Understanding the Psychology of Perfectionism - Dr Paul Hewitt

1. 0:00 – 7:11

   The Traumas That Create Perfectionists

   1. CWChris Williamson0:00

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

   2. PHDr Paul Hewitt0:08

      Okay. Well, first off, uh, perfectionism is kind of a deeply ingrained personality style, uh, that people use to kinda navigate their path through life. Um, so we talk about it as a way of being in the world, and, uh, um, it's, it's kind of the sense that at the core I'm not enough, that there's something that is, uh, flawed, defective. I'm not... I'm just not enough either to have worth or to be acceptable, uh, to other people, to fit, to belong, to have a place in the world. And so (clears throat) it's, um, 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, "Oh, okay, that's the way it is." We try to do something about it. We try to rectify it. (clears throat) One of the ways that a person can do that, and they learn this often very early in life, is that if, 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, uh, cared for. Uh, 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 (clears throat) what it is, is, um, this sort of way of navigating the world of trying to conceal imperfections, trying, uh, yes, to be perfect in, um, in, in tasks and activities and 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.

   3. CWChris Williamson2:06

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

   4. PHDr Paul Hewitt2:18

      Um, that can be an element of it. Um, I, I think that, uh, what we talk about in terms of the development would be a sense of... This comes from the attachment literature, uh, that people have probably heard, heard the term before, um, but also some writing, uh, self psychoanalytic writing, uh, on the development of the self by, uh, Heinz Kohut, and it's the notion that very early on in our lives, we develop a sense of, um, who, who we are, uh, uh, and a sense of the way other people work in our lives. And so, um, v- 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 that these basic, (clears throat) very human needs to have worth and to be acceptable, uh, uh, or to, to fit and belong, uh, are not met, uh, early in the person's life.

   5. CWChris Williamson3:25

      Mm.

   6. PHDr Paul Hewitt3:25

      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... Uh, uh, as I said, often very, very early in life. So, d- d- they do have a sense of, of, uh, 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, um, or if it just... that we just miss. We just don't connect.

   7. CWChris Williamson4:00

      Mm.

   8. PHDr Paul Hewitt4:00

      So it's not to say that the parents are to blame or bad. It's just that it's, uh, somehow what the child needs is just not a- a- attainable in that interaction. That's kind of the essence of attachment.

   9. CWChris Williamson4:16

      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?

   10. PHDr Paul Hewitt4:38

       Uh, yes, but it's not that sophisticated at that very early age. It's a, it, it's a sense of, "I, I, I'm just not enough. I, I... There's something wrong with me." And try in some sort of fashion to try to deal with that. And in a way, (clears throat) I mean, in, in a way, it's a very elegant solution to the pain of that because a child will learn, um, uh, uh, that s- 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 gonna happen. I will be acceptable to others. I'll feel good about myself. I'll have worth, uh, and I will fit and belong in the world." Now, it's a very childlike (laughs) solution to the problem, but, uh, but it's very elegant at, at that sort of stage of development, um, and it grabs on, uh, with these people. Sorry, you were gonna say something.

   11. CWChris Williamson5:39

       It makes sense if you say that one of the key drivers in a child that has 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."

   12. PHDr Paul Hewitt5:57

       Yes.

   13. CWChris Williamson5:57

       And more is more perfect, better in terms of my performance, higher in terms of my achievement, less in terms of my error and my mistake-making.

   14. PHDr Paul Hewitt6:08

       ... all of those, all of those kind of things that... But at the, at the basis of it is this sense that, (clears throat) "Yeah, I need, I need to be more." Uh, and i- i- it's, 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. Um, s- so it's quite idiosyncratic of, uh, 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, um, 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, but there's just paralysis that exists.

2. 7:11 – 16:30

   Inside Their Minds: An Imperfect Nightmare

   1. PHDr Paul Hewitt7:11

   2. CWChris Williamson7:11

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

   3. PHDr Paul Hewitt7:17

      Uh, abusive, harsh, critical. I mean, you're, there, there's a component, uh, of perfectionism that we call the, um, the intra-individual or the self-relational component, and the way to think about it is, (clears throat) Chris, just like you can have a, a way of relating to other people and it's a stylistic way. Uh, uh, n- n- n- n- you know, you're, 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, um, 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, e- 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 as well," and they're benign sorts of things. But every once in a while, (clears throat) d- n- that a style can be triggered where the individual is, uh, is e- evaluating themselves or anticipating some kind of performance and just stylistical, "I've got to do this perfectly. I've got to make sure I have all this covered. I've got to make sure I don't, I don't stutter, I don't mispronounce a word, I don't look silly or foolish or my voice sh-..." Uh, 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, and it's this kind of relational thing, and if you, if you took that dialogue and spoke it to (laughs) your spouse, your child, uh... And I'll ask patients this, like, "What if you used that dialogue with your spouse?" And they'd say, "I would be divorced and I'd probably be arrested."

   4. CWChris Williamson9:16

      (laughs)

   5. PHDr Paul Hewitt9:17

      To be honest with you. (laughs) And I say, "Well, isn't that interesting that you could be that, you know, that abusive or you're, you're not that abusive to loved ones in your life-

   6. CWChris Williamson9:26

      Mm-hmm.

   7. PHDr Paul Hewitt9:27

      ... 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. Um, and so inside the mind of, of perfectionistic people, um, that secret sort of world we live in that's only sort of there for us, um, uh, uh, it's pretty horrific.

