#1025 - Dr Paul Hewitt - Understanding the Psychology of Perfectionism

Summary

---

Podcast Summary: Modern Wisdom #1025

Guest: Dr. Paul Hewitt
Topic: Understanding the Psychology of Perfectionism
Host: Chris Williamson
Date: November 27, 2025

Episode Overview

In this episode, Chris Williamson welcomes Dr. Paul Hewitt, a renowned clinical psychologist and one of the world’s leading perfectionism researchers. Together, they unpack what perfectionism really is, its roots in childhood, how it feels from the inside, its real-life costs, distinctions from high achievement, and the rare (but real) paths toward change and self-acceptance. Dr. Hewitt shares decades of clinical insight, original research, and therapeutic wisdom, all in his candid and thoughtful style.

---

Key Discussion Points & Insights

1. Defining Perfectionism

• Perfectionism is a deeply ingrained personality style, not simply about high standards.
• At its core, it’s rooted in a belief of personal inadequacy or defectiveness.

  "It's kind of the sense that at the core I'm not enough, that there's something that is flawed, defective. I'm just not enough either to have worth or to be acceptable to other people..." — Dr. Hewitt [00:08]

• It's more a drive to avoid imperfection than to achieve excellence.
• Everyone's perfectionism is unique, with different patterns and triggers.

2. Developmental Origins

• The roots often lie in childhood experiences of non-attunement or unmet needs.
• Perfectionism is seen as a childlike solution: "If I am perfect, then I will be loved and accepted."
• Attachment theory and early caregiver relationships strongly influence this development.
• It’s rarely about “bad parents”—sometimes needs simply are not met, for various subtle reasons.

  "There's what we call an asynchrony or a non-attunement... it's not to say that the parents are to blame or bad. It's just that... what the child needs is just not attainable." — Dr. Hewitt [02:18]

3. Inner Experience of Perfectionists

• The internal monologue is often abusive, harsh, and critical.

  "If you took that dialogue and spoke it to your spouse, your child... you'd be divorced and probably arrested." — Dr. Hewitt [08:37]

• Perfectionists treat themselves in ways they would never treat others.
• Successes rarely register as satisfying; failures confirm their worst fears.

4. Perfectionism vs. High Achievement

• Healthy striving is not perfectionism.
• The motivation is what matters:
  • Achievement motivation: "pushing oneself"
  • Perfectionistic motivation: "trying to repair a defective self"
• Perfectionism is not an effective way to feel worthy—or to achieve more.

  "If the person is trying to correct themselves or correct their sense of fitting in the world, it becomes very maladaptive." — Dr. Hewitt [10:04]

5. Achievement Doesn’t Heal Perfectionism

• Accomplishments don't provide lasting relief.

  "Does achievement relieve perfectionism?"
  "No." — Dr. Hewitt [16:31–16:41]

• Success only brings temporary relief, quickly replaced by new, higher standards or continued dissatisfaction.
• Failure, on the other hand, reinforces the core belief in unworthiness.

  "Success doesn't relieve it, but failure confirms it." — Chris Williamson, Dr. Hewitt [18:42–18:47]

Memorable Story

Dr. Hewitt’s account of his university student patient who earned the highest mark but felt like a failure because he had to work hard—captures the futility of achievement for perfectionists.

"He said, you know, but 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 hard. It just illustrates that I really am not capable." — Dr. Hewitt [21:05]

6. Taxonomy of Perfectionism: Three Dimensions

Dr. Hewitt distinguishes several types (dimensions) of perfectionism:

• Self-oriented: "I need me to be perfect."
• Other-oriented: "I need you to be perfect (my spouse, children, coworkers...)"
• Socially prescribed: "Others need me to be perfect."

  "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." — Dr. Hewitt [28:22]

Expression Styles

• Appearing perfect (self-promotion)
• Concealing imperfection (avoidance, non-disclosure)
• Harsh internal dialogue (“self-relational” aspect)

7. Associated Traits and Outcomes

• Strong links to depression, anxiety, eating disorders, physical illness, early death, and even suicide risk.

• Perfectionism more reliably predicts suicide than depression and hopelessness (when controlling for those variables).

  "Perfectionism predicts suicide even when controlling for depression and hopelessness." — Chris Williamson [38:41]; Dr. Hewitt [38:51]

• Not strongly associated with conscientiousness (the excellence motive).

8. Perfectionism, Narcissism, and Social Function

• Perfectionism overlaps with narcissism, especially in public self-curation.
• Perfectionists may come across as distant, inauthentic, or even arrogant—ironically pushing others away.
• Attempts at performative vulnerability or “fake imperfection” rarely feel genuine to others.

  "I think people would still pick up the lack of genuineness... There's a genuineness to it." — Dr. Hewitt [42:12]

9. Perfectionists and Intimacy

• Intimate and romantic relationships are often fraught: perfectionists hesitate to reveal vulnerabilities or flaws.
• Those living with perfectionists (partners, children, coworkers) often experience "collateral damage," especially from other-oriented perfectionism.
• Intimacy requires risk and gradual mutual reveal; perfectionism stops the process.

