Video summary
Dr. Paul Hewitt defines perfectionism not merely as a habit but as a deeply ingrained personality style rooted in an early sense of being fundamentally flawed, defective, or insufficient to belong. This psychological construct often originates from childhood experiences where basic needs for worth and acceptance were unmet due to caregiver non-attunement or absence. To navigate this painful internal reality, the individual develops an "elegant" but ultimately maladaptive solution: they attempt to repair their sense of self-worth by striving for flawlessness in tasks and activities. The core belief driving this behavior is that if one can appear perfect or conceal imperfections, they will finally be acceptable, loved, and worthy. Consequently, perfectionism functions as a desperate mechanism to solve the existential fear of not fitting into the world, rather than a genuine pursuit of excellence. A critical distinction Hewitt makes is between healthy striving for achievement and toxic perfectionism driven by self-repair needs. While high standards and ambition are adaptive traits that can lead to success in fields like sports or business, true pathological perfectionism arises when performance becomes entangled with identity; if one performs poorly, they feel inherently bad as a person rather than simply having had an off day. This leads to the paradox where achievement fails to relieve feelings of inadequacy because it reinforces the fantasy that only more success can fix the underlying defect. Conversely, failure confirms these negative beliefs about inefficiency and unacceptability. Hewitt illustrates this with examples of high-performing individuals who view their worth as contingent on their output, noting that even Olympic athletes or successful entrepreneurs often carry a hidden sense of being "awful" at their core if they cannot meet impossible standards. The internal experience of the perfectionist is described as abusive and harsh, characterized by a critical inner dialogue that treats oneself with cruelty reserved for others in society. This self-relational style involves constantly evaluating one's performance to avoid exposure, leading to paralysis where individuals feel compelled to act but are unable to move due to fear of imperfection. Furthermore, Hewitt explores the different facets of perfectionism: self-oriented (needing to be perfect), other-oriented (requiring others to be perfect), and socially prescribed (believing one must meet external demands). He notes overlaps with narcissism in the need for an image but distinguishes it by the underlying feeling of defectiveness. The consequences are severe, including anxiety, depression, eating disorders, relationship dysfunction due to emotional distance, and even physical health risks like elevated cortisol levels associated with early death. Hewitt challenges the glorification of famous perfectionists like Steve Jobs or Elon Musk as blueprints for others to follow, arguing that their personal costs—such as damaged relationships and internal turmoil—are unsustainable sacrifices not worth emulating by those in the middle of the success distribution curve. He suggests that society glamorizes flawless performance while ignoring the human cost behind it, a dynamic exacerbated by cultural narratives where identity is narrowly defined by professional roles rather than relational ones like being a friend or parent. The danger lies in using these extreme examples to justify an approach that blows up one's life texture and enjoyment of the process. Ultimately, Hewitt posits that perfectionism increases over time as a societal vulnerability factor, pushing people toward isolation because their curated images prevent genuine connection, effectively driving away the very acceptance they seek. Regarding treatment, Dr. Hewitt advocates for psychodynamic psychotherapy over standard Cognitive Behavioral Therapy (CBT) approaches like worksheets or homework assignments, arguing that intellectual exercises fail to address deep-seated relational wounds. He uses the metaphor of learning to ride a bicycle: one cannot learn by reading instructions but must experience falling and being supported until balance is found. Effective therapy involves creating a safe therapeutic alliance where patients can reveal their flawed selves without fear of rejection or "being taken back," mirroring early childhood fears of abandonment often rooted in adoption stories or conditional love. The goal is not to eliminate perfectionism entirely but to help individuals accept themselves as they are, finding worth independent of performance and developing new ways to connect with others that do not rely on the exhausting tool of self-repair through flawlessness.
Read the full video transcript
give me a better than most people
probably already have working definition
of perfectionism.
>> Well, first off, a perfectionism is kind
of a deeply ingrained personality style
uh that people use to kind of navigate
their path through life. Um, so we talk
about it as a way of being in the world
and um it's it's kind of the sense that
at the core I'm not enough. That there's
something that is uh flawed, defective.
I'm not I'm just not enough either to
have worth or to be acceptable uh to
other people to fit to belong to have a
place in the world. And so it's um it's
a way of trying to navigate that because
when we have that sense of being flawed
and defective or I don't fit, we don't
just typically say okay that's the way
it is. We try to do something about it.
We try to rectify it.
One of the ways that a person can do
that and they learn this often very
early in life is that if if I am perfect
or if I can appear to others as perfect
then I will be acceptable to them. I
will be loved. I will be uh cared for.
Uh [clears throat] I will belong. I will
matter to other people and by virtue of
that I will have worth. it will repair
this sense of being flawed and defective
at the core. So [clears throat]
what it is is um this sort of way of
navigating the world of trying to
conceal imperfections, trying uh yes to
be perfect in um in in tasks and
activities and that but really it's more
of a drive not to be imperfect.
So that's kind of what that's kind of
the way we understand.
>> So the this typical sort of upbringing
of somebody that grows up to be a
perfectionist
uh is love contingent on performance
>> and that can be an element of it. Um I I
think that what we talk about in terms
of the development would be a sense of
this is comes from the attachment
literature uh that people have probably
heard heard the term before um but also
some writing uh soft psychoanalytic
writing uh on the development of the
self by hines cohut and it's the notion
that very early on in our lives we
develop a sense of um who we are uh uh
and a sense of the way other people work
in our lives. And so um very often the
very early kind of lives of individuals
who develop this flawed sense of self or
this not fitting is there's what we call
an asynchrony or a nonatunement. It's
that these basic [clears throat] very
human needs to have worth and to be
acceptable uh or to to fit and belong uh
are not met uh early in the person's
life.
>> So they they have a sense that I I'm
just not enough. There's something wrong
with me and they try to navigate that
very as I said often very very early in
life. So they do have a sense of of uh
caregivers or
family members or people that are
supposed to be caring for them as
they're incapable of giving me what I
need. They're don't care. They're
abusive or um or they just we just miss.
We just don't connect. So it's not to
say that the parents are to blame or
bad. It's just that it's somehow what
the child needs is just not attainable
in that interaction. That's kind of the
essence of attachment.
>> And what's the lesson from the
burgeoning protoerfectionist? What is
the lesson that that child takes away?
That I am not getting what I need.
Therefore, I need to be more than I am
in order to get what I need. If I can be
more impressive, less imperfect, then
the world might support me and love me
in the way that I want.
>> Uh, yes, but it's not that sophisticated
at that very early age. It's a it's a
sense of I I I'm just not enough. I
there's something wrong with me and try
in some sort of fashion to try to deal
with that. And in a way, I mean, in a
way, it's a very elegant solution to the
pain of that because
a child will learn um this sort of
sense. Well, if I am perfect or if I can
appear to others as if I am perfect or
conceal my imperfections,
then all of these wonderful things are
going to happen. I will be acceptable to
others. I'll feel good about myself.
I'll have worth uh and I will fit and
belong in the world. Now, it's a very
childlike
solution to the problem. But it but it's
very elegant at at that sort of stage of
development. Um and it grabs on uh with
these people. Sorry, you're going to say
something.
>> It makes sense if you say that one of
the key drivers in a child that is
continued into adulthood of a
perfectionist is I am not enough.