   8. CWChris Williamson9:54

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

   9. PHDr Paul Hewitt10:04

      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, and really what they're talking about, I believe, is an entirely different construct and to use perfectionism in the, in, in the, uh, in, in the term is inappropriate. We're talking about asc- 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, um, driven by this sense that there's something wrong with me and I... Uh, the whole purpose in, in, uh, navigating the world is to correct that to somehow feel worth, that's something entirely different. So, um, it, it, it's kind of at the basis of the motivation, uh, 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 a- attaining really difficult standards or even trying to attain the impossible things Elon Musk has kind of tried (laughs) to do throughout his, uh, uh, uh... That's wonderful. That's, that's po- uh, very, very helpful. So the distinction, uh, i- it is and do 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 and attain and, and accomplish different things.

   10. CWChris Williamson11:47

       I think one of the challenges people will be thinking about here is, "Well, I am my work in many ways. I feel, I feel, uh, um, 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-

   11. PHDr Paul Hewitt12:13

       Mm-hmm.

   12. CWChris Williamson12:13

       ... 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, uh, territories.

   13. PHDr Paul Hewitt12:27

       No.

   14. CWChris Williamson12:27

       And, uh, by fixing... I- i- if you, if you underperform in a sports game, the, the World Series is going on at the moment, and, uh, if, if you have a h- a horrendous couple of games back to back, well, yeah, your performance within the game, right, w- 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? Um, 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, um, I think that it, at least for me when I think about it, trying to delineate between the two is really d- like, uh, it, to me they are very much the same thing. We're very much-

   15. PHDr Paul Hewitt13:13

       Hmm.

   16. CWChris Williamson13:13

       ... sort of talking about the same thing, that if I do well, I am good, if I do badly, I am bad. Uh, and I think that, that, at least in my experience, knowing that I was gonna have this conversation with you and talking to some friends about this, uh, I, I think this is a very common, uh-

   17. PHDr Paul Hewitt13:28

       Mm-hmm.

   18. CWChris Williamson13:28

       ... interpretation, where the, the, the difference between what you do and who you are, so the difference in, um, improving and becoming more ambitious inside of the domain of your pursuit, and trying to fix yourself because you are your pursuit, uh-

   19. PHDr Paul Hewitt13:44

       Mm-hmm.

   20. CWChris Williamson13:45

       ... is, is often seen as one and the same.

   21. PHDr Paul Hewitt13:48

       You're right. And, and, uh, and very perfectionistic people will do that, "I will repair myself by becoming even better at what I'm trying to do." Uh, and i- in the clinical work I do, uh, with Olympians, with high performers all, uh, all over the place, there is a distinction. Um, and I think you, you s- you alluded to it in one of the things you said, that, you know, screwing up in two games in a row in the World Series, um, e- e- 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 d- s- a, uh, y- you're right. At, uh, on one level there is this, "Who I am constitutes a major portion of my identity." But, um, f- I mean, I, I work with Olympians, I work with artists, I work with, uh, uh, 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, uh, uh, uh, I'm just awful. I'm not good enough." And people will actually make a distinction, um, you know, between, uh, if I can use you, and this is an example, Mr. Williamson versus Chris. And Mr. Williams, who can do all of these incredible things that, you know, have a, a very successful podcast, interview people, connect with people in these amazing ways, you know, the accolades, but then there's Chris, who is this person when as a child, k- uh, you know, is just this, this guy, who's really n- not Mr. Williamson. And I'm, I'm making this up with you, of course, (laughs) 'cause I don't, I don't know you at all, but when a- when you make that distinction with people and with professionals, absolutely they understand that, uh, especially when you're doing in a therapeutic context, that they'll say, "Yeah, absolutely." It's incomprehensible, when I sit back I think, "Wow, I, I actually did do all those things, but it really doesn't solve the problem of me feeling like I, I'm just not, uh, uh, I'm just not worthy enough. I'm just not acceptable. I just don't fit."

3. 16:30 – 27:10

   Will Anything Ever Be Enough?

   1. PHDr Paul Hewitt16:30

   2. CWChris Williamson16:30

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

   3. PHDr Paul Hewitt16:41

      No. No. That's the fan- that's the fantasy. (laughs)

   4. CWChris Williamson16:45

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

   5. PHDr Paul Hewitt16:47

      (laughs) That's the fantasy, f- for these individuals, the fantasy, "If I am perfect, then that will solve the problem of my worth." 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, if I achieve these high, high s- standards, or this, the, the, get these accolades, that's gonna solve the problem." And it's just the wrong tool, uh, for trying to solve the problem. But grab onto the fantasy and maintain it, and, and it's, and it's produ- particularly pernicious whe- when you're thinking about perfectionism, because you can, you can have individuals, uh, uh, decide that the, this is gonna be the, this is gonna 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 they 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, I still feel this way. It wasn't perfect enough." And then, uh, 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 world," (inhales) um, th- they up the ante, uh, and think, "Okay, it's gotta be more perfect next time."

   6. CWChris Williamson18:23

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

   7. PHDr Paul Hewitt18:30

      No. That's my experience.

   8. CWChris Williamson18:33

      Does a, a-

   9. PHDr Paul Hewitt18:33

      That's not the solution.

   10. CWChris Williamson18:35

       Does a lack of success worsen the underlying-

   11. PHDr Paul Hewitt18:39

       Oh-

   12. CWChris Williamson18:39

       ... belief of unacceptability?

   13. PHDr Paul Hewitt18:41

       Yes. Yeah.