10. Broader Cultural Influences

• Western culture glamorizes flawless success, achievement, and perfection.
• Many people (especially high performers) over-identify their worth with what they do, at the expense of a multidimensional identity.

  “If I want to be a better father, I have to be a worse business person." — Chris Williamson [68:33]

11. Treatment and Recovery

• True recovery centers on deeper issues of self-worth, belonging, and mattering.
• Dr. Hewitt’s approach is grounded in psychodynamic therapy, not superficial behavioral fixes.

  "We don't really talk about perfectionism very much at all. We talk more about those deeper issues about worth, about needing to feel acceptable to other people, about connecting with other people. And it's also about growth." — Dr. Hewitt [46:09]

• The goal is self-acceptance, not symptom management.

On CBT for Perfectionism:

• Research (including Hewitt’s) indicates CBT only achieves temporary, limited changes; the core beliefs rarely shift.
• Long-lasting change requires relationship-based, experiential learning—a safe space to be fully seen and accepted.

  "The best metaphor I have... is it's through the experience of revealing the self." — Dr. Hewitt [75:25]

12. Helping Perfectionists

• True support is best provided by qualified professionals; friends or partners can encourage but rarely fix it independently.
• Relationship with therapist must be safe and genuine to create change.

  "I would be encouraging of people to try to find a therapist that they can work with, that they trust and that they could connect with to deal with those issues." — Dr. Hewitt [81:58]

13. Is Perfectionism Increasing?

• Yes, especially the trait dimensions.
• Cultural, societal, and possibly technological shifts are increasing both perfectionism and related psychological difficulties.

  "Perfectionism seems to be increasing over the decades. At least the trait elements seem to be." — Dr. Hewitt [85:33]

---

Notable Quotes & Memorable Moments

• "Inside the mind of perfectionistic people, that secret sort of world we live in, that's only sort of there for us, it's pretty horrific." — Dr. Hewitt [09:40]
• "Achievement doesn't relieve perfectionism." — Dr. Hewitt [16:41]
• "Success doesn't relieve it, but failure confirms it." — Chris Williamson, Dr. Hewitt [18:42–18:47]
• "You can turn abject successes into abject failures." — Dr. Hewitt [23:14]
• "If you suffered in a successful thing, there was some comfort... because... I was really pushing myself for this success." — Dr. Hewitt [24:57]
• "Perfectionism predicts suicide even when controlling for depression and hopelessness." — Chris Williamson [38:41]; Dr. Hewitt [38:51]
• "The perfectionistic individual knows they're flawed... for the narcissism, at times they can almost be delusional in the sense that, okay, I am but perfect." — Dr. Hewitt [34:53]
• "It's helpful for people to know that they can make changes... they're not trapped in it." — Dr. Hewitt [71:49]

---

Important Segment Timestamps

| Segment | Topic | Timestamps | |-------------|--------------------------------------------------------|-----------------| | Defining Perfectionism & Childhood Roots | 00:08–06:09 | | Inner Experience & Harsh Self-Dialogue | 07:11–09:54 | | Striving vs. Perfectionism; Motivation Differences | 09:54–11:47 | | Identity, Achievement, and Worth | 11:47–16:45 | | The Futility of Achievement for Perfectionists | 16:31–18:47 | | The Slippery Slope of Success and Suffering | 21:00–26:37 | | Taxonomy & Types of Perfectionism | 28:09–33:32 | | Perfectionism, Narcissism, & Social Perceptions | 34:40–42:12 | | Relationship, Intimacy, & Other-Oriented Perfectionism | 56:49–62:38 | | Why We Struggle with Imperfection | 62:38–68:57 | | Therapy, Recovery, & Treatment Approaches | 71:49–81:58 | | Perfectionism Trends Over Time | 85:27–86:35 |

---

Conclusion

Dr. Paul Hewitt’s insights reveal that perfectionism is much more than wanting to be good—it’s a deeply rooted, self-protective response to early wounds around worth, love, and belonging. Its consequences are far-reaching, from isolation to serious mental and physical health outcomes. True change is possible but slow, requiring safe, skilled therapy focused on self-acceptance and genuine connection, not just better "performance." For high achievers and everyday people alike, this conversation provides both a warning and a hopeful path forward.

---

Further Resources:

• Dr. Paul Hewitt’s clinical and university websites
• Upcoming trade book on perfectionism by Dr. Paul Hewitt and colleague

For those struggling or supporting someone with perfectionism:
Encouragement to seek professional help—deep healing is possible but not a solo journey.

---

End of summary.

Transcript

[A]

Give me a better than most people probably already have working definition of perfectionism.

[B]

Well, first off, perfectionism is kind of a deeply ingrained personality style that people use to kind of navigate their path through life. So we talk about it as a way of being in the world. And it's kind of the sense that at the core I'm not enough, that there's something that is flawed, defective. I'm just not enough either to have worth or to be acceptable to other people, to fit, to belong, to have a place in the world. And so it's a way of trying to navigate that. Because when we have that sense of being flawed and defective, where 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 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 cared for, 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 what it is is this sort of way of navigating the world, of trying to conceal imperfections, trying, yes, to be perfect in, in. In tasks and activities, in that. But really it's more of a drive not to be imperfect. So it's kind of what. That's kind of the way we understand.