Then the value judgment is if I can be
more then I may be enough and more is
more perfect in terms of my performance
higher in terms of my achievement less
in terms of my error and my mistake
making
>> all of those all of those kind of things
that but at the at the basis of it is
this sense that yeah [clears throat] I
need I need to be more uh and it it's
it's a nebulous kind of concept of
course. So each person's perfectionism
is entirely unique both in terms of how
they feel about or how they understand
themselves but also how they try to
navigate that how they try to be perfect
or appear to be perfect in the world. Um
so it's quite idiosyncratic in terms of
what that kind of looks like for each
person. So for some it can be absolutely
striving and driving and trying to do
lots of things. For many people it's a
concern with that but paralysis. They
don't really do anything. Uh but they
have this internal sort of dialogue this
sense of this is what I should be doing.
I need to be doing this in order to
solve the problem. But but there's just
paralysis that exists.
What does it feel like to live inside a
perfectionist's mind?
>> Uh abusive,
harsh, critical. I mean, you're there
there's a component uh of perfectionism
that we call the uh the intraindividual
or the self- relational component. And
the way to think about it is
[clears throat] Chris, just like you can
have a a way of relating to other people
and it's a stylistic way,
you know, you're you're open, you're
kind, you talk to people, you listen
carefully, and that's a style you have
of relating to other people. Just like
you can have that style with others,
there's a style we have of relating to
the self. And often we don't kind of
think of it that way. Um but one of the
ways to kind of capture the nature of
the relationship a person has with
themselves is by that dialogue that we
have. So
every day we have these conversations
with ourselves and most of the time
they're quite benign brushing your teeth
in the morning and you're thinking hey
I've got to do this interview today.
I've got to make sure I read that
article before his and they're benign
sorts of things, but every once in a
while
that a style can be triggered where the
individual is is evaluating themselves
or anticipating some kind of
performance. And this stylistic I've got
to do this perfectly. I got to make sure
I have all this covered. I got to make
sure I don't I don't stutter. I don't
mispronounce a word. I don't look silly
or foolish or my voice sh this kind of
dialogue or after an experience why did
I say that I can't believe I was so
stupid when I say that and and it's this
kind of relational thing and if you if
you took that dialogue and spoke it to
your spouse your child uh and I'll ask
patients this like what if you use that
dialogue with your spouse and they'd say
I would be divorced and I'd probably be
arrested [laughter]
during this thing. And I say, well,
isn't that interesting that you could be
that, you know, that abusive? You're not
that abusive to loved ones in your life,
>> but somehow you are to yourself. And
when you put it in those terms with
patients, very often it just makes an
incredible amount of sense. Um, and so
inside the mind of of perfectionistic
people, um, that secret sort of
world we live in that's only sort of
there for us. Um, it's pretty horrific.
>> So, I guess one obvious question is how
do you distinguish
healthy striving and standards and
ambition from toxic perfectionism?
>> Oh, absolutely. No, it's a great
question. I mean, it's confusing even in
the literature because people use the
term healthy adaptive perfectionism and
and really what they're talking about,
[clears throat]
I believe, is an entirely different
construct. And to use perfectionism in
the in in the in the term is
inappropriate. We're talking about
achievement, striving,
conscientiousness,
having really high difficult to attain
standards, striving for those absolutely
healthy and adaptive and some of the
most wonderful things that exists in our
world are because of that when it's um
driven by this sense that there's
something wrong with me and I the whole
purpose in in uh navigating the world is
to correct that to somehow field work
that's something entirely different. So
um it it's kind of at the basis of the
motivation uh for the behavior. If the
person is trying to correct themselves
or correct this sense of fitting in the
world, it becomes very maladaptive.
If it's striving for pushing oneself or
attaining really difficult standards or
even trying to attain the impossible
things Elon Musk has kind of tried to do
throughout his that's wonderful that's
that's very very helpful. So the
distinction it is in the way we
understand they're two very different
psychological constructs. One is to
repair the self and another is to push
the self and attain and accomplish
different things.
>> I think one of the challenges people
will be thinking about here is well I am
my work in many ways. I feel I feel uh
um existentially connected to the things
that I do, the way that I perform, my
sense of self and my performance in my
sport of choice or my job or my
relationship or how well the date went
or that presentation that I gave or the
most recent opera that I sang at or
whatever it is
>> that
is bleeding into who we are. who we are
and what we do now don't have
particularly well demarcated
uh territories and uh by fixing
I if you if you underperform in a sports
game the the World Series is going on at
the moment and uh if if you have a a
horrendous couple of games back to back
well yeah your performance within the
game right wasn't particularly great but
we all know that well does that mean
that I am not good as a person. I am not
worthy as a person. Um I think a lot of
people that are high performers and
maybe this is just a selection effect
that lots of people who end up being
high performers have perfectionistic
traits. Um I think that at least for me
when I think about it
trying to delineate between the two is
really like to me they are very much the
same thing. We're very much sort of
talking about the same thing that if I
do well I am good. If I do badly I am
bad. Uh and I think that that at least
in my experience knowing that I was
going to have this conversation with you
and talking to some friends about this
uh I I think this is a very common uh
interpretation where the the difference
between what you do and who you are. So
the difference in um improving and
becoming more ambitious inside of the
domain of your pursuit and trying to fix
yourself because you are your pursuit uh
is is often seen as one and the same.
>> You're right. and and very
perfectionistic people will do that. I
will repair myself by becoming even
better at what I'm trying to do. Uh and
in the clinical work I do with Olympians
with high performers all all over the
place there is a distinction. Um, and I
think you you you alluded to it in one
of the things you said that, [gasps] you
know, screwing up in two games in a row
in the World Series. Um,
for those individuals, how do they
continue? Well, it's because they can
demarcate this is what I do, but who I
am and my being still has worth. So,
there's a resiliency that's there. It's
not about I'm engaging in play in the
World Series in order to repair myself
in order to do something about this
defective sense of self. So it's a
you're right on one level there is this
[sighs and gasps]
who I am constitutes a major portion of
my identity but um
[laughter]
I I mean I I work with Olympians I work
with artists I work with professionals
who are highly successful in their
career and it doesn't touch their sense
of yeah but who I am really at the core
I I'm just awful. I'm not good enough.
And people will actually make a
distinction um you know between uh if I
can use you as an example, Mr.
Williamson versus Chris. And Mr.
Williamson can do all of these
incredible things, you know, have a very
successful podcast, interview people,
connect with people in these amazing
ways, the accolades. But then there's
Chris who is this person was a child,
you know, is just this this guy who's
really not Mr. Williamson. And I'm I'm
making this up with you, of course, cuz
I don't I don't know you at all. But
when I when you make that distinction
with people and with professionals,
absolutely they understand that uh
especially when you're doing in a
therapeutic context that they'll say,
"Yeah, absolutely. It's incomprehensible
when I sit back and think, "Wow, I I
actually did do all those things." But
it really doesn't solve the problem of
me feeling like I I'm just not I'm just
not worthy enough. I'm just not
acceptable. I just don't fit.
>> Yeah. I suppose that's an interesting
an interesting part of this. Does
achievement
relieve perfectionism?
>> No.
>> That's an uncomfortable realization,
isn't it? [laughter]
>> That's the fantasy for for these
individuals. The fantasy. If I am
perfect, then that will solve the
problem of my work and then pick a
domain, find a domain, do something that
you get some accolade, some attention or
some interest in.
>> [snorts]
>> and grab on to it with the belief that
if I if I achieve these high high
standards or this get these accolades
that's going to solve the problem and
it's just the wrong tool uh for trying
to solve the problem but grab onto the
fantasy and maintain it
and it's and it's part particularly
pernitious when you're thinking about
perfectionism because you can you can
have individuals
decide that the this is going to be this
is going to be the thing. If I can do
this perfectly or if I can conceal all
my imperfections in this context, that
will solve the problem. And they engage
in this and they could do a fantastic
job and then they come away from it feel
good for a few moments and then oh I I
still feel this way. It wasn't perfect
enough.
