’t think too much about it. Instead, I am always thinking about how I can better my teaching skills, and think of new and innovative ways to present the material.

KSM: One of my clients is a delightful middle-aged man with mild Intellectual Disability, and most of the work we do together is supportive therapy (learning affect management skills and relaxation techniques, testing the reality of certain thoughts, encouraging relationships, and planning enriching activities). Recently, he reported being distressed by panic attacks and anticipatory anxiety. Having some expertise in evidence-based treatments for panic, I quickly attempted to initiate one of the structured protocols I was familiar with. However, my progress in the treatment was stymied by his unique evaluation of the techniques we were using: The ones I thought most helpful he either did not wish to do or did not practice outside the session. I felt incredibly guilty for not being able to coax him into doing what I thought my training told me was best. However, he gained most out of asking me to write down statements that reassured him (something that I was reluctant to do because I assumed it promoted dependence and avoidance of panic feelings). Indeed, he asked me to photocopy one of the papers I had written for him because it had become tattered and faded from use.

BM: For the past several years, I have been serving as a dissertation chair for a student who has been a pleasure to work with mostly because she is self-motivated and has a strong work ethic. She has accomplished tasks with ease and has been successfully collecting data while applying for internship. Recently, she emailed to inform me that she received interviews from nearly all of the internship sites to which she had applied. Of course, I congratulated her and then immediately asked her about the dissertation! I reminded her that while obtaining these interviews is excellent news, she also needs to move along in the dissertation process. After I sent my response I wondered what was wrong with me, and why I could not relish in this exciting news with her? Instead, I had to remind her that there was more that was expected of her. In my mind I felt that there was still more for her to do.

In each of these examples, we see the high standards being unnecessarily applied to ourselves and others toward a frustrating effect. Clearly they are examples of the various ways maladaptive perfectionism can present itself. Interestingly, the context of with whom we were interacting did not matter—we both could easily come up with numerous examples in our emerging professional life. We chose these three to be brief and illustrative, however, there were no shortages between the two of us, suggesting perfectionism affected us equally regardless of gender. The quality of the episodes were slightly different: BM, identifying as a Indian American female, reported more shame and self-recrimination and a lack of the experience of individual pride, whereas KSM, identifying as a European American, reported more failed initiative and guilt.

What then might we do about this perfectionism that pervades our profession? First is self-awareness. Noticing that some of the stress in our professional (and personal!) lives is due to the standards we set for ourselves is important, especially given our personal experiences and cultural backgrounds. Even then, it is easy to get carried away with judging ourselves as the examples of perfectionism mount up, as a perfectionist is likely to do. We might display signs of maladaptive perfectionism in one area, but be more adaptive in other areas. Being mindful of these incidents, as well as the positive effect high standards might have for a person (some of us are adaptive perfectionists, after all), might give us compassion and psychological distance from these events.

BM did this in her example of working with a student and was able to correct herself and choose a new way of relating to her mentee. Finally, working with what works, that is, our own perfectionism, might be helpful. For instance, in selecting the perfect reading for a class, KSM will say that he will read only five articles and will select from those five. None of the articles will be perfect, in fact, their limitations are good for discussion and learning in class. Replacing rules with better rules might be a congruent method to help perfectionists. Our profession may in part shape us into perfectionists, but thankfully it also gives us the psychological knowledge and tools to be better and better perfectionists!

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Cite This Article

McCarthy, K. S., & Methikalam, B. (2015). The diversity of perfectionism and the early career psychologist. Psychotherapy Bulletin, 50(1), 37-40.


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