[A]

So the, this typical sort of upbringing of somebody that grows up to be a perfectionist is love contingent on performance.

[B]

And that can be an element of it. I think what we talk about in terms of the development would be a sense of. This comes from the attachment literature that people have probably heard the term before, but also some writing, soft psychoanalytic writing on the development of the self by Heinz Kohut. And it's the notion that very early on in our lives we develop a sense of who we are and a sense of the way other people work in our lives. And so 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 non attunement. It's at these basic very human needs to have worth and to be acceptable or to. To fit and belong are not met 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 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, or that just that 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.

[A]

And what's the lesson from the burgeoning proto perfectionist? 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.

[B]

Yes, but it's not that sophisticated at that very early age. It's a sense of I'm just not enough, 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 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, and I will fit and belong in the world. Now, it's a very childlike solution to the problem, but it's very elegant at that sort of stage of development. And it grabs on with these people. Sorry, you were gonna say something.

[A]

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, better in terms of my performance, higher in terms of my achievement, I less in terms of my error and my mistake making.

[B]

All of those, all of those kind of things. But at the, at the basis of it is this sense that, yeah, I need. I need to be more. And 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. 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, 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 there's just paralysis that exists.

[A]

What does it feel like to live inside a perfectionist's mind?

[B]

Abusive, harsh, critical. I mean, there was a component of perfectionism that we call the. The intra individual or the self relational component. And the way to think about it is, Chris, just like you can have a way of relating to other people, and it's a stylistic way. 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. 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. And they're benign sorts of things. But every once in a while that a style can be triggered where the individual is evaluating themselves or anticipating some kind of performance. And a stylistic, oh, I've got to do this perfectly. I've got to make sure I have all this covered. I got to make sure I don't stutter, I don't mispronounce a word. I don't look silly or foolish or my voice shit on 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 it's this kind of relational thing. And if you took that dialogue and spoke it to your spouse, your child, 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. And I say, well, isn't that interesting that you could be that, you know, that abuse, 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. And so inside the mind of perfectionistic people, that secret sort of world we live in, that's only sort of there for us, it's pretty horrific.

[A]

So I guess one obvious question is how do you distinguish healthy striving and standards of ambition from toxic perfectionism?

[B]

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 really what they're talking about, I believe, is an entirely different construct. And to use perfectionism 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 driven by this sense that there's something wrong with me and I. The whole purpose in. In navigating the world is to correct that, to somehow feel worth. That's something entirely different. So it's kind of at the basis of the motivation for the behavior. If the person is trying to correct themselves or correct their 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 life, that's wonderful. That's very, very helpful. So the distinction is in the way we understand it. They're two very different psychological constructs. One is to repair the self, and another is to push the self, entertain, and accomplish different things.

[A]

I think one of the challenges people will be thinking about here is, well, I am my work. In many ways, I feel 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 territories. And by fixing, if you. If you underperform in a sports game, the World Series is going on at the moment. And if you have 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? 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. 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 are very much sort of talking about the same thing, that if I do well, I am good. If I do badly, I am bad. And I think that, at least in my experience, knowing that I was going to have this conversation with you and talking to some friends about this, I think this is a very common interpretation where the. The difference between what you do and who you are. So the difference in improving and becoming more ambitious inside of the domain of your pursuit and trying to fix yourself because you are your pursuit is. Is often seen as one and the same.

[B]

You're right. And. And I. And very perfectionistic people will do that. I will repair myself by becoming even better at what I'm trying to do. And in the clinical work I do with Olympians, with high performers all over the place, there is a distinction, and I think you alluded to it in one of the things you said, that screwing up in two games in a row in the World Series 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 who I am constitutes a major portion of my identity. But 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'm just awful. I'm not good enough. And people will actually make a distinction, you know, between, 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 guy who's really not Mr. Williamson. And I'm making this up with you, of course, because I don't know you at all. But when you make that distinction with people and with professionals. Absolutely. They understand that, 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 actually did do all those things. But it really doesn't solve the problem of me feeling like I'm just not worthy enough. I'm just not acceptable. I just don't fit.

[A]

Yeah, I suppose that's an interesting part of this. Does achievement relieve perfectionism?

[B]

No. No.

[A]

That's an uncomfortable realization, isn't it?

[B]

That's a fantasy for these individual. 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 accolades, some attention or some interest in, and grab onto it with the belief that if I achieve these high, high standards or get these accolades, that's going to solve the problem. And it's just the wrong tool for trying to solve the problem. But grab onto the fantasy and maintain it. And it's particularly pernicious when you're thinking about perfectionism because you can have individuals decide that 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 I 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 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, they up the ante and think, okay, it's gotta be more perfect next time.

[A]

So success doesn't touch the underlying belief of unacceptability?