And then it ups the ante even the next
time. And rather than saying maybe this
is the wrong tool for trying to feel
worth or feel like I'm deserving of
anything in this work um they up the
ante uh and think okay it's got to be
more perfect next time.
>> So success doesn't touch the underlying
belief of unacceptability.
No, that's my experience.
>> Does a That's not the solution.
>> Does a lack of success worsen the
underlying belief of unacceptability?
>> Yeah.
>> Right. Okay. Reinforce. Success doesn't
relieve it, but fa failure confirms it.
>> Yes. And absolutely. Yeah. [laughter]
>> It's the wrong tool.
You know, if you take if you're trying
to pound a nail in and all you have is a
screwdriver, you can you could you could
pound you're usually going to make a
huge mess, but the odd time it might
actually get the screw uh might actually
get the nail in. But there's a better
tool to use that that actually solves
the problem.
It feels to me like perfectionism
self-perpetuating then. Uh achievement
doesn't relieve this sense that I'm not
enough. Uh, in fact, it reinforces in
many ways, oh, I must be more perfect if
it's it's not playing in front of 500
people. It's playing in front of 2,000
people. It's not achieving this job
title at work. It's achieving the
seauite. It's not getting a master's
degree. It's getting the doctorate
degree. It's getting the residency. It's
continuing to up the ante. So uh success
is never sufficient and failure is
always confirmation of your inefficiency
>> and it's always failure.
It's always failure.
>> Even a a special kind of success is a
type of failure because it didn't fix
the problem.
>> Yeah. I can
tell you about a patient I had uh I
write about this in one of my books. a
fellow who was very perfectionist and
very suicidal and uh I I started seeing
him he was um university student in a
particularly
challenging program
[clears throat and cough] and I started
seeing him just at the end of the school
year after he had been discharged from
hospital actually. Um and he talked
about in his program there was this one
course that was a definitive course in
the program and if you did well in the
course it was going to essentially say
well yeah you're going to do well in
this field and if you didn't do well in
the course you essentially well you
should just leave this field and go so
it's a very definitive course and he
talked about I I I want to do really
well in this course I have to get an A+
and he and I I I want to have the
highest mark of any other student in
there. And so I I had just started
working with him. Uh and
um it had maybe been 4 weeks I think
that we had been together. He came to a
session when I knew he would have been
given feedback and gotten the mark for
the course. He was very depressed and um
more depressed than I had seen him
actually over the course of that time.
and he said to me, "Well, I got the
grade. Uh, I I got the A+ and I actually
got the highest
score in the course."
And he and then for any of us that would
have been caused to celebrate and break
out the champagne and but for but he
said, you know, but I I got that, but
all it did is illustrate I had to work
so hard to get it. Like I had to really
work hard to get that heart. It just
illustrates that I really am not
capable. If I had been able to get the
course without working so hard, that
would have that would have done.
[laughter]
>> And that is so slippery. It's so
>> not unusual. It's not unusual to turn
>> turn abject successes into abject
failures.
>> Wow. Let me give you uh my own personal
example of that from when I used to run
nightclubs back in the day. So, Um my
criteria for success uh kept on morphing
to always move away from me. So first
off it was that the event needed to be
successful. We needed to be full. Um
then not only did the event need to be
successful uh I had drawn a
uh a link between when I suffer because
I work very hard typically the event
does better. And what that resulted in
was uh eventually landing at the point
where if the event was successful but I
hadn't suffered that meant that the
success of the event wasn't quite as
much or good or whatever as it should
have been. And what I'd basically done
was completely by so the event was a
failure. I was a failure. So that was
one uh source of potential uh upset. The
event was a success but I hadn't
suffered. That was another potential
source of upset. the event was a success
and I had suffered. That was kind of a
source of satisfaction for me, but
obviously I'd suffered. So, I was
unhappy at the fact that I'd it was so
slippery. And that kind of reminds me of
the story that you were you were talking
about with your your your ex exatient
there. I also have this uh I've been
having this conversation at the live
shows I've been doing around the US at
the moment. um this sense is your
presiding feeling when things go well
one of happiness or simply the abatement
of fear? Is it joy or is it relief? And
uh I I feel like all of this sort of
ties together.
>> Oh absolutely does. I mean, one of the
the paradoxes of perfectionism is that
striving for these successes, as you
say, and getting the success and as I
just illustrated, turning it into a
failure or
probably more commonly is just not
having a sense of satisfaction, uh, a
sense of celebration, a sense of, okay,
I I did do this, I did accomplish this.
um and they just don't don't experience
a a sense of satisfaction.
Um so again,
the majority of us when things go well,
we evaluate and hopefully we have a
sense in ourselves to sort of feel good
about that, but also other people to to
celebrate and to share uh in in that
experience, which is something that's
missing usually in perfectionist life.
all their life the sense of sharing
shared pride in something. Um but just
don't they just okay that's done.
It can be thank god that's over with but
it's okay well move on to the next thing
and it's just simply a progression uh
often up in the upping the ante each
time. M I I like the idea that I need to
think about it a bit more that if you
suffered I guess if you suffered in a
successful thing there was some comfort
in that because I guess it let you know
okay I I really did this I was really
pushing myself for this success so
>> it's it's almost the inverse of what
your uh your your patient had right
which I guess goes to show the
idiosyncrasy of of how this how this
comes about my British Puritan work
ethic was was was showing
Um, but I can see how his mindset would
be the fact that I had to work so hard
shows just how not enough I am that I've
had to compensate for my not enoughness
with all of my effort. I think uh at
least a part of mine was um things that
are successful
should be difficult. They should be
hard. And if you arrive at them without
suffering and without challenge,
uh that
it belies a kind of laziness,
>> there's a a sense of mailing it in.
There's maybe a fragility or a a
tenuousness to your hold on this because
well, how much did you really contribute
here? How much of this was fluke? Well,
if you really hurt for a good while
leading up to this, if you had two
sleepless nights trying to make sure
that the event was full or that, you
know, you really, you know, made your
mark, you put a dent in the universe by
doing it that way.
>> Makes some sense to me. Yeah. I I mean
what you're talk about is actually
healthier
I think than what than the kind of
people that that we're talking about in
in the
>> I will I will I will take that as the uh
the oddest kind of compliment that I
have ever I'll reverse engineer that
into a compliment. Um I have I I guess I
I'm interested if there's if there's
different types of perfectionism. I know
that you've said it's idiosyncratic sort
of where it comes from. Each person is
slightly different, but there must be uh
chunks, taxonomies, categories,
different ways that it shows. What what
are those?
>> Yeah, it it's quite complex in in some
ways. So, there's three different levels
that we sort of describe or define
perfectionism. And one is um like a
dispositional or trait level, a
consistent kind of
need to be perfect if you like. And you
know very simply we can talk about
individuals some individuals that will
be characterized by I need me to be
perfect and it it's comes from the self.
It's directed toward the self. Um and so
I require perfection of myself and it's
a it's a very autonomous kind of state
for individuals. There's also another
dimension or I don't say I don't like to
say type of perfectionism because
they're all intertwined, but another
dimension is where I don't need me to be
perfect, but I need you to be perfect. I
need my spouse to be perfect. I need my
children to be perfect. I need anybody
that I come in contact with or anybody
that I have a relationship with to be
perfect.