   14. CWChris Williamson18:41

       Right, okay, so-

   15. PHDr Paul Hewitt18:42

       Rein- reinforces and exacerbates-

   16. CWChris Williamson18:43

       ... success doesn't relieve it, but fa- fa- failure confirms it.

   17. PHDr Paul Hewitt18:47

       Yes. A- absolutely. Yeah.

   18. CWChris Williamson18:52

       (laughs)

   19. PHDr Paul Hewitt18:53

       It's the wrong tool.

   20. CWChris Williamson18:54

       (laughs)

   21. PHDr Paul Hewitt18:55

       You know if you take, if you're trying to pound a nail and, and all you have is a screwdriver, you can, you can, you can p- pound it. You're usually gonna make a huge mess, but the odd time, it might actually get the screw, uh, might actually get the nail in. But there's a better tool to use that, that actually solves the problem.

   22. CWChris Williamson19:15

       It feels to me like perfectionism's self-perpetuating then. Uh, achievement doesn't relieve this sense that I'm not enough. Uh, in fact, it reinforces in many ways, oh, I must be more perfect if, i- i- it's, it's not playing in front of 500 p- people, it's playing in front of 2,000 people. It's not a- 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, uh, success is never sufficient, and failure is always confirmation of your inef- insufficiency.

   23. PHDr Paul Hewitt19:57

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

   24. CWChris Williamson20:01

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

   25. PHDr Paul Hewitt20:07

       Yeah, I'm, I'm, I can, we m- t- tell you about a patient I had. Uh, I write about this in one of my books is a fellow who was e- very perfectionistic, very suicidal, and um, I, I started seeing him. He was, um, university student at a particularly challenging program. And I started seeing him just at the end of the school year after he'd been discharged from hospital actually. Um, 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 gonna s- essentially say, "Well, yeah, you're gonna 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 some- so it's a very definitive course. And he talked about, "I, I, I want to do really well in this course. I have to get an A+," and he, and, "I, I, I wanna have the highest mark of any other student in there." That's why, I had just started working with him, uh, s- and, e- um, it, it had maybe been four weeks I think that we'd been together. He came to a session when I knew he would've been given feedback and gotten a mark for the course. He was very depressed and, um, more depressed than I had seen him actually over the course of that time. And he said to me, "Well, I got the grade. Uh, I, I got the A+ and actually got the highest score in the course." And he, and then for any of us, that would've been cause to celebrate and break out the champagne and, but for, but he said, "You know, but I, I got that, but all it did was illustrate, I had to work so hard to get it, like I had to really work hard to get that high, uh, just illustrates that I really am not capable. If I'd been able to get the course without working so hard, that would've, that would've done."

   26. CWChris Williamson22:04

       (laughs)

   27. PHDr Paul Hewitt22:08

       And that is-

   28. CWChris Williamson22:08

       It's so slippery. It's so slippery-

   29. PHDr Paul Hewitt22:10

       That is not unusual. It's not unusual.

   30. CWChris Williamson22:14

       Let me give you-
4. 27:10 – 32:51

   The Three Levels of Perfectionist Hell

   1. CWChris Williamson27:10

      Um-

   2. PHDr Paul Hewitt27:10

      Perfect.

   3. CWChris Williamson27:10

      I have, I, I guess, I, I'm interested if there's, if there's different types of perfectionism. Uh, I know that you've said it's idiosyncratic, sort of where it comes from-

   4. PHDr Paul Hewitt27:17

      Sure.

   5. CWChris Williamson27:17

      ... each person is slightly different, but there must be, uh, chunks, taxonomies, categories, different waves that it shows.

   6. PHDr Paul Hewitt27:23

      Oh, absolutely.

   7. CWChris Williamson27:23

      What, what are those?

   8. PHDr Paul Hewitt27:24

      Yeah. It, it's quite complex in, in some ways. So there's three different levels that we've sort of d- described or defined perfectionism, and one is, um, like a dispositional or trait level of consistent kind of, uh, n- need to be perfect, if you like. And, uh, uh, y- you know, very simply we can talk about individuals, s- some individuals that will be characterized by, "I need me to be perfect," and, uh, it- it's comes from the self, it's directed toward the self. Um, and so, "I require perfection of myself," and it's, um, a, a, uh, it's a very autonomous kind of state for individuals. There's also another dimension or, uh, I don't say, I don't like to say type of perfectionism 'cause 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, uh, that's one kind. Still serves, it still serves the purpose of, um ... Well, let, but let me get to that in a second. I'll, uh, I'll continue to talk about the different sort of dimensions. Uh, 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, r- requires perfection of me. And those are sort of foundational, dispositional ways of kind of navigating the world. There's this other level where, um, uh, not only do we require this perfection, we express our perfection interpersonally. Most of the time, uh, most of the time, often we are interacting with other people and, uh, I, it, it may not be that I need, 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. Uh, 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 (clears throat) , you're gonna see a flaw. So if I public speak, you're gonna see that I stutter, I, I, uh, stumble over words, uh, and so I will never speak in public. So I will not display any imperfection. And then, um, 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, I will not (laughs) reveal to you verbally anything, um, a- about anything that I h- see as imperfect.... so (laughs) it's- 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-relational expression of perfection is that, uh, this dialogue, this harsh, negative, critical-

   9. CWChris Williamson31:00

      Mm-hmm.

   10. PHDr Paul Hewitt31:00

       ... inner relationship that we have. So those are all different, different facets of- of this w- way of being perfectionistic in the world, of trying to be perfect in the world. So it do- it does get kind of (laughs) complicated. Um...