[B]

No, that's my experience. That's not the solution.

[A]

Does a lack of success worsen the underlying belief of unacceptability?

[B]

Yeah, right.

[A]

Okay. Reinforcement. Success doesn't relieve it, but failure confirms it.

[B]

Yes, absolutely. Yeah. 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 can, you can pound them. You're usually going to make a huge mess. But the odd time it might actually get the screw, it might actually get the nail in, but there's a better tool to use that that actually solves.

[A]

The problem in other News Shopify powers 10% of all E commerce companies in the United States. They are the driving force behind Gymshark, Skims, Aloe and Nutonic, which is why I partnered with them. Because when it comes to converting browsers into buyers, they are best in class. Their checkout is 36% better on average compared to other leading commerce platforms. And with Shop Pay you can boost conversions by up to 50%. They've got award winning support there to help you every step of the way. Look, you are not going into business to learn how to code or build a website or do backend inventory management. Shopify takes care of all of that and allows you to focus on the job that you came here to do, which is designing and selling an awesome product. Upgrade your business and get the same checkout that I use with Nutonic on Shopify Right now. You can sign up for a $1 per month trial period by going to the link in the description below or heading to shopify.commodernwisdom or lowercase, that's shopify.commodernwisdom to upgrade your selling today. It feels to me like perfectionism, self perpetuating. Then achievement doesn't relieve this sense that I'm not enough. In fact, it reinforces in many ways, oh, I must be more perfect. 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 C suite. 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 success is never sufficient and failure is always confirmation of your insufficiency.

[B]

And it's always failure. It's always failure.

[A]

Even a special kind of success is a type of failure because it didn't fix the problem.

[B]

Yeah, I can tell you about a patient I had. I write about this in one of my books. It's a fellow who was very perfectionist and very suicidal. And I started seeing him. He was university student in a particularly challenging program and I started seeing him just at the end of the school year after he had been discharged from hospital actually. 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 want to do really well in this course. I have to get an A plus, and I want to have the highest mark of any other student in there. And so I had just started working with him and it had maybe been four 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 more depressed than I had seen him actually over the course of that time. And he said to me, when I got the grade, I got the A plus, and I actually got the highest score in the course. And. And then for any of us, that would have been caused to celebrate and break out the champagne. And 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 hard. 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 done.

[A]

And that is so slippery. It's so.

[B]

That is not unusual. It's not unusual.

[A]

Let me give you.

[B]

Turn abject successes into abject failures.

[A]

Wow. Let me give you my own personal example of that from when I used to run nightclubs back in the day. So my criteria for success 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. Then not only did the event need to be successful, I had drawn a link between when I suffer because I work very hard, typically the event does better. And what that resulted in was 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 bypass. So the event was a failure. I was a failure. So that was one source of potential 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 talking about with your ex patient there. I also have this. I've been having this conversation at the live shows I've been doing around the US at the Moment. 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 I feel like all of this sort of ties together.

[B]

Oh, it absolutely does. I mean, one of 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, a sense of celebration, a sense of, okay, I. I did do this. I did accomplish this, and they just don't. Don't experience a sense of satisfaction. 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 celebrate and to share in that experience, which is something that's missing usually in perfectionist life all their life, the sense of shared pride in something. But. 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, often upping the ante each time. 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 really did this. I was really pushing myself for this success. So they might.

[A]

It's almost the inverse of what your patient had, right? Which I guess goes to show the idiosyncrasy of how this comes about. My British puritan work ethic was showing, 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 at least a part of mine was, things that are successful should be difficult, they should be hard. And if you arrive at them without suffering and without challenge, that it belies a kind of laziness. There's a sense of mailing it in. There's maybe a fragility or 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.

[B]

Makes Some sense to me. Yeah. I mean, what you're talking about is actually healthier, I think, than what? Than the kind of people that we're talking about. You know, I will. I will.

[A]

I will take that as the. The oddest kind of compliment that I have ever. I'll reverse engineer that into a compliment.

[B]

Perfect.

[A]

I guess 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 chunks, taxonomies, categories, different waves that it shows. What. What are those?

[B]

Yeah, it's quite complex in some ways. So there's three different levels that we sort of describe or define perfectionism. And one is like a dispositional or trait level, a consistent kind of need to be perfect, if you like. And very simply, we can talk about individuals, some individuals that will be characterized by I need me to be perfect, and it comes from the self. It's directed toward the self, and so I require perfection of myself. And it's a very autonomous kind of state for individuals. There's also another dimension, or 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. Well, let me get to that in a second. 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 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 it may not be that I need to be perfect, but I sure need to appear to you as if I'm perfect. So I will promote myself for 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, you're going to see a flaw. So if I public speak, you're going to see that I stutter, I stumble over words, 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 not reveal to you verbally anything about anything that I see as imperfect. 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 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 relation expression of perfection. Is that this dialogue, this harsh, negative, critical inner relationship that we have. So those are all different facets of this way of being perfectionistic in the world, of trying to be perfect in the world. So it does get kind of complicated.

