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Effectively Treating Pathological Self-Criticism in Depressed & Dysthymic Clients
Effectively Treating Pathological Self-Criticism in Depressed and Dysthymic Clients

Section 21
Perfectionism: The Stuff of Which Self-Criticism is Made

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Perfectionism in Adults
Historically, mental health professionals working with adults have conceptualized perfectionism as a unidimensional and negative or maladaptive character trait (e.g., Blatt, 1995; Burns, 1980; Hollender, 1965). In thinking about clients who described themselves or were described by others as perfectionistic, counselors have usually assumed that perfectionism was at least part (and maybe the bulk) of the problem. Because of this negative, unidimensional perception, most interventions with clients who "admitted" being perfectionistic have traditionally revolved around "curing" the client of his or her perfectionism (Burns, 1980). Research based on this way of viewing perfectionism (Blatt, 1995; Flett, Hewitt, Blankstein, & O'Brien, 1991; Hewitt & Flett, 1990) has supported the premise that perfectionism has a negative impact on perfectionists. This approach seems to ignore the possibility that "being a perfectionist could well be a good thing if it means having high standards, for high standards ultimately lead to high achievement" (Winner, 1996, p. 215).

Several recent empirical investigations into perfectionism in adults have lent credence to this more positive interpretation of perfectionism. This research has supported the concept of a multidimensional model which allows for the idea that some aspects of perfectionism can prove to be helpful, rather than harmful, to clients.

Slaney, Mobley, Trippi, Ashby, and Johnson (1996) developed a measure designed to assess both the positive and negative aspects of perfectionism. They contended that, while experiencing extreme distress when one's performance did not match one's standards might be destructive and unhealthy, the holding of high personal standards and a desire for order were not necessarily negative. The results from a study by Rice, Ashby, and Slaney (1997) supported the distinction between adaptive and maladaptive dimensions of perfectionism. The authors of this study found that one duster of perfectionism dimensions (including high personal standards and orderliness) were related to higher self-esteem and lower levels of depression. However, a second cluster of perfectionism dimensions (including concern over mistakes and self-criticism) were related to increased depression and decreased self-esteem. Using this instrument, several authors have found differences between adaptive and maladaptive perfectionists on levels of inferiority (Ashby & Kottman, 1996); levels of career decision-making self-efficacy (Ashby, Bieschke, & Slaney, 1997); levels of general self-efficacy and social self-efficacy (Ashby, LoCicero, Kottman, Schoen, & Honsell, 1998); and levels of locus of control by powerful others (Periassamy, Ashby, & LoCicero, 1999).

Perfectionism in Children and Adolescents
There has been little empirical research in the psychological literature exploring perfectionism in children and adolescents. Many of the articles in this area have focused on perfectionism as a difficulty for gifted children (Kline & Short, 1991a, 1991b; LoCicero, Ashby, & Periasamy, in press; Parker, 1997; Roberts & Lovett, 1994) or for children with problems such as eating and mood disorders (Steiger, Leung, Puentes-Newman, & Gottheil, 1992), negative cognitive beliefs (Robins & Hinkley, 1989), and depression (Leon, Kendall, & Garber, 1980).

In most of the quantitative studies conducted with gifted subjects, the researchers used a negative, unidimensional definition of perfectionism (e.g., Kline & Short, 1991a, 1991b). With this definition of perfectionism, Kline and Short (1991b) found that gifted girls in grades 9 through 12 reported having significantly higher perfectionism than peers who were less gifted but found no difference on perfectionism between gifted adolescent boys and peers who were less gifted (Kline & Short, 1991a). Using Hewitt and Flett's (1991) multidimensional model of perfectionism, Roberts and Lovett (1994) reported that gifted children demonstrated higher levels of self-oriented perfectionism relative to their nongifted peers. Measuring with Multidimensional Perfectionism Scale, Parker (1997) found that the majority of gifted children in his sample were likely to fit into the healthy perfectionistic type (41.7%), with 25.5% falling into the dysfunctional perfectionistic type, and 32.8% falling into the nonperfectionistic type. In a study by LoCicero et al. (in press), the researchers used the Almost Perfect Scale to discover that gifted middle school children had higher levels of adaptive perfectionism but lower levels of maladaptive perfectionism than a comparison group of nongifted students.

In other empirical studies of perfectionism in children and adolescents, the researchers used a unidimensional, negative characterization of perfectionistic behavior and found that children and adolescents with higher levels of pathology tend to fit this description of perfectionism. Steiger et al. (1992) examined perfectionism as one aspect of the psycho-social profile of adolescent girls with eating and mood disorders and found that girls who manifest eating and mood symptoms have elevated levels of perfectionism as compared with girls who do not manifest these symptoms. Robins and Hinkley (1989) and Leon et al. (1980) found that depression in children and adolescents was related to high levels of perfectionism. None of these researchers used an instrument based on a multidimensional model which may have predetermined their confirmation that perfectionism tends to be maladaptive.