   11. CWChris Williamson31:18

       What about sort of you, the- the self-oriented, other-oriented, and socially prescribed elements-

   12. PHDr Paul Hewitt31:25

       Yes.

   13. CWChris Williamson31:25

       ... to this too?

   14. PHDr Paul Hewitt31:26

       Yes. Yeah, the self-orien- "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."

   15. CWChris Williamson31:37

       Oh, okay, and that shows up as in, "I need to be perfect"?

   16. PHDr Paul Hewitt31:42

       Yes.

   17. CWChris Williamson31:42

       As in, "I need to not do anything which would risk me not being perfect, and I not- I need to not divulge to you anything that you would see as me being imperfect"?

   18. PHDr Paul Hewitt31:53

       Yeah. Well, s- wh- wh- one is a driver of the behavior, the self, other, social.

   19. CWChris Williamson31:58

       Yeah.

   20. PHDr Paul Hewitt31:58

       And then these other pieces is, uh, like I can require myself to be perfect and you're kind of irrelevant to me.

   21. CWChris Williamson32:06

       Right, okay.

   22. PHDr Paul Hewitt32:07

       But it may- may- maybe that my perfectionism is about, "I know I'm not 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."

   23. CWChris Williamson32:24

       Mm, okay.

   24. PHDr Paul Hewitt32:25

       So that's- that's a distinction.

   25. CWChris Williamson32:27

       Yeah, it- uh, it's interesting the difference between needing perfection and needing to appear perfect.

   26. PHDr Paul Hewitt32:33

       Yes, yes. Think of a politician. Do they need to be perfect (sniffs) i- in their work? Not particularly. Do they need to appear? Absolutely. That's the emphasis of that- that domain. Um...

5. 32:51 – 38:23

   The Link to Depression

   1. PHDr Paul Hewitt32:52

   2. CWChris Williamson32:52

      I imagine, uh, have you found a crossover between perfectionism and narcissism?

   3. PHDr Paul Hewitt32:57

      Yes, absolutely.

   4. CWChris Williamson32:59

      Yeah, th- I- I can see the lineage immediately, right? "I can't see a- uh, nobody else must be able to see me at my weakest. I must pretend to be completely perfect, this unfettered-"

   5. PHDr Paul Hewitt33:09

      Mm-mm.

   6. CWChris Williamson33:09

      "... 10 out of 10."

   7. PHDr Paul Hewitt33:11

      Yeah. Yeah, there is tho- exactly those elements, especially in the- the interpersonal world is about, "I'm- I'm gonna show you how perfect I am." Uh, where it is a little bit different is the perfectionistic individual knows (laughs) they're flawed, they're defective, they g- they feel that way, they feel they know that, uh, and "I don't fit in the world," and for the narcissism, it, at times, they can almost be delusional in the sense that, "Okay, I am perfect." But very similar roots, very similar pathways, uh, but they're divergent, so...

   8. CWChris Williamson33:49

      What other personality traits does this cross over with? I would imagine, uh, conscientiousness, neuroticism, maybe some depression, uh, wh- what el- what else do you see typically?

   9. PHDr Paul Hewitt34:00

      Um, dep- depression for sure. And in fact, um, the depressive personality style, um, which is, um, that's not a DSM category, that's a psychodynamic diagnostic s- systems category, um, but a very depressive personality style. Um, there's some, yeah, neuroticism if you're thinking about the big five. Um, conscientiousness, actually not so much. Um, that's more that healthier piece. Um, and there's a, actually there's a domain of research that, um, distinguishes perfectionism from what's called excellencism. It's kind of hard to pronounce, but-

   10. CWChris Williamson34:45

       Mm-hmm.

   11. PHDr Paul Hewitt34:45

       ... 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- to perfect the self. Um, so there- there's that component. Um, you know, there- when we start looking at the outcomes of the perfectionism, and- and especially as we've kind of conceptualized it, uh, there's psychiatric, uh, psychological problems that come from it, so it's overlapping with, uh, anxiety, depression, eating disorders, ar- all kinds of difficulties. Uh, there's relationship problems, and as I probably delineated some of the perfectionism components, you could say that, yeah, if I have, uh, if I'm perfectionistic for my wife, yeah, that's probably not gonna go well, uh-

   12. CWChris Williamson35:40

       Hm.

   13. PHDr Paul Hewitt35:41

       ... and indee- and indeed it does not go well. But there's relationship problems that come from that, from intimacy problems to, uh, to like dysfunctional intimate relationships, to sexual problems, physical health problems, uh, perfectionisms 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 work from my lab or- or my colleague Gordon Fett's lab, um, where perfectionism is associated with early death. Um, so when you look at other risk factors for early death, perfectionism, self-oriented and socially prescribed, are associated, um, uh, t- t- uh, uh, uh, and- and just associated with early death among people.So it's-- 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 these-- all these domains of outcomes of the perfectionism that it's been-- uh, that have been associated with those kind of outcomes. So...

   14. CWChris Williamson36:59

       Yeah, you had, uh, perfectionism predicts suicide even when controlling for depression.

   15. PHDr Paul Hewitt37:05

       And hopelessness. Th- two factors that are hi- historically, uh, predictive of suicide would be depression and hopelessness, and we've shown (clears throat) in several studies that it, that it-- socially prescribed predicts beyond that. Um, so... And it- and you know, in some ways it's- it sort of dovetails nicely with some of the work that's been going on, um, uh, um, in terms of loneliness or alienation and the impact that has on physical health, uh, for people, and o- of course suicide. But if you have a process that ensures that you have a dis- disconnection with others, um, that you can't connect with other people and you live a life of isolation and loneliness, yeah, prediction, uh, th- eh, su- suicide is a easy thing to kind of predict from that. And- 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 'cause you're distant, so you're not genuine. You're prickly, um, and you push people away.