[A]

What about sort of you, the self oriented, other oriented and socially prescribed elements to this too?

[B]

Yes. Yeah. The self oriented, 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.

[A]

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 need to not divulge to you anything that you would see as me being imperfect.

[B]

Yeah, well, one is a driver of the behavior, the self, other social. And then these other pieces is like, I can require myself to be perfect and you're kind of irrelevant to me. But maybe that my perfectionism is about, I know I'm not perfect 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. So that's a distinction.

[A]

Yeah. It's interesting, the difference between needing perfection and needing to appear perfect.

[B]

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 domain.

[A]

This episode is brought to you by gymshark. You want to look and feel good when you're in the gym. And gymshark makes the best men's and girls gym wear on the planet. Let's face it, the more that you like your gym kit, the more the more likely you are to train. Their hybrid training shorts for men are the best men's shorts on the planet. Their crest hoodie and light gray marl is what I fly in every single time I want a plane. The Geo seamless T shirt is a staple in the gym for me. Basically everything they make. It's unbelievably well fitted, high quality, it's cheap, you get 30 days of free returns, global shipping and a 10 discount site wide. If you go to the link in the description below or head to gym S.H. modernWisdom use the code Modern Wisdom 10 at checkout. That's Jim S.H. modernWisdom and ModernWisdom 10 at checkout, I imagine. Have you found a crossover between perfectionism and narcissism?

[B]

Yes, absolutely.

[A]

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.

[B]

Yeah, yeah. There is exactly those elements, especially in the interpersonal world is about I'm going to show you how perfect I am. Where it is a little bit different is the perfectionistic individual knows they're flawed, they're defective, they feel that way, they feel, they know that and I don't fit in the world. And for the narcissism, at times they can almost be delusional in the sense that, okay, I am, but perfect. But very similar routes, very similar pathways, but they're divergent.

[A]

So what other personality traits does this cross over with? I would imagine conscientiousness, neuroticism, maybe some depression. What. What else do you see? Typically.

[B]

Depression, for sure. And in fact the depressive personality style, which is. That's not a DSM category, that's a psychodynamic diagnostic systems category, but a very depressive personality style. There's some neuroticism, if you're thinking about the big five. Conscientiousness, actually, not so much. That's more that healthier piece. And there's a. Actually there's a domain of research that 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. So there's that component when we start looking at the Outcomes of the perfectionism. And especially as we've kind of conceptualized it, there's psychiatric psychological problems that come from it. So it's overlapping with anxiety, depression, eating disorders, all kinds of difficulties. 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. 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. Perfectionism is 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 worked from my lab or my colleague Gordon Flett's lab, where perfectionism associated with early death. So when you look at other risk factors for early death, perfectionism, self oriented and socially prescribed, are just associated with early death among people. So 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 all these domains of outcomes of the perfectionism that have been associated with those kind of outcomes.

[A]

So yeah, you had. Perfectionism predicts suicide even when controlling for depression and hopelessness.

[B]

Two factors that are historically predictive of suicide would be depression, hopelessness. And we've shown in several studies that socially prescribed predicts beyond that. In some ways it sort of dovetails nicely with some of the work that's been going on in terms of loneliness or alienation and the impact that has on physical health for people and of course suicide. But if you have a process that ensures that you have this disconnection with others, 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 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 because you're distant, you're not genuine, you're prickly, and you push people away.

[A]

That's a good, that's 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?

[B]

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. I can do this and I can do that, and I'm fantastic. And immediately you're gonna take a step back and say, get me away from this person. Or if I come across as cagey, I'm not really revealing. You interact with me and you think, 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 pick that up, so they pull away.

[A]

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 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 people, the imperfect perfectionists are perfect, that they've even put imperfection in.

[B]

That's very interesting. I think people would still pick up the lack of genuineness. I think it's kind of like when you watch. 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 genuineness 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 and generally we pick up there's something missing here. There's a. I don't want to say a creepiness to it, but I'm not. I don't have the full picture. This is kind of making me uncomfortable.

[A]

Yeah. So just going back to how deadly and dangerous perfectionism can be.

[B]

Yeah.

[A]

I have to assume as well that perfectionists would probably delay seeking help.

[B]

Oh, absolutely.

[A]

Admitting illness must feel like a failure.

[B]

Absolutely. You hit it right on the head because that is revealing an imperfection in many of the clinicians that I see in my practice. It's very difficult for them to seek help in that vein and they forestall. So I had. I had a patient who had. There was a newspaper back in the day when they actually had newspapers, 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 this world of what it's like for a distressed classical musician. In this context, being perfectionist carried it around for six 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 were gone, meaning the family. And it was so he knew he needed to seek help. He had seemingly found someone need 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 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 you and your imperfection and your flawed sense of that's what we're going to work with and that you have to work with kid gloves with folks on that.

[A]

Yeah, well, look, I think 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.

[B]

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 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, about needing to feel acceptable to other people, about connecting with other people. And it's also about 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 the person being 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. And so it's more about helping the person kind of grow and develop new ways of developing worth and connectedness.