Empirical studies using a multidimensional measure of perfectionists are rare. LoCicero et al. (in press) provided support for making a distinction among adaptive perfectionists, maladaptive perfectionists, and nonperfectionists at the middle school level in the area of basic lifestyle approaches. They found that adaptive perfectionists had significantly lower propensity toward being willing to shape their behavior to fit perceived social-environmental cues than maladaptive perfectionists and nonperfectionists. They also found that adaptive perfectionists were likely to manifest significantly a higher developed sense of belonging and the desire to cooperate, level of comfort with receiving recognition and/or praise for their accomplishments, and a need to strive to do things well than nonperfectionists.

Adaptive and Maladaptive Perfectionism
In order to help teachers, students, and parents recognize these two distinct "faces" of perfectionism, school counselors must consider how children and adolescents can express the adaptive and the maladaptive characteristics of perfectionism in the school setting. The differences between adaptive and maladaptive perfectionists are typified by the ways they handle their high standards and need for order Adaptive perfectionists use these traits constructively, as a spur to better performance. They are not overly anxious about their high standards and do not feel discouraged when they do not attain their goals--they simply vow to work harder and smarter Maladaptive perfectionists, on the other hand, are extremely anxious about meeting their own elevated expectations and routinely feel discouraged when they are not perfect.
The school counselor must also remember that both of these dimensions occur on a continuum from mild to severe. Even the potentially adaptive behaviors can become negative when taken to extremes. Conversely, the potentially maladaptive behaviors such as concern over mistakes and self-criticism can be helpful to children when they are manifested in moderation and used constructively.

Adaptive Manifestations
In schools, children and adolescents can manifest high standards and a need for order in several different adaptive ways. Adaptively perfectionistic students will usually express high personal standards in academic, athletic, and interpersonal endeavors. They will expect themselves to perform to the best of their ability and may express concern or disappointment when they do not feel that they have fulfilled their own potential or achieved their personal goals. Perfectionistic students quite frequently also have high expectations for others--counting on their peers and their teachers to live up to the standards that they set for them. As long as high personal standards do not become unreasonable or unrealistic, and setbacks or failures to meet standards do not result in extremely harsh self-criticism, these factors will not cause a problem for students; they will simply provide strong motivation.

The same is true of the other positive attribute in the adaptive cluster of perfectionistic traits--need for order. Adaptively perfectionistic students will manifest this behavior by turning in neat and well-organized assignments, maintaining tidy work areas and lockers, and suggesting that other students and teachers work to make classrooms and other areas in the school building organized and orderly places to be. Organization of materials, strong study habits, dearly defined schedules, and so forth will be important to students who manifest a high need for order They will expect others to value structure and organization as well. Again, it is important to monitor the intensity and pervasiveness of perfectionistic students' need for order so that it does not interfere with their healthy functioning, but rather serves as a positive force in their lives.

Maladaptive Manifestations
In schools, extreme concern over mistakes and self-criticism can be debilitating to students. Concern over mistakes can prevent students from trying to successfully complete written assignments. Rather than risk a less than perfect paper, maladaptively perfectionistic students simply may not do their work. They might rather have a zero in the grade book than have a chance of any score less than 100%. Because these students are unwilling to make mistakes, they frequently refuse to participate in class discussions, based on their fear that they could volunteer an incorrect answer and be embarrassed. When maladjusted perfectionists turn in assignments and participate in class discussion with less than perfect results, they may react with feelings of extreme sadness, disappointment, and/or anger at themselves, at their peers, or at teachers. These students have exaggerated reactions to mistakes. One or two errors seem like a complete failure to them. They tend to demonstrate an all-or-nothing attitude toward the accuracy of their school work and their participation in class discussions, sports, and other extracurricular experiences.

Sometimes these children and adolescents blame others for any self-perceived mistake or failure, suggesting that it is someone else's fault that their performance did not live up to their standards. Usually, however, maladaptive perfectionists are extremely self-critical. They have a tendency to focus exclusively on their negative qualities and on anything that they perceive to be less than perfect about themselves (e.g., their performance at school, athletic functions, and/or extracurricular activities; their appearance; their social interactions; and so forth). Because they are so difficult to satisfy and so quick to criticize themselves, students manifesting maladaptively perfectionistic traits may fall prey to such maladies as eating disorders, depression, and suicidal ideation.

- Kottman, Terry; Perfectionistic Children and Adolescents: Implications for School Counselors; Professional School Counseling; Feb 2000; Vol. 3; Issue 3.

Personal Reflection Exercise #7
The preceding section contained information regarding how perfectionism relates to self-criticism.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 21
What are three of the reactions that a maladjusted perfectionist may exhibit after a less-than-perfect classroom participation? Record the letter of the correct answer the CEU Test.

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