6. 38:23 – 45:49

   The World Sees Through Your Mask

   1. PHDr Paul Hewitt38:23

   2. CWChris Williamson38:23

      That's a go- that's a- 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...

   3. PHDr Paul Hewitt38:41

      Mm-hmm.

   4. CWChris Williamson38:41

      How does the world typically see perfectionists?

   5. PHDr Paul Hewitt38:47

      (inhales deeply) Well, if you think about if I meet you for the very first time, probably not in this kind of an- but face-to-face, and I say, "Oh, let me tell you how wonderful I am. Let me... I- I can do this and I can do that and I'm fantastic," and I, um, th- immediately you're gonna s- take a step back and say, "Get me away from this person." Um, or if I come across as cagey, I'm not really revealing, you interact with me and you think, "Ah, I- I'm not getting the whole story here," we also kinda pull back.

   6. CWChris Williamson39:25

      Mm.

   7. PHDr Paul Hewitt39:25

      And so in trying to create safety for myself as a perfectionistic person, I'm not gonna let you see who I really truly am inside. I'm gonna curate an image for you. And th- uh, people pick that up, so they pull away. Um...

   8. CWChris Williamson39:43

      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- I understand that you see me in this sort of a way, but no, not me," because th- 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 gonna downplay," like, the- the, uh, imperfect perfectionist, so perfect that they've even put imperfection in.

   9. PHDr Paul Hewitt40:28

      (laughs) Uh, uh, this is very interesting. I think people would still pick up the lack of genuineness. Um, I think it's kind of like when you watch... Uh, and I'm fascinated by this. When you watch certain actors in a performance and (clears throat) 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 th- 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, in the-

   10. CWChris Williamson41:10

       Mm.

   11. PHDr Paul Hewitt41:11

       ... generally, we pick up, "Uh, there's something missing here. There's a, I don't want to say a creepiness to it, but, uh, I'm not- I don't have the full picture. This is kind of making me uncomfortable."

   12. CWChris Williamson41:23

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

   13. PHDr Paul Hewitt41:27

       Yeah.

   14. CWChris Williamson41:27

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

   15. PHDr Paul Hewitt41:33

       Oh, absolutely.

   16. CWChris Williamson41:34

       A- a- admitting illness must feel like a failure.

   17. PHDr Paul Hewitt41:40

       A- absolutely. Uh, you're- you hit it right on the head, because that- that is revealing the- a- an imperfection. Um, and m- many of the, um, many of the clinicians that I see in my practice, uh, it's very difficult for them to s- to seek help, uh, i- in that vein. And it's- it- they forestall. Um, so I had, um, I had a patient who had... There was a newspaper back in the day when they actually had newspapers, a 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 m- my musical background or anything, but I talked about perfectionism. And he had read this article, cut it out, and fol- put it in his wallet, thinking somehow this guy seems to know, uh, w- this world of what it's like for, um, a- a distressed classical musician in this context, th- imperfectionist, 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 that, "You either get treatment or we're gone," uh, meaning the family. Um, and it was, so he knew he needed to seek help. He had seemingly found someone, me, 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, uh, to the edge. So i- 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, tell me about you (laughs) and your imperfection and your flawed sense of se-"

   18. CWChris Williamson43:45

       Mm-hmm.

   19. PHDr Paul Hewitt43:45

       "That's what we're gonna work with." And that, that you have to work with kid gloves, uh, with folks on that. Um-

   20. CWChris Williamson43:54

       Yeah.

   21. PHDr Paul Hewitt43:54

       ... so-

   22. CWChris Williamson43:55

       Well, (clears throat) look, I, I think, um, I'm kind of fascinated by the idea of recovery with a perfectionist mindset because I, I have to assume that pain es- pain and suffering is worsened by an all-or-nothing mindset. If recovery isn't total, then it's going to be worthless.

   23. PHDr Paul Hewitt44:13

       Hmm.

   24. CWChris Williamson44:14

       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.

   25. PHDr Paul Hewitt44:27

       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, about, um, 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, uh, about needing to feel acceptable to other people, about connecting with other people. And it, it, and it's also about, um, growth. So the way to think about therapy is not as, not, "W- okay, we're gonna reduce the person's perfectionism from this level to this level." It's more about, um, 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. Um, and so it, it's, it's more about helping the person kind of grow, um, and develop new ways of, of developing worth and connectedness.

7. 45:49 – 54:08

   Performance Enhancer or Toxic Fuel?

   1. PHDr Paul Hewitt45:49

   2. CWChris Williamson45:49

      Is perfectionism a performance enhancer? I, I see the traits that you're talking about among lots of high achievers, and if it's, if, if your sole goal in life is to achieve this thing and you're saying, "I'm, 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.

