Several years ago, I had a therapist who called herself “a recovering perfectionist.” While I thought that was clever, it wasn’t really something that I personally wanted to strive for. Sure, perfectionism can be hugely problematic and maladaptive… but I think that on many levels, perfectionism is okay. In the “real world,” perfectionism has a positive connotation, but in treatment, it kind of gets a bad rap.
A recent article was published on “Psychological inflexibility and symptom expression in anorexia nervosa.” It makes a lot of interesting points on controlling the bodily experience, using verbal rules to deal with fears, maladaptive social scripts, etc, but what really interested me was the distinction between psychological inflexibility and perfectionism.
Definition of pyschological inflexibility (according to the journal article):
The inability to behave flexibly in the presence of difficult thoughts, feelings, and bodily sensations.
Definition of perfectionism (acording to wikipedia):
The unitary combination of a desire to be perfect, a fear of imperfection, and an emotional conviction that perfection (not “near-perfection”) is the only route to personal acceptance by others. The difference [between perfectionism and striving for excellence] is in the meaning given to mistakes. Those who strive, however intently, for excellence can simply take mistakes (imperfections) as inducements to further learning and work. Perfectionists take mistakes as signs of personal defects that make them less acceptable. Anxiety over potential failure is the reason perfectionism is felt as a burden.
I think this is a great distinction for several reasons:
- “psychological inflexibility” encompasses more than just perfectionistic tendencies
- the word “inflexibility” suggests something problematic
- perfectionism is not necessarily a bad thing
- perfectionism is a personality trait, which may not change even if someone does completely recover from their eating disorder
By examining psychological inflexibility rather than perfectionism, the study was able to separate perfectionistic thoughts from actions/consequences. Meaning, you can still have perfectionistic thoughts without reacting to them negatively. This lead to several great findings:
“Although the frequency of perfectionistic cognitions did not change, adolescents’ reported decreased distress in response to those thoughts. Importantly, decreased distress was associated with reductions in dietary restraint and lower global scores on a structured interview of eating disorder symptoms when baseline levels of symptoms were controlled. This is consistent with studies of adults with AN that have reported greated acceptance of negative thoughts and feelings about weight and shape corresponded with ED symptom improvement in the absence of any significant change in the content or frequency of the thoughts and feelings themselves.”
“Lower levels of psychological flexibility distinguish individuals with full syndrome AN from those who are weight restored and health controls, while the ability to engage flexibly with distressing throughts and feelings is associated with AN symptom remission across treatment. Perfectionism and related cognitions which have long been desribed as part of the phenomenology of AN, do not change in frequency but in impact as a result of successful intervention, suggesting how individuals with AN relate to these thoughts may be of prime importance.”
Maybe one of the goals of treatment, then, is not to eliminate perfectionistic tendencies, but to change your reactions to them. Distress tolerance. “It’s not perfect, but I can deal with that.” I don’t think it’s really the perfectionism that’s the problem, so much as the interpretation/internalization of what a mistake (or being out of control, or uncomfortable emotions, etc.) means.