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Effectively Treating Pathological Self-Criticism in Depressed & Dysthymic Clients
On the last track we discussed recognizing the difference in your depressed or dysthymic client between destructive self-degradation and constructive recognition of personal limits. We also discussed three criteria for determining if self-criticism is destructive self-degradation or not. These three criteria were realism versus lack of realism, wider implications of worth, and degree of self-punitiveness present.
On this track we will discuss perfectionist patterns that self-criticizing depressed or dysthymic clients may follow and the perfectionist standards they uphold.
As you know, perfectionism is a common self-critical pattern. Among all perfectionist depressed or dysthymic clients, the common belief is that perfection is adequacy. However, the ways in which the perfectionist depressed or dysthymic clients try to achieve their "adequate perfection" vary.
Standard # 1. Being Number One
Standard # 2. Being God
Standard # 3. Better Way
Standard # 4. Ceaseless Productivity
Now lets consider the case study of Caroline. As I describe Caroline’s situation, think of the four perfectionist standards and try to determine which one Caroline is using. Is Caroline operating under the "Being Number One," the "Being God," the "Better Way," or the "Ceaseless Productivity" standard?
Caroline, age 34 and a successful graphic artist, came to one session more depressed than she usually felt. Caroline explained that she had been to a party the night before. Caroline stated, "I felt sort of anxious before I went, because usually every time I go to a party, something happens and by the end of the night I go home depressed. Sure enough, something happened last night!" Caroline then explained that at the party, she met a man named Seth.
Which of the four perfectionist standards do you think Caroline was using? Obviously, Caroline was using the second perfectionist standard of "Being Number One." As you could see, Caroline spent the entire duration of the party comparing herself to another man attending the party. As we discussed earlier, the disposition to compare oneself to others is often a giveaway that the client is using the "Being Number One" standard. Despite the fact that she’s a successful graphic artist, the fact that Seth was a better conversationalist than she was left Caroline feeling worthless.
Do you have a self-criticizing depressed or dysthymic client who is a perfectionist? Which perfectionist standard is he or she using?
On this track we have discussed the four perfectionist standards which depressed or dysthymic clients who self-criticize may use. These four standards were "Being Number One," "Being God," "Better Way," and "Ceaseless Productivity."
On the next track, we will discuss consequences of perfectionism in self-criticizing depressed or dysthymic clients. These consequences include constant failure, demotivation, disillusionment, failure to achieve safety, loss of satisfaction, negative focus, and diminished achievement. We will also revisit Caroline’s case study to see the consequences she faced as a result of his perfectionism, as well as to discuss a technique that helped her.
Peer-Reviewed Journal Article References:
Dunkley, D. M., Starrs, C. J., Gouveia, L., & Moroz, M. (2020). Self-critical perfectionism and lower daily perceived control predict depressive and anxious symptoms over four years. Journal of Counseling Psychology. Advance online publication.
Monroe, S. M., Anderson, S. F., & Harkness, K. L. (2019). Life stress and major depression: The mysteries of recurrences. Psychological Review, 126(6), 791–816.
Moore, E., Holding, A. C., Moore, A., Levine, S. L., Powers, T. A., Zuroff, D. C., & Koestner, R. (2021). The role of goal-related autonomy: A self-determination theory analysis of perfectionism, poor goal progress, and depressive symptoms. Journal of Counseling Psychology, 68(1), 88–97
Nepon, T., Flett, G. L., Hewitt, P. L., & Molnar, D. S. (2011). Perfectionism, negative social feedback, and interpersonal rumination in depression and social anxiety. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement, 43(4), 297–308.
“Self-critical perfectionism and depressive and anxious symptoms over 4 years: The mediating role of daily stress reactivity”: Correction to Mandel et al. (2015) (2017). Journal of Counseling Psychology, 64(2), 232.
Online Continuing Education QUESTION 4
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