Clinical literature on the treatment of perfectionism suggests that perfectionists are not exactly easy to treat.  In fact, “perfectionism is associated with a relatively poor working alliance between the perfectionist and the therapist” (Flett and Hewitt, 2002, p. 24).

Sorotzkin (1998), while treating adolescent perfectionists, writes about how perfectionism gets in the way of treatment progress:  “as [perfectionists] become more knowledgeable about psychological issues, they may also become perfectionistic in the process of therapy, by trying to become the perfect emotional specimen (i.e., by not having any anxieties, conflicts, or fears)” (p. 92).

Let’s face it: as a perfectionist, you can present a formidable challenge.  You tend to be over-invested in your philosophy of living.  You set high standards for yourself in therapy and you expect a lot from your therapist (no surprise here!).  And once you decide to tone down your perfectionism, you become perfectionistic about not being a perfectionist.  Naturally, you get frustrated with your lack of progress and, of course, with your therapist.  Finally, in trying to be a “good” patient, you may be pushing all kinds of counter-transference buttons in your therapist.

Medication isn’t much help either.  Clinical literature suggests that not only are perfectionists (with their premium on personal control) resistant to medication in the first place (Flett & Hewitt, 2002), but even when treated by psychotropic medication, perfectionistic cognitive schema lives on (Reda et al., 1985).

Now, let me clear up some of this prognostic doom and share my own clinical experience of working with perfectionists.  Fact is you are my favorite clinical population.   How come?  I have found perfectionists to be a very sympathetic, cognitively vibrant and highly motivated lot.  With your genuine hunger for well-being and your excellent work ethic, as a perfectionist, you are perfectly positioned for self-help.  Bottom-line: as a perfectionist, you are the ultimate do-it-yourselfer.  So, embrace your perfectionism (even if it challenges your therapist) – it just might ironically provide the wind for the sails of self-help.  And best wishes to you as you get started with your existential self-rehab!

Related: Existential Self-Rehab



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From Psych Central's website:
PsychCentral (July 23, 2010)

    Last reviewed: 9 Jul 2011

APA Reference
Somov, P. (2010). Self-Help for the Ultimate Do-It-Yourselfer. Psych Central. Retrieved on April 2, 2015, from


Select books by Pavel G. Somov, Ph.D.:
Mindful Emotional Eating Reinventing the Meal
Present Perfect
Eating the Moment

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