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.

I have found that there are four common perfectionist standards that depressed or dysthymic clients may apply to themselves.  As I describe these four perfectionist standards, think of your depressed or dysthymic client. Is he or she a perfectionist? Which type of perfectionist is he or she? After we have looked at each of the four perfectionist standards, we will consider a brief case study and discuss which perfectionist standard that client uses.

4 Common Perfectionist Standards

Standard # 1. Being Number One
As you are probably aware, depressed or dysthymic clients who are perfectionists and use this standard usually operate with the motto "Be number one or you are nothing." Obviously, this perfectionist depressed or dysthymic client’s stance is that it is vital to be the absolute best in at least one area of life, if not all areas of life.

Generally, the perfectionist depressed or dysthymic client compares him or herself to other people. Have you noticed, as I have, that if that client at any point feels that he or she has failed the comparison, he or she feels it is grounds for feeling deficient and inferior?

Although this comparison game often leaves the perfectionist client feeling deficient, inferior, and, as a result, depressed, I have noticed that perfectionist depressed or dysthymic clients are often incapable of simply not comparing him or herself to others.

Does your perfectionist depressed or dysthymic client compare him or herself to others frequently? Might he or she be using the "Being Number One" standard?

Standard # 2. Being God
Obviously, perfectionist depressed or dysthymic clients using the Being God standard don’t actually say things like "I expect myself to be God." It is, however, implied by their expectations of themselves. I have found that perfectionist depressed or dysthymic clients operating with the "Being God" standard will criticize themselves for things they could not have possibly accomplished. These self-criticisms only make sense when you realize that the standards implicitly being upheld are omniscience or omnipotence.

Does your client make statements like "I should have known" frequently? Often, statements like "I should have known" imply a claim to omniscience. Other common statements from perfectionist depressed or dysthymic clients are often omnipotent ones, or statements that imply that the client could have controlled another person’s behavior. In this type of mindset, perfectionist depressed or dysthymic clients will often condemn themselves for not upholding society's standard for them.  Sound like a client of yours?

Standard # 3. Better Way
I have found that perfectionist depressed or dysthymic clients using the "Better Way" standard believe that there is always a better way to do something and because they have not used that better way, they are failures. In other words, the perfectionist depressed or dysthymic client essentially places the criteria for acceptability beyond what he or she has actually achieved. In my experience, the perfectionist depressed or dysthymic client who uses the "Better Way" standard often fears complacency, which he or she thinks will be the result of being satisfied with anything he or she has done.

Standard # 4. Ceaseless Productivity
As you probably guessed, perfectionist depressed or dysthymic clients using the "Ceaseless Productivity" standard believe that they should always be engaged in activities with utilitarian value. In other words, anything they do must be constructive, educational, or productive. I have found in my perfectionist depressed or dysthymic clients with the "Ceaseless Productivity" standard that they often find engagement in recreational pastimes as grounds to indict themselves.

As you know, to the perfectionist depressed or dysthymic client, this indictment seems appropriate because these recreational pastimes have accomplished nothing. Often these indictments will be meted out by many perfectionist depressed or dysthymia clients even at the end of a day in which they have pushed themselves to their limits and accomplished a great deal.

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.

Caroline noticed that Seth was a charming conversationalist. Over the course of the night, Seth had a chance to talk to nearly everyone and almost immediately won them over. Caroline stated, "At first I tried not to pay attention to him, but as the night wore on I couldn’t avoid it.  He was just so good at talking and getting people to like him! There was no way I could compare. I felt so socially awkward I wanted to sink into the floor."

Caroline then said that she left the party that night feeling more depressed than she had in a couple of weeks. Caroline stated, "By the time I made it back to my apartment, I felt worthless, and like I wasn’t good at anything."

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."

Online Continuing Education QUESTION 4
What are the four perfectionist standards that depressed or dysthymic clients who self-criticize may use? To select and enter your answer go to CEU Test.