Clinical Perfectionism

Dysfunctional perfectionism is defined as the tendency to hold excessively high standards which brings on significant distress or impairment. This could include struggling to be the perfect parent, artist, or student. Holding such standards can bring on symptoms of fatigue, anxiety, and depression. At times, it can also trigger eating disordered behaviour.

Perfectionism is a dimensional construct with varying degrees of severity. David Burns (1980) argues that perfectionism can be clinically significant when it starts to impair performance and mental health. He indicated that a goal worth achieving is best to be achieved through a healthy pursuit of excellence than dysfunctional perfectionism. Burns argues that the healthy pursuit of excellence allows you to be who you are in being extra ordinary, but creates awareness in maintaining healthy self-boundaries. This means that you aren’t sacrificing your relationships, yourself, or personal boundaries to achieve goals. You can be ‘extra,’ but not give up your life doing so.

The program that we have helps individuals recognize patterns of dysfunction and creates challenges to their all or nothing thinking patterns. In other words, the world will not end if you give yourself a break, study a little less, or not get 100% on every assignment. Analyzing your path and questioning if it can be done while living the life you want is what’s imperative to the therapeutic journey.

Self-monitoring (which is done daily) is important in this type of therapy. Recognizing and challenging your thinking and behaviour helps you create change. Creating alternatives to your negative thoughts will help bring clarity and challenge core rigid beliefs. Behaviour change is also a necessary component to the program. We work with you hand in hand to help facilitate all changes. We will never force you to do something you aren’t comfortable with, but we will challenge you to see an alternative perspective that you may consider as a healthier way of operating.  

Contamination Obsessive Compulsive Disorder

Contamination OCD can take on a variety of forms in individuals. Most patients report an overwhelming anxiety or fear that they can be contaminated or accidently spread their contamination to other people. Most of the fear of contamination are grossly out of proportion to the actual risk. Patient symptoms may differ as some may present with fears of being contaminated by germs of other physical contaminants and others may present with fears of being contaminated by other unlikely sources that most people wouldn’t typically consider to be contaminated. Other OCD suffers report a general sense of feeling dirty and often become anxious of their emotional reaction to the feeling. Contamination OCD isn’t always typically associated with over washing and cleaning. An assessment will be done to determine if perfectionism OCD or other compulsions may play a factor in maintaining the behaviour.

One of the major goals of treatment is to highlight the irrational thoughts that the individual sufferer experiences. We challenge the OCD by identifying how their OCD patterns and thinking don’t make sense. Some of these challenges include helping patients understand that germs don’t survive hours even days on chairs or germs cannot jump if you get too close to them. Of course, these are just some examples of irrational thoughts and not every patient will identify with them. But, the goal still remains the same- challenge the irrational thinking and help them identify how they are already breaking their OCD rules that they have created for themselves. For example, we may highlight that they may not want to hold or touch inside a garbage can, but at the same time it may be easy for them to take a wrapper off a sandwich and touch the garbage can flap when throwing it away and continue eating. The flap may just be as dirty as the insides of the garbage can, but most people continue to carry on with their day (including OCD sufferers) without a second thought. This unawareness and inconsistency is what’s highlighted during our cognitive work.

Of more importance, we help our clients live with the risk and maintain some level of acceptance that nothing is certain in life.

Some of the irrational thoughts we challenge:

Mental pollution is a term used to describe a sense of internal dirtiness that can be brought on by certain thoughts, words, or memories. Mental pollution are typically brought on by thoughts of a potential threat, it’s also associated with emotions such as shame and responsibility. 

Sympathetic Magic is a term used to describe the implausible belief about the nature of getting contaminated. This can manifest in many ways, but two irrational thoughts most often thought by OCD suffers are ‘once in contact, always in contact’ and if one object touches another contaminated object, it too can contaminate many other objects (a pencil touching a toilet seat and the pencil now contaminating many other objects it comes in contact with)

How we Challenge the Unnecessary Behaviours

We work with each patient to recognize and challenge their avoidance behaviours maintaining their fear reactions. This may look like helping the patient recognize that compulsive washing and cleaning may be a form of active avoidance, which only creates more anxiety. Passive avoidance is also addressed in session. 

Focuses on Thinking and Behaving 

The basic premise of the cognitive model is that how you feel is largely influenced by how you think. The principle suggests that emotional and behavioural reactions are learned. The goal is to help patients unlearn responses and to adopt a new way of responding to stressors. The process includes assessing the patterns that the patient undertakes in their thinking and behaviours. These thoughts and behaviours are challenged and a new modified way of thinking happens. Gaining control is of most importance in this process and the psychologist strives to empower the patient to do so.

Focus on the Present

When people are anxious they tend to think of the future. The goal for cognitive behavioural therapy is to help patients open their focus to the present moment and to assess situations without distorting their realities to the future. We want to help our clients remain focused on the present situation that brings on their anxiety and manage their symptoms in the moment.

Direct Session Activities

A psychologist conducting CBT will help guide the session by being directive. This means that the therapist sets the agenda, plans activities, and engages in discussion to help the patient move forward. The therapist and patient will mutually agree on assignments and treatment decisions. The therapist will work on helping you move forward session by session. Being specific and task orientated is very important throughout this process.

Teaching Valuable Skills

The therapist focuses on teaching valuable skills to help manage the patient’s anxiety symptoms. This may include helping with problematic situations or dealing specifically with learning new skills. This in turn will help achieve and maintain treatment goals.

Provide Guidance Through Research Supported Techniques

CBT Psychologists and Psychotherapists use techniques that have demonstrated effectiveness through clinical research. A well-trained therapist will also provide well thought out homework for their patients to read and process.

Assessment

Your first session will be conducted by the psychologist working with you. The psychologist will be taking a lot of notes and possibly ask your permission to conduct a formal assessment with the use of a specific measure that will help identify any issues that may influence your ongoing treatment. The assessment session will help gather information that it’s important to develop a treatment plan. You may be asked questions about your health history, your symptoms, and family. We recommend that you take the time to reflect on your responses and be as open as you can. Assessments could take up to two hours.

Why is it Important to Form a Therapeutic Relationship?

The therapeutic relationship is very important to develop for both the client and the therapist. Genuine openness is imperative to the healing process. This process is important for both parties to nurture throughout the therapeutic journey. Your therapist will attempt to establish a collaborative relationship. They will do this by being supportive, encouraging, and non-threatening.