   3. PHDr Paul Hewitt46:15

      Sure. Well, there's been some research done on perfectionism and (clears throat) performance, uh, uh, in, in the workplace or in people's career, um, i- uh, with the assumption that when, um... In, in one very early study, they looked at this, uh, how did they do this, the, um, commissions. Pe- people who were in careers that they have commission. So the better they work, the higher money, uh, the higher the commission, the more money they make. (clears throat) 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. Uh, and looked at perfectionism in those university students, uh, professors, to see if higher levels of perfectionism was associated with higher productivity. The opposite, again. Uh, it interfered with their productivity. Now having said that, um, there are many very famous, uh, famous people who are noted to be highly perfectionistic and, um, Steve Jobs comes to mind for me, but also l- a lot of people in the music world who were, who were kind of like that. And we can say, "Well, somebody like this into perfection, look what they accomplished." And I think we can stand back and say, "Wow, those are g- are great accomplishments that the person has." But if you look at the person's personal life or their relationships and mar- it's often devastated. Uh, it's often really problematic. So I guess it depends on the perspective you take, that perfectionism could be good. Sorry. Go ahead. You had a thought.

   4. CWChris Williamson48:14

      No, I just, I think, I think you're so right. I, I got all excited 'cause this is one of my favorite pet theories. (laughs) Um, a lot of the time we use the people at the absolute top of the tree as a blueprint for how w- people trying to get to- toward that should behave. Um, we'll look at how Michael Jordan showed up. Perhaps this is how your Sunday league baseball team should look to conduct themselves.

   5. PHDr Paul Hewitt48:46

      Sure.

   6. CWChris Williamson48:46

      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 i- 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? You've... First off, you've got no guarantee that you're going to achieve that. The- there is only one Olympian in each, uh, category every four years.

   7. PHDr Paul Hewitt49:18

      Mm-hmm.

   8. CWChris Williamson49:19

      So, in order to get that... And by design, that means that out of the, whatever, seven, eight 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. Um, my point being, I think it's a dangerous strategy to use the, uh, 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-

   9. PHDr Paul Hewitt49:51

      Yeah.

   10. CWChris Williamson49:52

       ... to try and justify an approach that you, somebody who's falling much closer toward the middle of the bell curve, maybe, you know, s- you're up... on the upper end of the distribution-

   11. PHDr Paul Hewitt50:01

       Yeah.

   12. CWChris Williamson50:02

       ... of either 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 withou- without having to blow your life up with the perfectionism.

   13. PHDr Paul Hewitt50:17

       And maybe you can feel worth, and that you are lovable, or that you are acceptable, or that you fit in this planet in a different way. B- one of the thing... uh, what d- one of the things you said made me remember, and I'm... I hope I can get this right. Um, (clears throat) I think Elon Musk was being interviewed by somebody probably somebody. Um, and, uh, they, they said, they, they said, "I'd, I'd love to be able to think like you or to be as creative as you." And Musk's response, uh, as I recall it, was, "Yeah, if you lived in my mind, you wouldn't like it. It's not a... 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 i- what is it like to be inside that mind? And, and i- th- there's... I'm... I'm... Ag- again, I don't know him or anything, but from that comment it just seemed telling that, okay-

   14. CWChris Williamson51:18

       I mean, uh, I've got... uh, he said, um, on Lex Fridman, "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." Like, all right, that's pretty f- fucking apocalyptic-

   15. PHDr Paul Hewitt51:32

       (laughs)

   16. CWChris Williamson51:33

       ... as, as much-

   17. PHDr Paul Hewitt51:33

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

   18. CWChris Williamson51:35

       I just... I've, I've kind of become obsessed with that passage. Um, so-

   19. PHDr Paul Hewitt51:39

       Ah, yeah. Pretty powerful.

   20. CWChris Williamson51:40

       And it's for the same reason, presumably, that, that, that, that you have. So, okay, I guess, um, how much of perfectionism is about fear, like this, this underlying fear? Is that, is that a, a big part? It is a, a sense of unsafety, ambient unsafety, that's sort of permeating people's lives?

   21. PHDr Paul Hewitt51:59

       I think it's an existential fear, uh, about not fitting, belonging, who am I, where am I. So, I think you're right, um, uh, uh, th- that it is about fear. And one of the ways to qu- quell some of that existential fear, because we're social crea- is, is to have connection, to f- to fit, belong, uh, to matter to people, to be, to be loved, but also, fundamentally, to have a sense that, "Uh, uh, I'm okay. I'm deserving. I'm good enough, um, that I have worth." And so those deep, basic issues, uh, I think are powerful there. And what happens when they're not met is that what... exactly what you're saying. It's about there's this, this f- this fear. One, one of the more difficult pro- um, 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." Um, w- 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, their... It's just the unknown. They don't-

   22. CWChris Williamson53:22

       Because their previous motivation was so much "be perfect."

   23. PHDr Paul Hewitt53:27

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

8. 54:08 – 59:58

   The Standards That Kill Healthy Relationships

   1. CWChris Williamson54:08

      Can you explain to me the other-oriented perfectionism?

   2. PHDr Paul Hewitt54:12

      Sure.

   3. CWChris Williamson54:12

      'Cause that, that feels a little bit, mm, more, uh, a little bit more on the outside. I can understand how-

   4. PHDr Paul Hewitt54:22

      Yeah.

   5. CWChris Williamson54:22

      ... socially imposed and the self-oriented perfectionism, th- 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," uh, is still the same currency but seems to be pointing in a very different sort of direction.

   6. PHDr Paul Hewitt54:39

      Right, right. Um, I would imagine, Chris, in your life, if you're out in a public cont- you'll have people come up who will be very excited to meet you and they'll want to hang out and, uh, uh, you know, you're s- you're thinking, "Well, hey, I'm, I'm, I'm a person here. I don't really (laughs) don't need this." But they're coming to you f- for a reason. Um, and to, to be in the presence of somebody with high status, for example, it gives them status.So if I need my, uh, 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 they'll, they'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 ab- in order to feel a sense of worth. That's, um, part of what's called borderline personality disorder pathology, or borderline pathology. Uh, I don't have a sense of identity, so I'll borrow yours, essentially.