And
that's another that's one kind still
serves it still serves the purpose of um
well let let me get to that in a second.
I'll I'll continue to talk about the
different sort of dimensions. So there's
I need me to be perfect. I need you to
be perfect. And then there's the sense
or the perception that I have that other
people need me to be perfect. And this
can be my parents, my spouse, the world
in general requires perfection of me.
And those are sort of foundational
dispositional ways of kind of navigating
the world. There's this other level
where um not only do we require this
perfection, we express our perfection
interpersonally. Most of the time, not
most of the time, often we are
interacting with other people. And I it
may not be that I need I need to be
perfect, but I sure need to appear to
you as if I'm perfect. So, I will
promote myself of perfect. I'll tell you
how wonderful I am, what amazing skills
and abilities I have. That's one way to
try to demonstrate my perfection to you
or express my perfection to you. The
other is I will never display any
imperfection. So I know if I do this
performance, [clears throat] you're
going to see a flaw. So if I public
speak, you're going to see that I
stutter. I I stumble over words. Uh and
so I will never speak in public. So I
will not display any imperfection. And
then another piece of it is in a
relationship, I will never disclose any
imperfections. I will not talk about
things that don't go well with me. I
will I will not reveal to you verbally
anything um about anything that I see as
imperfect.
So it's so it's getting complicated
because there's this need to be perfect.
I need me to be perfect. I need you. I
perceive it. And then [snorts] there's
this I need to appear perfect to you in
these different ways. And then finally
there's this other piece that we have
already talked about this self-
relational
expression of perfection is that uh this
dialogue this harsh negative critical
inner relationship that we have. So
those are all different different facets
of of this way of being perfectionistic
in the world of trying to be perfect in
the world. So it it does get kind of
complicated. Um
>> what about
sort of you the the self-oriented other
oriented and socially prescribed
elements to this too.
>> Yes. Yeah. The self-or I need me to be
perfect other oriented. I need you to be
perfect. And socially prescribed is I
have the perception that other people
require me to be perfect.
>> Oh, okay. And that shows up as in I need
to be perfect. As in I need to not do
anything which would risk me not being
perfect and I not I need to not dulge to
you anything that you would see as me
being imperfect.
>> Yeah. Well, one is a driver of the
behavior, the self, other social. And
then these other pieces is
>> I like I can require myself to be
perfect and you're kind of irrelevant to
me. But it may be that my perfectionism
is about I know I'm not perfect. I will
never be there, but I want to convince
you that I am perfect. And so I try to
navigate the social context in teaching
you how perfect I am.
>> Okay.
>> So that's that's a distinction.
>> Yeah. It it's interesting the difference
between needing perfection and needing
to appear perfect.
>> Yes. Yes.
Think of a politician.
Do they need to be perfect
in their work? Not particularly. Do they
need to appear? Absolutely. That's the
emphasis of that that domain. Um
>> I imagine have you found a crossover
between perfectionism and narcissism?
>> Yes, absolutely.
>> That I I can see the lineage
immediately, right? I can't see nobody
else must be able to see me at my
weakest. I must pretend to be completely
perfect. This unfettered 10 out of 10.
>> Yeah. Yeah. There is no exactly those
elements especially in the the
interpersonal world is about I'm I'm
going to show you how perfect I am. Uh
where it is a little bit different is
the perfectionistic individual
knows
they're flawed they're defective they
they feel that way they feel they know
that uh and I don't fit in the world.
And for the narcissism it at times they
can almost be delusional in the sense
that okay I am perfect but very similar
roots very similar pathways uh but
they're divergent. So
>> what other personality traits does this
cross over with? I would imagine uh
conscientiousness, neuroticism, maybe
some depression. What what else do you
see typically?
um dep depression for sure and in fact
um the depressive personality style um
which is um that's not a DSM category
that's a psychonammic diagnostic
systems category um but a very
depressive personality style um there's
some yeah neuroticism if you're thinking
about the big five um conscientiousness
actually not so much um that's more that
healthier piece. Um and there's a
actually there's a domain of research
that um distinguishes perfectionism from
what's called excellencism.
It's kind of hard to pronounce, but this
notion of striving for excellence versus
striving for perfection. And when we
talk about when people talk about
healthy and adaptive stuff that's more
in the domain of striving for excellence
as opposed to striving for to perfect
the self. Um so there there's that
component. Um you know when we start
looking at the outcomes of the
perfectionism and especially as we've
kind of conceptualized it there's
psychiatric uh psychological problems
that come from it. So, it's overlapping
with uh anxiety, depression, eating
disorders, all kinds of difficulties. Uh
there's relationship problems. And as I
probably delineated some of the
perfectionism components, you could say
that yeah, if I have if I'm
perfectionistic for my wife, yeah,
that's probably not going to go well. Uh
and and indeed it does not go well. But
there's relationship problems that come
from that. From intimacy problems to
dysfunctional intimate relationships to
sexual problems, physical health
problems, uh perfectionisms associated
with it just the perfectionism just
increases the person's level of stress
and everything that comes along with
that. Elevated cortisol, all sorts of
hormonal stuff. And so there's physical
health problems most particularly and
this wasn't work from my lab or or my
colleague Gordon Fett's lab um where
perfectionism associated with early
death um so when you look at other risk
factors for early death perfectionism
self-oriented and socially prescribed
are associated
um
just associated with early death among
people. So it's the thought is that it
just elevates the level of stress in
people's lives to a degree that it will
deteriorate physiological symptoms. So
there's these all these domains of
outcomes of the perfectionism that it's
been uh that have been associated with
those kind of outcomes. [snorts] So
>> yeah, you had uh perfectionism predicts
suicide even when controlling for
depression
>> and hopelessness.
two factors that are historically
uh predictive of suicide would be
depression and hopelessness. And we've
shown in [clears throat] several studies
that it that it socially prescribed
predicts beyond that. Um, so and you
know in some ways it's it sort of
dovetales nicely with some of the work
that's been going on um
um in terms of loneliness or alienation
and the impact that has on physical
health uh for people and of course
suicide. But if you have a process that
ensures that you have this disconnection
with others um that you can't connect
with other people and you live a life of
isolation and loneliness. Yeah.
Prediction suicide is a easy thing to
kind of predict from that and and that's
one of the paradoxes of perfectionism is
you're striving for this connection with
people. You're doing all this stuff to
try to be acceptable, to be lovable, to
be connected and fit, and your behaviors
actually create the opposite. They push
people away cuz you're distant. You're
not genuine, you're prickly. Um, and you
push people away.
>> That's a good that's a a good point. How
do perfectionists come across to other
people? If a big part of the drive for
perfectionists is I am not good enough
and I must be good enough. I would like
to be enough. I would like to be
accepted, wanted, needed, validated,
seen by the world.
>> How do how does the world typically see
perfectionists?
Well, if you think about if I meet you
for the very first time, probably not in
this condiment but face to face and I
say, "Oh,
let me tell you how wonderful I am. Let
me I I can do this and I can do that and
I'm fantastic and I immediately you're
going to take a step back and say get me
away from this person." um or if I come
across as ky, I'm not really revealing,
you interact with me and you think, h I
I'm not getting the whole story here. We
also kind of pull back.
>> And so in trying to create safety for
myself as a perfectionistic person, I'm
not going to let you see who I really
truly am inside. I'm going to curate an
image for you. And people picked that
up. So they pull away.
