Barbara Morrell, Ph.D.
Brigham Young University
Presented at the AMCAP Spring Convention
April 3, 2008
“Perfectionism is not a quest for
the best. It is a pursuit of the
worst in ourselves, the part that
tells us that nothing we do will
ever be good enough — that we
should try again.”
Julia Cameron
“Heresy Seven: There are those who believe we must
be perfect to gain salvation.
This is . . .a doctrinal misunderstanding. . .Faithful
members of the Church will be saved, even though
they are far from perfect in this life. . .[Joseph
Smith] taught that there are many things to be
done, even beyond the grave, in working out our
salvation.”
Bruce R. McConkie “The Seven Deadly Heresies,”
(1980)
“Perfectionists are apt to be especially familiar
with the self-conscious emotions [i.e. shame,
guilt, embarrassment, pride] because they
focus so much energy on self-evaluation.
Perfectionists do not just set high, often rigid,
standards for themselves in a particular
domain; they are oriented toward the process
of evaluation. Life is a series of quizzes, tests,
and final exams, and their name is always at
the top of the report card.”
(Tangney, 2002, p. 199)
How do clients
learn
Perfectionism?
Sources of Perfectionism
 American/Asian/other Cultures
 Competition Mentality
 Worth based on achievements, looks, money, success
 Mormon Culture
 Distortion of Doctrine of Eternal Perfection
 Influence of American culture
 Negative feedback in childhood
 Human Nature/Natural Temperament
 Anxiety: Biological Predisposition
 Attachment Issues/Abuse/Neglect
Doctrine of Eternal Perfection vs.
Cultural Perfectionism
 Language: Matt 5:48 “Be ye therefore Perfect” vs. “Be ye
therefore complete and fully developed (in the
eternities).”
 Two sets of undifferentiated values: Eternal and Material
 Equating behavior with the essence of the self:
bad behavior = bad person
 All things become moral: grades, looks, income, talents,
etc.
The LDS Therapist’s Dilemma:
How do we facilitate clients in
modifying perfectionism as a
therapist, not as a teacher,
leader, or church member?
Potential Pitfalls for LDS Therapists
working with LDS Clients
 Assuming we understand a client’s worldview and values
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because they are LDS (or another religion)
Violating ethics by entering a client’s spiritual/religious
world without permission
Alienating a client who is struggling with their beliefs
and/or affiliation
Feeling responsible for clients to make good choices and
becoming another voice of authority
Imposing Mormon cultural ideals or “shoulds” on clients
because of our own unexamined cultural influences
Helping Clients Teach Themselves
Correct Doctrine: Guidelines
 Wait for clients to raise Spiritual/Religious concerns
 Ask about clients’ beliefs and worldview and validate
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their individuality and agency
Don’t make assumptions about what clients want
spiritually and religiously
Clarify our role as a therapist, not a doctrinal authority
Don’t assume we have the answers for spiritual dilemmas
Follow the client’s lead
Ask permission to use spiritual interventions, even when
clients raises spiritual issues
Understanding the Impact of
Perfectionism on Clients
 Assess client’s view of how self-critical or perfectionistic
tendencies affect them: level of self-awareness
 Assess severity of impact of client’s perfectionism on
psychological well-being and functioning.
 Seek to understand the origins of client’s perfectionism to
help with treatment planning.
Influences on Perfectionism:
Continuum of Severity
Competitive
Cultural
Environment
(in and out of
church settings)
Family Examples,
Expectations
and/or
Peer Rejection
Perceived Failure
Negative
Feedback
Attachment/
Trauma Issues
(profound
underlying
negative
sense-of -self)
Cultural Perfectionism:
Chicken or Egg?
Does American/Mormon culture breed
Perfectionism or do individuals who
feel a sense of inherent “badness” or
“worthlessness” project their
feelings about themselves onto the
doctrine?
Shame vs. Guilt
“People experiencing guilt often are motivated to confess,
apologize, or atone. In contrast, when people feel shame,
our key concern is with our self, as a person. Feelings of
shame involve a painful negative scrutiny of the entire
self-a feeling that “I am an unworthy, incompetent, or
bad person.” They feel worthless and powerless, and they
feel exposed. As in guilt, feelings of shame can arise from
a specific behavior or transgression, but the . . .“bad
behavior” is taken not simply as a local transgression,
requiring reparation or apology; rather, the offending or
objectionable behavior is seen as a reflection, more
generally, of a defective, objectionable self.”
(Tangney, 2002, p. 201)
Attachment and the Self
 “Attachment bonding is critical to development of the right brain
systems involved in processing emotion, modulation of stress, selfregulation, and the early origins of the bodily-based implicit self.”
( Schore , 2003)
 Through constant interactions from birth, the caregiver is a mirror
for child to develop his/her sense of self.