   7. CWChris Williamson56:32

      Mm-hmm.

   8. PHDr Paul Hewitt56:32

      And that- that's how that wor- so it, it... The ultimate goal is the same, to try to elevate my sense of worth, but I'm gonna use (laughs) , I'm gonna, I'm gonna come to know you and I'm gonna hang out with you so that other people can see me with you and say, "Oh, well, he must be pretty special if he's hanging around with this guy." And it, it's that kind of mechanism, uh, and, and I... That's how other-oriented works. When people fall short, when my wife screws up, oh my god, um, then what the h- you know, then that voice, that inner voice that's directed toward me with other kinds of pers- that gets directed toward her. Harsh, critical, nasty, um, some people call it a narcissistic rage, and it, it's, it, uh, uh, kind of captures that, so...

   9. CWChris Williamson57:26

      Mm. 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 a- a- a additional, uh-

   10. PHDr Paul Hewitt57:44

       Yeah.

   11. CWChris Williamson57:44

       ... difficulty level on top.

   12. PHDr Paul Hewitt57:47

       No, you're right there's, there's very good research. There's lots of relationship problems but in-intimacy in particular. And if you, if you think about how intimacy evolves, it, it's this, uh, this series of, um, interactions of each of like one person taking a risk and revealing just a little bit more about themselves, and the other person recognizes... Not consciously, but recognizes it and then also reveals a little bit more. And it's this over time, this revealing more and more of who we are. Um, and so couples that have been married 40 years, yeah, there's not a lot of secrets. They kinda hang out and let it hang out (laughs) , uh, h- however, but brand new couples, no. There's still this, "Oh, 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, uh, in- intimacy is really problematic.

   13. CWChris Williamson58:56

       Also, if you are, "I need my partner to be perfect," that's going to be very uncomfortable for your partner.

   14. PHDr Paul Hewitt59:03

       Oh, that's where the-

   15. CWChris Williamson59:04

       It's not a fantastic gr- foundation to keep a- a- 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.

   16. PHDr Paul Hewitt59:19

       Oh, absolutely. The, the complaints when you... For people who have other-oriented perfections don't come from the perfectionist, come from the other people in that-

   17. CWChris Williamson59:29

       Ah.

   18. PHDr Paul Hewitt59:29

       ... person's life.

   19. CWChris Williamson59:30

       Oh, wow.

   20. PHDr Paul Hewitt59:31

       Yeah. That's where you see the- the- the distress show up. I mean, there's still distress in, in the perfectionist, but it, it can be, it can get pretty, um, yeah, (laughs) it can get pretty awful. And it's not just partners. It's chil- person's children, the person's subordinates in their workplace, um-

   21. CWChris Williamson59:50

       Mm-hmm.

   22. PHDr Paul Hewitt59:52

       ... you know. Uh, uh, yeah, it, it... Very problematic for those folks, so...

9. 59:58 – 1:08:48

   Why Imperfection Feels Like Failure

   1. PHDr Paul Hewitt59:59

   2. CWChris Williamson59:59

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

   3. PHDr Paul Hewitt1:00:09

      Um, yeah, I don't know that we (laughs) ... Imperfection may be common. I don't know that we embrace it, uh, in- in any sort of way. And I mean, even from religious teachings for- for thousands of years, it's been, you know, try to be more godlike but not become a god, but you know, try to be more like Christ or try to be more like these s- 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 if, when you attain perfection, and it's that the- that's- that somehow the route to good things happening or bad things not happening seems to lie, uh, in that domain. And whether it's from various religions that might be talking about it or philosophies, um, or even, you know, children trying to, trying to navigate the world that they, that they live in. L- let me tell you a- a- a- a story about a patient who really... Eh, eh, it illustrates a whole bunch of different things as we're talking. Um, this was a woman who in her 40s was, um-... 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 (clears throat) . Came to see me, uh, knowing she needed... Thinking things were just not going well in her life and hadn't been. 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, given, uh, uh, you know, uh, 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, um, of having been adopted, uh, as a child very early, like as an infant. And her parents, um, 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, uh, I, I don't quite know who the experts were, but, uh, 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 this story, is, "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." Uh, and, uh, uh, uh, gave her that story, which sounds like incredibly loving (laughs) thing to do, um, and, and it absolutely was with the motivation out of this love and caring. Sh- 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, she had this 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 it 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, that was terrifying for her, and so from a very early in life she made sure she was never gonna do anything to be disposed of or to be taken and that's how-

   4. CWChris Williamson1:04:09

      Taken back to the-

   5. PHDr Paul Hewitt1:04:10

      Absolutely.

   6. CWChris Williamson1:04:11

      ... purse store.

   7. PHDr Paul Hewitt1:04:12

      And every relationship she had, including romantic relationships, was this incredible fear that at any moment, if, if I reveal any imperfection or any piece of who I am that's flawed or whatever, I, I will be taken back. And it's just a model of the way the world works for her, um, and it took a while to kind of get to that under- that understanding. So, um, can't remember what your original question was, but somehow it was connected to (laughs) r- r- romantic relationships and relationships with people and-

   8. CWChris Williamson1:04:50

      Yeah, and this, this concern about imperfection being, um, being so unbearable, this sort of failure being unbearable. I think as well, you know, (sighs) the fact that we glamorize perfection so much in art, sport, entrepreneurship, you, as you said, s- religious ceremony, um, media, you know, a flawless performance, even some of-

   9. PHDr Paul Hewitt1:05:14

      Yeah.