>> Is there not? Surely there must be
people who are such good perfectionists
that they have realized that programming
imperfection in is a way that other
people will tend to like them more. Like
the performative vulnerability, the
performative imperfectionism, the
downplaying, the modesty. Oh no, no. I I
understand that you see me in this sort
of a way, but no, not me. Because
they're so desperate for that positive
reinforcement. And if they've split
tested it enough times, they will work
out, well, this seems to work a little
bit more effectively at getting people
to like me. And what I want is for
people to like me. So, I'm even going to
downplay like the the uh imperfect
perfectionist so perfect that they've
even put imperfection in.
>> This is very interesting. I think people
would still pick up the lack of
genuiness. Um, I think it's kind of like
when you watch uh, and I'm fascinated by
this, when you watch certain actors in a
performance and you think, "Oh, yeah, I
recognize that's actor so and so doing
that role." And then sometimes you watch
an actor and you just believe they are
the character, like there's a genuiness
to it. So I I might assume that really
good
professional actors might be able to do
that. But I think in the in the real
world, in the generally we pick up uh
there's something missing here. There's
a I don't want to say a creepiness to
it, but uh I'm not I don't have the full
picture. This is kind of making me
uncomfortable.
>> Yeah. So, just going back to how deadly
and dangerous perfectionism can be.
>> Yeah. I have to assume as well that
perfectionists would probably delay
seeking help for absolutely admitting
illness must feel like a failure.
[snorts]
>> Absolutely. You hit it right on the head
because that that is revealing the an
imperfection. um in many of the um many
of the clinicians that I see in my
practice um it's very difficult for them
to to seek help uh in that vein and it
it they forall um so I had um I had a
patient who had there was a newspaper
back in the day when they actually had
newspapers uh newspaper article about
some of my work and this was a he was a
professional musician, a classical
musician. And I didn't talk in the
article about my musical background or
anything, but I talked about
perfectionism. And he had read this
article, cut it out and fold, put it in
his wallet, thinking
somehow this guy seems to know uh this
world of what it's like for um a
distressed classical musician in this
context, being perfectionist. carried it
around for 6 months in his wallet until
he had a failed suicide attempt and his
wife brought him to my office finally
saying
you either get treatment or we're gone.
Uh meaning the family. [snorts] Um it
was so he knew he needed to seek help.
He had seemingly found someone need me
that might actually be of a help to him
but still didn't seek out help until it
got like he got right to the edge almost
literally uh to the edge. So very
difficult for those folks to seek help.
Once they do get in therapy it's
difficult. You have to navigate it very
carefully because you're asking them to
do something they've lived their life
not doing which is
essentially tell me about tell me about
you and your imperfection and your
flawed sense of that's what we're going
to work with
>> and that that you have to work with kid
gloves uh with folks on that. Um
>> yeah well look I I think um I'm kind of
fascinated by the idea of recovery with
a perfectionist mindset because I have
to assume that pain pain and suffering
is worsened by an all or nothing
mindset. If recovery isn't total then
it's going to be worthless. If my if my
recovery from some sort of illness or
shortcoming or failure or whatever isn't
in its entirety, then there was no even
even my recovery from an imperfection
must be perfect.
>> Well, hopefully you're working on the
perfectionism so they don't have that
judgment about treatment outcome. But
the way to think about it is not so much
about about um getting rid of the
perfectionism. It's about dealing with
those deeper issues about worth and
about belongingness and connectedness
with others. So in the therapy that we
do with perfection, we don't really talk
about perfectionism very much at all. We
talk more about those deeper issues
about worth uh about needing to feel
acceptable to other people, about
connecting with other people. And it it
and it's also about um growth. So the
way to think about therapy is not as not
okay, we're going to reduce the person's
perfectionism from this level to this
level. It's more about um the person
being [snorts] relieved of that
personality style in order to navigate
the world because that tool does not
does not work to have worth or to feel
connected with the world. Um, and so it
it's it's more about helping the person
kind of grow um
and develop new ways of of developing
worth and connectedness.
>> Is perfectionism a performance-enhancer?
I I see the traits that you're talking
about among lots of high achievers. And
if it's if if your sole goal in life is
to achieve this thing and you're saying
I'm I'm happy to even completely blow up
my own the texture of my own mind and
the enjoyment of the process and all of
these things along the way.
Perfectionism might be less of a
pathology and more just the price of
being the best. Sure. Well, there's been
some research done on perfectionism and
[clears throat] performance uh in in the
workplace or in people's career um with
the assumption that when um in in one
very early study they looked at this uh
how did they do this the um
commissions people who are in careers
that they have commissions. So the
better they work, the higher money, the
higher the commission, the more money
they make. And they found that
perfectionistic individuals with the
assumption that more perfectionistic he
would have higher income. No, it's the
opposite. There's another study we did
looking
at university professors and one of the
measures of success in university
professors is number of publications,
number of times your work is cited and
so forth. uh and looked at perfectionism
in those university students professors
to see if higher levels of perfectionism
was associated with higher product the
opposite again uh it interfered with
their productivity.
Now having said that um there are many
very famous uh famous people who are
noted to be highly perfectionistic and
um Steve Jobs comes to mind for me but
also a lot of people in the music world
who were who are kind of like that and
we can say well somebody like this into
perfection look what they accomplished
and I think we can stand back and say
wow that was a a great accomplishment.
that the person has. But if you look at
the person's personal life or their
relationships in America,
[sighs and gasps]
>> I just I think I think you're so right.
I I got all excited because this is one
of my favorite pet theories. Um,
a lot of the time we use the people at
the absolute top of the tree as a
blueprint for how people trying to get
to toward that should behave. Um, we'll
look at how Michael Jordan showed up.
Perhaps this is how your Sunday league
baseball team should look to conduct
themselves. Well, look at how Steve Jobs
built, you know, one of the biggest
companies in the entire world and one of
the most revolutionary products in
history. Well, you as somebody that's a
founder of a startup new business,
perhaps that's the way that you're
supposed to show up. But you said that
what are the personal costs that most of
these people pay and is that really
something that you are prepared to
sacrifice in order to achieve that
thing? You first off, you've got no
guarantee that you're going to achieve
that. there is only one Olympian in each
uh category every four years. So in
order to get that and by design that
means that out of the whatever 7 8
billion people on the planet almost
everybody isn't even in the running for
that let alone the person that's going
to be it. Um
my point being I think it's a dangerous
strategy to use the uh blueprint and the
playbook of people who are as far on the
tail end of the distribution of outcomes
as you can get literally one in a you
know human history of a Steve Jobs
>> to try and justify an approach that you
somebody who's falling much closer
toward the middle of the bell cub maybe
you know you're up on the upper end of
the distribution of success or outcomes
or whatever it might be. But the price
that you need to pay in order to be able
to do that is one that you typically
wouldn't foot the bill for. And maybe
you can reap most of the rewards of
excellence without having to blow your
life up with the perfectionism.
>> And maybe you can feel worth and that
you are lovable or that you are
acceptable or that you fit in this
planet in a different way.
One of the thing what one of the things
you said made me remember and I I hope I
can get this right. Um I think
[clears throat] Elon Musk was being
interviewed
by somebody probably somebody um and
they they said they they said I'd love
to be able to think like you or to be as
creative as you. And Musk's response, as
I recall it, was, "Yeah, if you lived in
my mind, you wouldn't like it. It's not
a It's not a good place to be." And I
think that kind of captured, yeah, we
can look at all this stuff, but what is
what is it like to be inside that mind?
And it there's I'm I'm again I don't
know him or anything but from that
comment it just seemed telling that
>> I mean I've got he said um on Lex
Freriedman most people think they would
want to be me. They do not want to be
me. They don't know. They don't
understand. My mind is a storm. Like all
right that's pretty [ __ ] apocalyptic
as [laughter]
>> well. You said it way more elegantly
than I did.