(Kohut in Cashdan, 1988)
 Internalized negative and positive interactions become the basis for
sense of self: parental negative voice becomes internalized
(Melnick, 1995)
Mother-Infant Communication
and Attachment
Communication happens Right Brain to Right Brain
 80% of Right and Left-handed mothers cradle infant in left
arm—easier access to left ear and face (right brain)
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 “During eye-to-eye transactions the infant’s maturing right
hemisphere is ‘psycho biologically attuned’ to the output of
the mother’s right hemisphere.”
(Schore, 1995)
 Left side of face shows emotions: Van Gogh Self-Portrait
Focus of Therapy for
Attachment Issues
Right Brain (non-verbal) Relational connection
 Corrective Emotional experience
 Neuroplasticity:
 Brain can rewire healthier attachment patterns
 Sense of self can develop more positively
(Schore, 2005)
Skills Training:
• DBT, ACT: Emotional Regulation, Distress Tolerance,
Mindfulness, etc.
Implications for Therapy
 For severely perfectionistic clients a frontal attack on
their perfectionism may feel like attack on the self.
 Positive feedback about their worth may generate
confusion and emotional pain instead of relief
 Clients may have intense fear of change
 The therapeutic relationship may be difficult to build and
maintain (Blatt, et al 2002)
General Treatment Considerations
for Perfectionism
 Explore, understand, empathize with feelings of worthlessness
before challenging them: Challenge is inherently non-validating
 Process fears of change: “who will I be?”; “loss of motivation &
achievement;” “what if I’m wrong?” “what will others think?”
 Shame vs. Guilt or Remorse: Shame indicates deep-seated negative
sense of self
 Axis I Disorders: Anxiety and Depression must often be addressed
before perfectionism can be tackled
Questions and Feedback to Promote
Self-Exploration & Understanding
 You seem really hard on yourself. How do you feel about that? How
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does it affect you?
How does it help/hurt you to have such high expectations?
How does being hard on yourself affect your anxiety/depression?
Is that something you want to work on changing?
Where did you learn to be so self-critical? What are you earliest
memories of feeling inadequate?
What are your fears of changing? What would you lose? How
would things be different? What would you like about that?
I’m not sure I understand your guilt for getting B’s. Do you believe
grades can make you more or less righteous?
What do you believe makes a person important or worthwhile?
It sounds like you believe in unconditional worth for others, but not
for yourself. How fair is that? What gets in the way of believing in
your worth?
Questions & Feedback cont.
 So you believe that something is wrong with you because you can’t do
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it all? That sounds very painful. What is it like for you?
How possible is for anyone to do it all perfectly? Why not?
(If they raise LDS doctrine of Perfection) Does LDS doctrine say God
expects you to be perfect right now? Is there anything you know that
tells you that might not be true? How do you think God sees your
weaknesses? It sounds like you judge yourself more harshly than God
does.
You really hate to be human don’t you? Me, too. What is painful about
making mistakes for you?
How would you like to see yourself? How would you like to view your
mistakes and weaknesses? It’s really hard to change things you’ve
believed for many years. It can be like fighting a tidal wave.
It seems like you feel caught between the eternal perspective and the
worldly perspective of your worth. What would you like to base your
life on? How would things be different if you did?
Changing Beliefs (Not just Thoughts)
 Focus on Negative/Perfectionistic beliefs as “learned” and the process
of “unlearning” them:
 Normal to reach adulthood with irrational beliefs, but don’t have to
keep believing them.
 Teaching self “correct doctrine”
 Differentiate “behavior” and “achievement” from “personhood”:
 Instead of “better” and “worse” think “better off” and “worse off”
(positive and negative consequences)
 Deepening New Beliefs—From Head to Heart:
 Use of analogies to understand process of change and growth:
Alma’s seed, learning to play the piano, etc.
 Internalizing in a way that works for individual clients: Reading,
talking, thinking, writing, praying, feedback from others.
Use of Scriptures & Religious Quotes
 Pros of using scriptures:
 May be very appropriate if client is comfortable with it(may help
to ask if they are interested in seeing a scripture that relates to
the point of doctrine they are wrestling with).
 Can be used in a way to help clients “teach themselves”
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“How is this different from how you have been seeing this issue?”
 Cons of using scriptures:
 Can shut down process of finding own answers if seen as “the
answer” or “solution”, or that the therapist is a church authority.
 Might seem too simplistic or prescriptive.
 Can be very alienating to some clients who are struggling.
Using a Developmental Perspective
 Help clients understand how a negative sense of self develops
 Children think in black and white-- believe the negative feedback they receive,
so view self as bad
 Children tend to blame themselves for bad things and think it is their fault
 Encourage clients to view selves in the process of normal Development:
 Clarifying Values (Chickering): Highlighting contradictions between conflicting
sets of values and beliefs (Mormon Culture vs. Doctrine vs. Materialism) and
making conscious choices
 Process of Separation/Individuation/Identity Development (Chickering)
 From Dualistic (Good/Bad) view of self and others to more complex view
(Perry)
 Young Adulthood as the time to sort through beliefs learned in childhood and
to teach oneself “correct doctrine” or see what is true with adult eyes.
 A perceived weakness is not a flaw, but something we haven’t yet learned to
do.