[A]

In other news Elements Newest flavor Lemonade sold out immediately, but now it's back in stock. This little thing here is like a grown up lemonade stand in a stick with actual function behind. The flavor replaces electrolytes that your body genuinely needs, sodium, potassium and magnesium. It makes a massive difference to your brain function, your appetite and your energy throughout the day. I've been drinking it every single day for yours and in the Texas heat or any workout, this lemonade flavor in a cold glass of water is unbelievably good. Best of all, they have a no questions asked refund policy with an unlimited duration. And who knows when this is going to sell out again. So get it now. If you don't like it for any reason, they will give you your money back and you don't even have to return the box. Plus they offer free shipping in the US right now. You can get a free sample pack of elements most popular flavors with your first purchase by going to the link in the description below or heading to drinklmnt.com modernwisdom that's drinklmnt.com ModernWisdom is perfectionism a performance enhancer? I see the traits that you're talking about among lots of high achievers. And if it's if your sole goal in life is to achieve this thing and you're saying 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.

[B]

Sure. Well, there's been some research done on perfectionism and performance in the workplace or in people's career with the assumption that in one very early study they looked at this. How did they do this? The commissions? People who are in careers that they have commission. 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 people 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. And looked at perfectionism in those university students, professors to see if higher levels of perfectionism was associated with higher productivity. The opposite again, it interfered with their productivity. Now, having said that, there are many very famous people who are noted to be highly perfectionistic and 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 the perfection, look what they accomplished. And I think we can stand back and say, wow, those are great accomplishments that the person has. But if you look at the person's personal life or their relationships in America, it's often devastated. It's often really problematic. So I guess it depends on the perspective you take that perfectionism could be good. Sorry, go ahead.

[A]

No, I just, I think, I think you're so right. I got all excited because this is one of my favorite pet theories. 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. We'll look at how Michael Jordan showed up. Perhaps this is how your Sunday league baseball team should look to conduct themselves. We'll 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? First off, you've got no guarantee that you're going to achieve that. There is only one Olympian in each category every four years. So in order to get there, 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. My point being, I think it's a dangerous strategy to use the 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 curve, 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.

[B]

And maybe you can feel worse and that you are lovable or that you are acceptable or that you fit in this planet in a different way. One of the things you said made me remember, and I hope I can get this right. I think Elon Musk was being interviewed by somebody, probably somebody, and 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 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 there's, again, I don't know him or anything, but from that comment, it just seemed telling that.

[A]

I mean, I've got. He said on Lex Friedman, 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. All right, that's pretty fucking apocalyptic.

[B]

Well, you said it way more elegantly than I did.

[A]

I just. I've kind of become obsessed with that passage, so. And it's for the same reason, presumably, that you have. So, okay, I guess 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.

[B]

I think it's an existential fear about not fitting, belonging, who am I? Where am I? So I think you're right that it is about fear. And one of the ways to quell some of that existential fear, because we're social creators, is to have connection to fit, belong, to matter, to people, to be loved, but also fundamentally to have a sense that I'm okay, I'm deserving, I'm good enough, that I have worth. And so those deep basic issues, I think, are powerful there. And what happens when they're not met. Is that exactly what you're saying it's about? There's this fear One of the more difficult 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. 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 it's just the unknown.

[A]

They, because that previous motivation was so.

[B]

Much be perfect, so ingrained and so much a part of their life that there's just this void. And as humans, we don't navigate the unknown very, very well. And it can be terrifying if you just lose a way of being in the world and there's some other expectation. So within the therapy, we approach that, I don't want to say gingerly, but we approach it in a way that, that tries to help them with the fear of that and to get to a place that there's a different way of being in the world that can actually increase the probability of meeting those needs.

[A]

Can you explain to me the other oriented perfectionism? Because that feels a little bit more, 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.

[B]

Right, Right. 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're thinking, well, hey, I'm a person here, I don't really don't need this. But they're coming to you for a reason. And to be in the presence of somebody with high status, for example, it gives them status. So if I need my 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 there'll 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 gonna sidle 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 part of what's called borderline personality disorder pathology or borderline pathology. I don't have a sense of identity, so I'll borrow yours essentially. And that's how that works. So the ultimate goal is the same, to try to elevate my sense of worth. But I'm going to use, 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. And that's how other oriented works. When people fall short. When my wife screws up, oh my God, 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. Some people call it a narcissistic rage. And it, it's it that kind of captures that.

[A]

So 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 an additional difficulty level on top.

[B]

Yep, no, you're right. There's very good research. There's lots of relationship problems, but in intimacy in particular. And if you think about how intimacy evolves, it's this series of interactions of each of like one person taking a risk and revealing just a little bit more about themselves and the other person recognized, 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. 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. But brand new couples know there's still this, okay, just gotta be careful here. And so that intimacy evolves with these folks who can't reveal shortcomings, shortfalls, aspirations, emotions that are difficult vulnerabilities. Intimacy is really problematic also if you.

[A]

Are, I need my partner to be perfect. That's gonna be very uncomfortable for your partner. Oh, that's where it's not a fantastic foundation to keep 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.