>> I just I've I've kind of become obsessed
with that passage. Um so and it's for
the same reason presumably that that you
have. So okay I guess
>> um how much of perfectionism is about
fear
>> like this this underlying fear is that
is that a big part is a sense of
unsafety ambient unsafety that's sort of
permeating people's lives.
>> I think it's an existential fear uh
about not fitting belonging. Who am I?
Where am I? So I think you're right. um
that it is about fear. And one of the
ways to quell some of that existential
fear
because we're social is is to have
connection to to fit belong uh to matter
to people to be to be loved, but also
fundamentally to have a sense that I I'm
okay, I'm deserving, I'm good enough, um
that I have worth. And so those deep
basic issues uh I think are powerful
there. And what happens when they're not
met is that what exactly what you're
saying it's about there's this this this
fear. One of the more difficult
pro um stages to navigate in the therapy
with folks with this is when they get to
a place where they're kind of
considering relinquishing
this sense of if I'm perfect or if I
appear perfect. Um as they start to
relinquish it, the problem that they run
into is well, how do I navigate the
world? And it's just a void. So they're
it's just the unknown they
>> because their previous motivation was so
much be perfect
>> so ingrained and so much a part of their
life that there there's just this void
and as humans
we don't navigate the unknown very very
well. Um and it can be terrifying if if
you just lose a way of being in the
world and there's some other
expectation. So that in within the
therapy we approach that I don't want to
say gingerly but we approach it in a way
that tries to help them with the fear of
that and to to get to a place that
there's a there's a different way of
being in the world that can actually
increase the probability of meeting
those needs.
>> Can you explain to me the other oriented
perfectionism because that that feels a
little bit
more uh a little bit more on the
outside. I can understand how socially
imposed and the self-oriented
perfectionism
those two things other people need me to
be perfect. I need me to be perfect if I
don't fall short. But the I need other
people to be perfect
is still the same currency but seems to
be pointing in a very different sort of
direction.
>> Right. Right. Um,
I would imagine Chris, in your life, if
you're out in a public context, you'll
have people come up who will be very
excited to meet you and they'll want to
hang out. And, you know, you're you're
think, well, hey, I'm I'm a person here.
I don't really don't need this, but
they're coming to you for a reason. Um,
and to to be in the presence of somebody
with high status, for example,
it gives them status.
So
if I need my
uh wife to be perfect,
it's because
I can share in her perfection and it
elevates me. I get status. I get worth.
I can borrow her identity and all the
good things about her and people will
see me and they'll connect me with this
person and I will have status for that.
One of the things that and this is an
overlap with narcissism. One of the
things about people with narcissistic
personality style or disorder is they'll
there'll [clears throat] be a business
meeting and they'll walk into the
meeting and they very quickly figure out
who has the highest status in the room
and I'm going to cidle up to that person
and connect myself with that person. And
it's about borrowing
the identity of the other person in
order to feel a sense of worth.
That's um part of what's called
borderline
personality disorder pathology or
borderline pathology. Uh I don't have a
sense of identity so I'll borrow yours
essentially.
>> And that that's how that work. So it it
the ultimate goal is the same to try to
elevate my sense of worth, but I'm going
to use I'm I'm going to come to know you
and I'm going to hang out with you so
that other people could see me with you
and say, "Oh, well, he must be pretty
special if he's hanging around with this
guy." And it's that kind of mechanism.
Uh and and that's how other oriented
works. When people fall short, when my
wife screws up, oh my god. Um,
[clears throat] then what the, you know,
then that voice, that inner voice that's
directed toward me with other kinds of
that gets directed toward her, harsh,
critical, nasty. Um,
some people call it a narcissistic rage
and it it's it kind of captures that. M
yeah I have to assume that intimacy and
romantic relationships for these people
are very difficult. Perfectionists
generally
and also if you've got the other
oriented stuff in that's just a a
additional uh difficulty level on top.
>> Yep. No, you're right. There's there's
very good research. There's lots of
relationship problems, but in intimacy
in particular, and if you if you think
about how intimacy evolves, it it's this
series of um interactions of each of
like one person taking a risk and
revealing just a little bit more about
themselves and the other person
recognize not consciously, but
recognizes it and then also reveals a
little bit more. And it's this over time
this revealing more and more about who
we are. Um and so couples that have been
married 40 years, yeah, there's not a
lot of secrets that kind of hang out and
let it hang out. However, uh but brand
new couples know there's still this
okay, just got to be careful here. And
so that intimacy evolves with these
folks who can't reveal
shortcomings, shortfalls, aspirations,
emotions that are difficult,
vulnerabilities,
uh in intimacy is really problematic.
>> Also, if you are I need my partner to be
perfect, that's going to be very
uncomfortable for your partner. Oh, it's
not a fantastic foundation to keep a a
loving relationship. Even your partner
who may have come into this relationship
feeling safe and feeling enough, your
fear of not enoughness will begin to
infect them.
>> Oh, absolutely. The the complaints when
you for people who have other oriented
perfection don't come from the
perfectionist, come from the other
people in that person's life.
>> Wow.
>> Yeah. That's where you see the the the
distress show up. I mean, there's still
distress in in the perfectionist, but it
it can be it can get pretty um yeah, it
can get pretty awful. And it's not just
partners, it's ch person's children, the
person's subordinates in their
workplace.
>> Um
you know,
yeah, it it very problematic for those
folks. So
>> if imperfection is human, which it is,
why does failure still feel so
unbearable to so many of us?
>> Um,
yeah, I don't know that we [laughter]
imperfection may be common. I don't know
that we embrace it uh in in any sort of
way. And I mean even from religious
teachings for for thousands of years
it's been you know try to be more
godlike but not become a god but you
know try to be more like Christ or try
to be more like these deities that are
there or try to and it's always talking
about the imperfection but somehow
there's a there's the promise of
something if when you attain perfection.
And it's that the that that somehow the
root to good things happening or bad
things not happening seems to lie uh in
that domain. And whether it's from
various religions that might be talking
about it or philosophies
um or even you know children trying to
trying to navigate the world that they
that they live in. Let me tell you a a a
a story about a patient who really it
illustrates a whole bunch of different
things as we're talking. Um this was a
woman who in her 40s was um you know
over the over the course of therapy
became clear that she really had this
need to conceal any imperfection either
showing it or talking about it. [cough]
came [clears throat] to see me knowing
she needed thinking things were just not
going well in her life and hadn't been.
Came to see me and it took quite a while
before we actually she would actually
say what she wanted to be doing.
[snorts] But she would conceal including
from me even, you know, elements of
herself that were emotional, that were
difficult, that were vulnerable. And we
began to work and she told initially a
story and then retold the story over the
course of the dialogue of therapy over
many months um of having been adopted uh
as a child very early like as an infant.
And her parents um
went to the experts and in a very loving
way and said, "Okay, she's adopted. Do
we do we tell her? Do we hide it from
her? If we tell her, when do we tell
her? And consulted with who I don't
quite know who the experts were, but you
know, came to the conclusion that, okay,
we need to tell her early on so she
knows right from the start that she's so
special. She's so lovable. And so they
kind of told her the story is we went to
the place where [snorts] little babies
don't have parents. and we looked at all
these babies and immediately saw you and
we fell in love with you and we chose
you and we brought you home. Uh and uh
gave her that story which sounds like
incredibly loving thing to do. Um and
and it absolutely was with the
motivation out of this love and care
at the time she was told and it took her
a while to kind of realize she had done
this as we're doing therapy. She she had
the sense that mommy goes to the store
sometimes and buys purses and she'll
bring the purse home and she'll have it
for then she starts not to like and
takes it back to the store.
