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Clinical perfectionism
and cognitive behavioral therapy
E. Papadomarkaki, S. Portinou
Hellenic Centre for Mental Health and Research, Athens, Greece

Psychiatriki 2012, 23:6171

The present study constitutes a brief literature overview, in which the term of clinical perfec-
tionism, its etiopathology, its assessment and its relation to psychopathology, as well as the
therapeutic interventions based on the Cognitive Behavioral Model are discussed. According
to Frost, perfectionism is associated with ones desire to achieve the greatest degree of perfor-
mance and it is accompanied by an extremely strict evaluation of that particular performance.
The relationship with oneself as well as the relationship with others are both characterised by
high standards and demands which tend to exhaust one individual and dramatically toughen
the development of proximity with the others. Perfectionism, as a personality trait, presents
functional and dysfunctional elements for a person. Dysfunctional, clinical perfectionism a
term recently coined by researchers has been linked to a number of disorders, such as social
phobia, obsessive-compulsive disorder, eating disorders anorexia and bulimia nervosa de-
pression and personality disorders. From a perfectionists point of view, perfection exists and
its attaintment is feasible. The existence of a particularly high and often unrealistic goal can
lead the person to severe disappointment when this specific goal is not finally reached. A per-
son with functional perfectionism is possible to set another, more achievable, goal next time,
while a person with clinical perfectionism will interpret this failure as a sign of personal in-
adequacy and will either make another attempt to reach the same goal or will abandon the
effort altogether. A sense of weakness and subsequent negative automatic thoughts are the
aftermath of both the first and the second choice. Cognitive Behavioral Therapy focuses on
the realisation that clinical perfectionism is undesirable, on the dispute of negative automatic
thoughts and on the replacement of unfunctional cognitive schemas with other, more func-
70 E. . 23 (1), 2012

tional ones. In the therapeutic process, one individual can learn how to set specific and realistic
goals, to focus on the process of a task instead of its result, to organise activities in a hierarchy
depending on their significance and, finally, to feel fulfilled even if they have not brought a
task to completion. It is a fact that the core schemas of clinical perfectionism are characterised
by rigidity due to the excessive number of secondary benefits they provide for one person.
The exploration of those benefits and the discovery of alternative sources of fulfillment are
areas of therapeutic work.
Key words: Perfectionism, schemas, cognitive behavioral therapy.

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