[B]

Oh, absolutely. The complaints when you. For people who have other perfections don't come from the perfectionist, come from the other people in that person's life. Yeah, that's where you see the. The distress show up. I mean, there's still distress and in the perfectionist, but it can be. It can get pretty. Yeah, it could get pretty awful. And it's not just partners, it's person's children, the person's subordinates in their workplace, you know. Yeah, it's very problematic for those folks.

[A]

So if imperfection is human, which it is, why does failure still feel so unbearable to so many of us?

[B]

Yeah, I don't know that we. Imperfection may be common. I don't know that we embrace it in any sort of way. And I mean, even from religious teachings for thousands of years, it's been, you know, try to be more God, like 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 when you attain perfection. And that somehow the root to good things happening or bad things not happening seems to lie in that domain. And whether it's from various religions that might be talking about it or philosophies, or even children trying to navigate the world that they live in. Let me tell you a story about a patient who really. It illustrates a whole bunch of different things as we're talking. This was a woman who in her 40s, was, 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. Came to see me knowing she needed thinking things were just not going well in her life and hadn't. And came to see me. And it took quite a while before we actually. She would actually say what she wanted to be doing, 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 of having been adopted as a child very early, like as an infant, and her parents 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 expert 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 stories. We went to the place where 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 and gave her that story, which sounds like incredibly loving thing to do. And it absolutely was with the motivation out of this love and caring 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 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 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 absolute. And every relationship she had, including romantic relationships, was this incredible fear that at any moment, if I reveal any imperfection or any piece of who I am that's flawed or whatever, I will be taken back. And it's just a model of the way the world works for her. And it took a while to kind of get to that under that understanding. So can't remember what your original question was, but somehow it was connected to romantic relationships and relationships with people.

[A]

Yeah. And this concern about imperfection being so unbearable, this sort of failure being unbearable. I think as well, you know, the fact that we glamorize perfection so much in art, sport, entrepreneurship, as you said, religious ceremony, media, you know, a flawless performance, even some of the language that we use. And the fact, again, we are our work for a lot of people, 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 a 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.

[B]

Ha.

[A]

In there, like belies the fact that I cannot be perfect. So I need to adjust the deployment of my resources and my efforts 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.

[B]

Yeah. One of the things I'll do with some patients is say to them, on your deathbed, in 50 years from now, as you're laying there thinking about your life, what do you think you're going to regret? And usually it's something you didn't do. And what are you going to regret more? Another day at the office connecting with your grandchild. And I just ask people about if they put themselves in that position, what are they going to look 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. And it kind of tries to put that in perspective, some of those elements in perspective as well. I mean, you've said this a couple of times, Chris, that what we do is kind of who we are. And I think that's very true. I. That may be kind of a cultural thing in North America and the Western world, that we define ourselves in that fashion. I think we catch up with some things at different points in our lives. So there's different stages. 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.

[A]

That's interesting. There's a degree of buffer between the two that relinquishes the ownership. The directness of your impact has been sort of removed a little bit. That's kind of funny.

[B]

Yeah. And I think there's just at different times, different things kind of become more important. And I think as we get older, relational pieces. I'm just guessing here because I don't really know this work, but it seems relational pieces seem to evolve. So the concept of generativity, it's the older folks who want to give more. They're not so much involved in their own success, but they want to mentor people, they want to teach people. 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.

[A]

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 say, 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.

[B]

Sure. Well, I guess the question is, what cost are you willing to pay for it? I mean, it can come down to that. Most of the people that I see in treatment are pretty desperate and it's pretty painful for them. So in the training of, especially my graduate students, to learn to work with these folks is to prepare them a little bit for once. You open, open the door for these folks where they can express the emotional pain. It's pretty breathtaking and pretty powerful. So there can be a lot of pain that people kind of live with. But I guess at the end of the day it's always okay, you're paying a price for this. Everything has a cost and a benefit and those shift and change over time in different contexts and it's just, you know, how much are you willing to pay? But it's helpful for people to know that they can make changes in that they're not trapped in it.

[A]

What are the steps out of perfectionism? How do people learn to get past this? I imagine that there is some evidence based approaches. Okay, so take me through it.

[B]

While the work we've done is from a psychodynamic, psycholytic perspective of really trying to deal with the deeper issues that produce the perfectionism. So it's kind of the notion if you really hurt your knee, the symptom you have is pain. And hopefully when you go to a clinician about 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. Hopefully the clinicians admit, in truth, this is what clinicians would do and 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 psychodynamic 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, I mean, it's an evolved process, but it's also, 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 and that there's an acceptance of other people, that other people are also flawed. 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 about finding a place for oneself.

[A]

What are the most common interventions that you use to increase somebody's self acceptance?