So that's the model that this little
girl understood.
So if I can be chosen from this store
that has babies, I can be taken back.
And that that was terrifying for her.
And so from a very early in life, she
made sure she was never going to do
anything
to be disposed of or to be taken
>> back to the
>> absolutely
>> and every relationship she had,
including romantic relationships, was
this incredible fear that at any moment
if if I reveal any imperfection or any
piece of who I am that's flawed or
whatever, her
I will be taken back and it's just a
model of the way the world works for
her. Um and it took a while to kind of
get to that under that understanding. So
um can't remember what your original
question was but somehow it was
connected to [laughter]
romantic relationships and relationships
with people and
>> yeah and this this concern about
imperfection being being so unbearable
this sort of failure being unbearable I
think as well you know [sighs]
the fact that we glamorize perfection so
much in art sport entrepreneurship
as you said religious cere ceremony um
media you know a flawless performance
even some of the language that we use um
it and the fact again
we are our work for a lot of people um
we don't have particularly well
distributed identities we don't hedge
our identity you know I am a businessman
I am a sports person I am it's very
rarely well I'm a friend and I'm a
brother and I'm a father and I'm a this
and I'm that. Yeah, exactly. And I have
to assume that, you know, the more
hedged that you are, the more you
realize, well, opportunity cost and just
straight up resource constraints means
that if I want to be a better father, I
have to be a worse business person. H in
there like belies the fact that I cannot
be perfect. So, I need to adjust um the
uh deployment of my resources and my
efforts in in different ways. And that
must be a little bit of a realization of
huh there are trade-offs in life and
sometimes those make things a little bit
difficult. Wow. Like you know sort of
your brain explodes thinking about that.
Yeah. One of the things I'll do with
some patients is um say to them on your
deathbed in 50 years from now as you're
laying there uh thinking about your
life, what do you think you're going to
regret? Uh and usually it's something
you didn't do. and what are you going to
regret more? Um,
another day at the office, uh,
connecting with your grandchild. I I and
I just ask people about if they put
themselves in that position,
what are they going to look on back on
and think feel like they might regret
and say, "Well, those seem to be some of
the foundational things that are
important to you in your life."
Um, and it it kind of tries to put that
in perspective. Uh, some of those
elements in perspective as well.
I mean, you you've said this a a couple
of times, Chris, that you know, what we
do is kind of who we are. And I I I
think that's very true. I that may be
kind of a cultural thing in North
America and the western world um that
that we define ourselves in that in that
fashion. I think we catch up with some
things at different points in our lives.
So um
you know there's different stages like
often when people become grandparents
they have a very different way of
relating to their grandchildren than
they might have had when they had their
own children.
>> That's interesting. There's a degree of
buffer between the two that relinquishes
the the like the ownership the direct
uhness of your impact has been sort of
removed a little bit. That's kind of
funny.
>> Yeah. And and I think there's just at
different times different things kind of
become become more important. [snorts]
Um and I think as we get older
relational pieces I I [clears throat] I
I I'm just guessing here cuz I don't
really know this word but I it seems
relational pieces seem to evolve. So the
concept of generativity it's the the
older folks want to give more. they're
not so much in involved in their own um
success but they want to mentor people
they want to teach people um and I think
that's a part of we just develop more
relational
we pay attention to more of those
relational needs at that time
>> ah so in your experience can
perfectionists ever truly let go of
those patterns it seems to me like the
perfectionists
>> in that are listening will just think
well this is just who I am. It's
ingrained. It's given me some things I
want in the world and maybe there's some
suffering, but this is just part of the
source code of me.
>> Sure. Well, I got I guess the question
is what cost are you willing to pay for
it? I mean, it it can come down to that.
Um, most of the people that I see in
treatment are pretty desperate and
pretty it's pretty painful for them. So
in the training of of especially my
graduate students to learn to work with
these folks is um to to prepare them a
little bit for once you open open the
door for these folks where they can
express uh the emotional pain that it
it's pretty breathtaking uh and and
pretty powerful. So, um, there can be a
lot of pain that people kind of live
with, but I I I guess at the end of the
day, it's always okay, you're paying a
price for this. Um, everything has a
cost and a benefit, and those shift and
change over time in different contexts.
>> And it's just, um,
you know, how much are you willing to
pay? But it's helpful for people to know
that they can make changes uh, in that
they're not trapped in it.
What are the steps out of perfectionism?
How do how do people learn to get past
this? I imagine that there is some
evidence-based approaches.
>> Okay, so take me through it.
>> Um, well, the work we've done is is from
a psychonamic psycholytic perspective of
of really trying to deal with the deeper
issues that produce the perfectionism.
So, it's kind of the notion if you if
you really hurt your knee, the symptom
you have is pain. And hopefully when you
go to a clinician about your your knee,
they're not going to say, "Oh, the
symptom is pain. Here's some
medications. It'll take the pain away
and then you go about your life." Uh
hopefully the clinicians and in truth,
this is what clinicians would do is say,
"Okay, the pain is simply an indication
there's something wrong in your knee. we
need to poke around in your knee and
figure out what the cause of that is and
deal with the cause and then the pain
just goes away. And so with
perfectionism, the psychonamic approach
is the same thing. We try to work with
what's producing the perfectionism. And
in this case, it's these deep relational
needs. The need for worth, the need to
belong, the need to be acceptable to
others. and that's where where we work.
So from that perspective um I mean you
[laughter]
it's an involved process but it's also
[snorts] um
[sighs and gasps]
at at the end of the day what we're
trying to do is get the person to have
some sense of acceptance of themselves
as who they are in truth. just some
acceptance of them that there's nothing
fundamentally flawed or wrong with them.
They've learned that lesson well, but
there really isn't the flaws that they
have. Um and uh that there's an
acceptance of other people that other
people are also flawed and um
but there's still ways to kind of
navigate a sense of fitting and
belonging and connectedness with them.
So it's about self-acceptance and it's a
it's about finding a place for oneself.
>> What are the most common interventions
that you use to increase somebody's
self-acceptance?
Um
well, you would use in psychonamic work,
you use the therapeutic alliance and you
form a connection with the individual to
provide a place of safety that they can
actually begin to
put that flawed self on the table and
will actually look at it in a really
truthful, honest way.
And it's usually it's not so flawed and
not so defective. But but we use the
therapeutic alliance to create a place
of safety uh for the individual to be
able to do that. We also work in that
context on the kinds of things that
people automatically do to avoid
the the deep pain, the emotional stuff
to actually look at who they truly are.
Uh and so again we use that therapeutic
alliance that way. [snorts] Um there's a
domain of um treatment that likes the
notion of worksheets and practice and um
telling yourself not to be worried about
making mistakes and that sort of thing.