Treating Attachment &
Trauma-Related Perfectionism
 Emotional/Trauma processing: Negative, perfectionistic beliefs about self
are often embedded in memories and/or family dynamics.
 Work on understanding they survived as best they could and that
adult/peer/perpetrator treatment of them wasn’t about them.
 Self-care: Learn from experience that attending to one’s own needs is
important.
 Re-parenting Oneself: How would an unconditionally loving parent talk to
you about this weakness or mistake?
 Attending to outside Relationships: People learn self-love in supportive
relationships: Friends, Mentors, Bishops, Spouses & dating partners, etc.
Skills, Awareness, Interventions
 Acceptance Commitment Therapy (ACT): Focus on
Mindfulness & Self-awareness, Acceptance & Tolerance of
Distress & Pain
 DBT Skills Training: Mindfulness, Emotional Regulation,
Distress Tolerance, Interpersonal Effectiveness
 Positive Psychology Interventions
 Bibliotherapy
 Relaxation and Imagery for Ego-strengthening:
http://ccc.byu.edu/counseling/skills.php
Case Examples
 Melissa: “Then I would have a choice.”
 Mark: Question: “Do you believe the Lord grades on the
curve?” His answer: “I want to be the first one into the
Celestial Kingdom.”
 Sam: “I’m going to cure myself of Perfectionism and
Masturbation by tomorrow.”
 Melanie: “I’m really starting to get that it wasn’t about me.”
Perfectionizm Bibliotherapy
Burns, David, (1980). Feeling Good: The New Mood Therapy, Signet: New York.
Dew, Sheri (2004). No One Can Take Your Place, Deseret Book: Salt Lake City
Holland, Jeffrey R. “The Other Prodigal.” Ensign, May, 2002, 62.
http://www.lds.org/ldsorg/v/index.jsp?vgnextoid=f318118dd536c010VgnVCM1000
004d82620aRCRD&locale=0&sourceId=13d68d00422fe010VgnVCM100000176f620
a____&hideNav=1
McConkie, Bruce R. (1980). “The Seven Deadly Heresies,”
http://speeches.byu.edu/reader/reader.php?id=6770
Nielsen, “Perfection Pending.” Ensign, November 1995
http://www.lds.org/ldsorg/v/index.jsp?vgnextoid=2354fccf2b7db010VgnVCM1000
004d82620aRCRD&locale=0&sourceId=453c6e9ce9b1c010VgnVCM1000004d82620
a____&hideNav=1
Okazaki, Chieko, (2002). Being Enough, Bookcraft: Salt Lake City.
Bibliotherapy cont.
Robinson, Stephen, (1992). Believing Christ, Deseret Book: Salt Lake
City.
Samuelson, C. O. “What Does it Mean to be Perfect” New Era,
January, 2006, 10-13.
http://www.lds.org/ldsorg/v/index.jsp?vgnextoid=024644f8f206c01
0VgnVCM1000004d82620aRCRD&locale=0&sourceId=ca81092480e
6c010VgnVCM1000004d82620a____&hideNav=1
Seligman, Martin, (1991). Learned Optimism, Pocket Books, New York.
Seligman Positive Psychology Website:
http://www.authentichappiness.sas.upenn.edu/Default.aspx
Ulrich, Wendy (2007) Forgiving Ourselves: Getting Back Up When We
Let Ourselves Down, Desert Book: Salt Lake City
“Brothers and sisters, I testify that no one of us
is less treasured or cherished of God than
another. I testify that He loves each of us——
insecurities, anxieties, self-image, and all. He
doesn’t measure our talents or our looks; He
doesn’t measure our professions or our
possessions. He cheers on every runner, calling
out that the race is against sin, not against
each other. “
Jeffrey R. Holland “The Other Prodigal”
Ensign, May, 2002
References
Blatt, S. J. & Zuroff, D. C. (2002). Perfectionism in the therapeutic process. In G.L. Flett &
P.L. Hewitt (Eds.), Perfectionism: Theory, Research, and Treatment (pp.393-406).
Washington, DC: APA
Bowlby, J. (1988). A secure base: Parent-Child attachment and healthy human development.
New York: Basic Books, Inc.
Cashdon, S. (1988). Object relations therapy. New York: W.W. Norton & Company:
Melnick, S. (2005). “Trauma and Attachment” Presentation at the Harvard Medical School
Attachment and Related Disorders conference, Boston, May 7, 2005.
Shore, A. (2003). Affect disregulation and disorders of the self. New York: Norton.
Shore, A. (2005). “Recent Advances in the Neurobiology of Attachment: Implications for
Interventions and Prevention.” Presentation at the Harvard Medical School Attachment
and Related Disorders conference, Boston, May 6, 2005.
Tangney, J.P. (2002). “Perfectionism and the Self-Conscious Emotions: Shame, Guilt,
Embarrassment, and Pride.” In G.L. Flett & P.L. Hewitt (Eds.), Perfectionism: Theory,
Research, and Treatment (pp.393-406). Washington, DC: APA
Contact Information: barbara_morrell@byu.edu