[B]

Well, you would use, in psychodynamic 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 we use the therapeutic alliance to create a place of safety 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 deep pain, the emotional stuff, to actually look at who they truly are. And so again, we use that therapeutic alliance that way. There's a domain of treatment that likes the notion of worksheets and practice and tell yourself not to be worried about making mistakes and that sort of thing. And I just, I find it, to be honest, I find it really silly. Like, 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? 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 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 on how to ride a bicycle. And you go to the lecture, he provides all the information, you take notes, write the multiple choice 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 together, and you wobbled and fell and got up again. 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 am, other psychodynamic people are trying to do to teach people new behavior to is. It's through the experience of revealing the self. It's through the experience of having, being able to connect with somebody and to have them kind of 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 of it. So it's not, 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 a good bunch of people, which is great. Kind of like doing that to really show what the evidence is for a CBT based approach for perfectionism. And how did it not. And well, when they wrote about this stuff it was wonderful. But when we actually looked at it, we saw that 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. There's good 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 follow up, a few months or six months later, no, the changes disappear. So it's not maintained. 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 pernicious ones, socially prescribed doesn't change. And it's the one associated well along with self oriented by suicide, early death, anorexia nervosa, depression, anxiety. So those pernicious pieces don't seem to change with CBT in the work that we do. 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 pernicious elements. And there's three different, five different studies that have shown, yeah, there's changes that are made in that the way we do the treatment research is, yeah, we've developed a treatment, we'll do a study and we'll show the effects. We then try to figure out, okay, well, how could we find 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 pretty good or very good. How can we improve it even more?

[A]

What would you say to somebody who has a perfectionist person in their life? How can those around perfectionists show up in a way that helps them to improve their worldview?

[B]

I would encourage them to find somebody to work with them on it, to find a professional to work with it. 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 that is easily changeable. But I would be encouraging of people to try to find a therapist that they can work with, that they trust and that they could connect with to deal with those issues.

[A]

What is the school or is there an accreditation body that you guys ratify to say this person is perfectionism certified to be able to do this at a standard?

[B]

We're in the process, we're in the process of doing that actually. Again, we're at a place now where we're pretty confident that the kind of approach that we do actually is helpful and not just helpful to change the levels of perfectionism, that it's clinically relevant, like the clinically significant change in people, and that it's actually in psychodynamic work, not only is the change maintained over period of time, if you do it right, the change continues after the treatment ends. 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 continues to heal, you're not doing any treatments. As it continues to heal, the pain eventually kind of goes away. And in good psychodynamic psychotherapy, there's very good evidence that that's what happens happens. It's just to know if you get rid of the cause, the symptoms kind of go away.

[A]

That's interesting. What's the role of mattering in all of this?

[B]

Mattering is one of the ways that those relational needs can show up. So some people. Well, I think for everybody it's kind of a foundational part 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 so generally mattering, but at an idiosyncratic level with people that can be manifest. Like, I have a voice, that I grew up in a family where nobody cared. I couldn't say anything that anybody would ever hear or listen to. And 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 narcissistic and tell everybody how wonderful, or I can try to be perfect in everything that I do. So mattering 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, to be loved and to have a sense of being lovable. Two different pieces there. So it all kind of fits in very generally in sort of some of the basic needs that we need to navigate the world.

[A]

Are we becoming more perfectionist over time? Is this. Have you done any longitudinal stuff?

[B]

There has been. We haven't done this work, but some colleagues of ours have actually looked at our conceptualization and looked at the scores over decades and show that indeed, yeah, perfectionism seems to be increasing 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, otherworld, socially prescribed, they're increasing. There's no, I don't know of any research that's done this, but you may know there are 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 makes sense that if a vulnerability factor for these problems is increasing, we may see an increase in depression. Some of the outcomes of those vulnerability factors. I haven't seen any work directly to address that, but it logically makes sense.

[A]

Heck yeah. Dr. Paul Hewitt, ladies and gentlemen. Paul, you're great. I really appreciate this work. I think it's very of the moment and for the sort of people that listen to podcasts, specifically stuff like this, I think many are going to feel seen and.

[B]

Oh, good.

[A]

Accused today. Where should people go to keep up to date with your work?

[B]

Well, I have a. I mean, I have a. I have both a clinical website where with more clinically relevant information, but also a website at the University of British Columbia. So there is a website. We've published books. I just. My agent said I should do this I don't. But we're just signing a contract with Norton to do a trade book on Gord. Flatt and I are doing a trade book on our work over the years to make it less academic and more available to people so they can kind of see the way we think about it, understand it, the problems and how to deal with it.

[A]

I think that would be good for the world. Paul, I appreciate you.

[B]

Thank you very much. It was wonderful meeting you, Chris. So you have very good listening skills. I've done numerous podcasts where I get the questions and then the person is busy trying to figure out what the next question is rather than having a dialogue. So it's very nice that way. So I appreciate that.

[A]

Thank you.

[B]

Okay.

[A]

I get asked all the time for book suggestions. People want to get into reading fiction or non fiction or real life stories. And that's why I made a list of 100 of the most interesting and impactful books that I've ever read. These are the most life changing reads that I've ever found and there's descriptions about why I like them and links to go and buy them. And it's completely free and you can get it right now by going to ChrisWillX.com/books. That's ChrisWillX.com books.