Um and I just I I find it to be honest I
find it really silly. like you I mean
one of the things when you work with
perfectionistic people is they will say
can't you give me something to read
can't you give me like homework uh and
the idea is
what we're trying to do is teach a
person it's kind of like learning to
ride a bicycle if you've never ridden a
two-wheeler and you decide okay I'm you
know I'm 30 years old I'm going to learn
to do this so I don't know you phone up
Lance Armstrong and say, "I need a
workshop. Give me a lecture uh on how to
ride a bicycle." And you go to the
lecture. He provides all the
information. You take notes, write the
multiplechoice exam, ace it, get out on
the driveway, get on the bike, and you
promptly fall over. And the tool of
intellectually learning what you need to
do to ride a bike. Contract this muscle,
relax that one is not going to teach you
to ride a bike. But if you have, you
know, if you think about how I assume
how you rode a bike, much like me, you
had somebody who was holding the bike
you got on and they kind of pushed you,
got you going, and they let go and
grabbed on to get and you wobbled and
fell and got up again and and through
the experience of that process,
eventually you got to do this insanely
complicated thing of riding a
two-wheeler.
in traffic with lights with and if you
think about how complicated that is, oh
my god, it's it's the experiences that
have taught you how to do that, not the
information,
not you know ex cognitive exercises to
do that. And and that's the best
metaphor I have of what I what I and
other psychonamic people are trying to
do to teach people new behaviors. It's
through the experience of revealing the
self. It's through the experience of
having
um being able to connect with somebody
and to have them kind of um to care for
you, accept you, see all the stuff
that's bad and try to be helpful to you.
So that's the process uh of it. So it's
not it's not you know session one you do
X session two you do Y that's a very CBT
approach and it's that approach in
particular that
we just published a paper which really
pissed off [laughter] a good bunch of
people which is great kind of like doing
that um to really show uh what the
evidence is for a CBT based approach for
perfectionism and
>> it's not good
>> um well when they wrote about this
stuff. It it was wonderful. But when we
actually looked at it, we saw that um
the majority of people drop out from it,
which means they don't tolerate. It's no
good to have a treatment that people
don't continue in. Uh there's there's
good uh evidence that for some parts of
perfectionism,
it will change post treatment, meaning
sort of at the last session, they can
show these big changes. if you test them
in a followup a few months or 6 months
later, no, that the changes disappear.
Uh so it it's not maintained. Um there's
very good evidence that only certain
elements of perfectionism change from a
CBT perspective. Not the traits that we
talked about, not the self- relational,
those styles of expressing what those
don't change. Those are the pernitious
ones. Socially prescribed doesn't change
and it's the one associated well along
with self-oriented but suicide uh early
death anorexia nibosa depression anx. So
those pernitious pieces don't seem to
change with CDT
in in the work that we do. Um you it's
going to come as a surprise I'm sure but
we try to deal with those underlying
issues and show the changes in the more
pernitious elements and there's um three
different uh five different studies that
have shown yeah there's changes that are
made in that. The way we do the
treatment research is if you have
developed a treatment, we'll do a study
and we'll show the effects. We then try
to figure out, okay, well, how could
refine it to try to get even better
effects or longer lasting effects. So,
use treatment not as a way of saying,
hey, look at the treatment we've got.
It's fantastic. We say, here's a
treatment. It looks like it's it's it's
pretty good uh or very good. How how can
we improve it even more? M what would
you say to somebody who has a
perfectionist person in their life? Uh
how can
those around perfectionists show up in a
way that helps them to uh improve their
worldview? [snorts]
>> I I I [clears throat]
would encourage
them to to find somebody to work with
them on it, to find a professional to
work with it. Um,
I mean, as we're talking, you can see
it's pretty deep-seated. There's a lot
of pain. There's a lot of outcomes with
it. So, it's not something that, um, is
easily changeable. Um, but I would be
encouraging of people to try to find a
therapist that they can work with that
that that they trust and that they could
connect with to deal with those issues.
What is the what is the school or is
there an accredititation body that you
guys ratify uh to say this person is
perfectionism certified to be able to do
this at a standard and
>> we're in the process we're in the
process of doing that actually with
again we're at a a place now where we're
pretty confident that the kind of the
the kind of approach that we do actually
is is helpful uh and not just helpful to
change the levels of perfectionism that
it's clinically relev relevant like the
clinically significant change in people
and that it's actually in psychonamic
work not only is the change maintained
over
period of time if you do it right the
change continues after the treatment
ends. Um, and it's kind of the idea like
with your knee, if you fix the problem
in your knee, as soon as they fix it,
there still might be pain there, but as
it as it continues to heal, you're not
doing any treatments. As it continues to
heal, the pain eventually kind of goes
away. And in good psychonamic
psychotherapy, there's very good
evidence that that's what happens. It's
just not if you get rid of the cause,
the symptoms kind of go away. M that's
interesting. What's the role of
mattering in all of this?
>> Um I mattering is one of the one
[clears throat] of the ways that those
relational needs can show up. Uh so some
people um well I think for everybody
it's kind of a foundational
part of of having a sense of worth is
that I matter to somebody that somebody
communicates to me that I'm important to
them that I'm relevant but it so
generally mattering but at an
idiosyncratic level with with people it
can be that can be manifest like I you
know I have a voice that I I grew up in
a family where
nobody cared. I I couldn't say anything
that anybody would ever hear or listen
to. Uh and the the only way of
understanding that was well if I was
more important they might actually hear
my voice or and one of the ways to be to
solve that is okay well I can be I can
be narcissistic and tell everybody how
wonderful or I can try to be perfect in
everything that I do. So mattering is is
one piece of the relational needs. But
other people might need to be respected,
to be to be seen, to be heard, not to be
invisible, [snorts]
um to be loved, and to have a sense of
being lovable.
Two different pieces there. Um so it it
all kind of fits in very generally in in
uh sort of some of the basic needs that
we need to navigate the world.
>> Are we becoming more perfectionist over
time? Is this have you done any
longitudinal stuff? There has been and
we haven't done this work but some uh
colleagues of ours have uh actually
looked at our conceptualization
um and looked at the the scores over
decades and show that indeed yeah
perfectionism seems to be uh increasing
uh over the decades at least the trait
elements seem to be those are the only
ones that have been evaluated at this
point. So that self-oriented other
socially prescribed uh they're
increasing um there's no I don't know of
any research that's done this but there
you may know there also rates of
depression and anxiety that sort of
thing either seem to be increasing or
people are more open to admitting that
they have depression and anxiety. So it
see makes sense that if a vulnerability
factor for these problems is increasing,
we may see an increase in some of the
outcomes of those vulnerability factors.
I I haven't seen any work directly to
address that, but it logically makes
sense.
>> Heck yeah. Dr. Paul Huitt, ladies and
gentlemen, Paul, you're great. I I I
really appreciate this work. I think
it's uh very of the moment and um you
know for the sort of people that listen
to podcasts specifically stuff like this
um I think uh many are going to feel
seen uh and
accused today. Where should people go to
keep up to date with your work?
Um well I have a I mean I have a I have
both a clinical website where with with
more clinically relevant information but
also a website at uh at at the
University of British Columbia. So um
there is a website um we publish books.
I just
my agent said I should do this. I don't
know. [laughter] But uh we're just
signing a contract with Norton to do a
trade book on Gordlet and I are doing a
trade book on our work over the years to
make [clears throat] it less academic
and more available to people so they can
uh kind of see the way we think about
it, understand it, the problems and how
to deal with it.
>> I think that'll be good for the world.
Paul, I appreciate you.
>> Thank you very much. It was wonderful
meeting you, Chris. So, you have very
good listening skills. I've done
numerous [clears throat] podcasts where
I get the questions and then the person
is busy trying to figure out what the
next question is [laughter]
rather than having a dialogue. So, it's
it it's very nice that way. So, I
appreciate I I appreciate that.
>> Thank you.
>> Okay. Congratulations. You made it to
the end of an episode. Your brain has
not been completely destroyed by the
internet just yet. Here's another one
[music] that you should watch.
Come on.