   10. CWChris Williamson1:05:14

       ... the language that we use. Um, it... And the fact, again, we are our work for a lot of people. Um, 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-"

   11. PHDr Paul Hewitt1:05:38

       Right. Yeah.

   12. CWChris Williamson1:05:38

       "... and I'm a that." Yeah, exactly.

   13. PHDr Paul Hewitt1:05:40

       Very much. Very much.

   14. CWChris Williamson1:05:40

       Str- uh, 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." Ha! In there, like, belies the fact that, "I cannot be perfect, so I need to adjust, um, the, uh, deployment of my resources and my efforts in, in different ways." And that must be a little bit of a realization of, "Ha, there are trade-offs in life, and sometimes those make things a little bit difficult. Wah!" Like, you know, sort of y- your brain explodes thinking about that.

   15. PHDr Paul Hewitt1:06:16

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

   16. CWChris Williamson1:07:53

       Oh, that's interesting. There's a degree of buffer between the two that relinquishes the, the, uh, the... Like, the ownership. The direct, uh, ness of your impact has been sort of removed a little bit. That's kind of funny.

   17. PHDr Paul Hewitt1:08:05

       Yeah. And, and I think there's... Uh, just at different times, different things kind of become, become more important. Um, and I think as we get older, relational pieces... I, I, I'd, I'd... I'm just guessing here 'cause I don't really know this word, but I... It seems relational pieces seem to evolve, so the concept of generativity. It's the, the older folks who want to give more. They're not so much in- involved in their own, um, success but they want to mentor people, they want to teach people. Um, and I think that's a part of we just develop more relational... Uh, we pay attention to more of those relational needs at that time.

   18. CWChris Williamson1:08:47

       Ah.

10. 1:08:48 – 1:19:00

    The First Steps to Healing

    1. CWChris Williamson1:08:48

       So in your experience, can perfectionists ever truly let go of those patterns? It, it seems to me like-

    2. PHDr Paul Hewitt1:08:55

       Yeah.

    3. CWChris Williamson1:08:56

       ... the perfectionists, uh, in the, the 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."

    4. PHDr Paul Hewitt1:09:09

       Sure. Well, I'd, uh... I guess the question is what cost are you willing to pay for it? I mean, it, it, it can come down to that. Um, most of the people that I see in treatment are pretty desperate and pretty... And it's pretty painful for them. So, in the training of, of especially my graduate students to learn to work with these folks is, um, to, to prepare them a little bit for once you open, open the door for these folks where they can express, uh, the emotional pain that it, it, it's pretty breathtaking, uh, and, and pretty powerful. So, um, there can be a lot of pain that people kind of live with, but I, I, I guess at the end of the day, it's always, "Okay, you're paying a price for this." Um, everything has a cost and a benefit, and those shift and change over time in different contexts.

    5. CWChris Williamson1:10:04

       Mm.

    6. PHDr Paul Hewitt1:10:04

       And it's just, um, uh, uh, uh, you know, how much are you willing to pay? But it's helpful for people to know that they can make changes, uh, in that. They're not trapped in it.

    7. CWChris Williamson1:10:18

       What are the steps out of perfectionism? How do, how do people learn to get past this? I imagine that there is some evidence-based approaches.

    8. PHDr Paul Hewitt1:10:24

       Oh, yes. Yeah.

    9. CWChris Williamson1:10:25

       Okay, so take me through it.

    10. PHDr Paul Hewitt1:10:27

        Um, well, the work we've done is, is from a psychodynamic, psychoanalytic perspective of, of really trying to deal with the deeper issues that produce the perfectionism. So it's kind of the notion if you, if you really hurt your knee, the symptom you have is pain, and hopefully when you go to a clinician about your, your knee, they're not gonna say, "Oh, the symptom is pain. Here's some medications. It'll take the pain away, and then you go about your life." Uh, hopefully the clinicians... And in truth, this is what clinicians would do is 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, it... 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, um, I mean (laughs) you... It, it, it's an involved process, but it's also, um... At, 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, uh, 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. Um, and, uh, that there's an acceptance of other people, that other people are also flawed and, um, uh, 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 a, it, it's about finding a place for oneself.

    11. CWChris Williamson1:12:36

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

    12. PHDr Paul Hewitt1:12:42

        Um, uh, well, you would use... Uh, 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... Uh, it's not so flawed and not so defective. But, but we use the therapeutic alliance to create a place of safety, uh, 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, the deep pain, the emotional stuff to actually look at who they truly are. Uh, and so again, we use that therapeutic alliance that way. Um-There's a domain of, um, treatment that likes the notion of worksheets and practice and, um, tell yourself not to be worried about making mistakes and that sort of thing. Um, and I ju- I, I find it, to be honest, I find it really silly. Like, you're, uh, 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?" Uh, 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, uh, you know, I'm 30 years old, I'm gonna learn to do this," so, I don't know, you phone up Lance Armstrong and say, "I need a workshop, give me a lecture, uh, 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 (laughs) 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 gonna teach you to ride a bike. But if you have, you know, if you think about how, how you, sort of 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 onto you, and you wobbled and fell and got up again, and, 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- uh, cognitive exercises to do that. And, and that's the best metaphor I have of what I, uh, what I and other psychodynamic people are trying to do to teach people new behaviors. It's through the experience of revealing the self. It's through the experience of having, uh, uh, uh, uh, um, being able to connect with somebody and to have them kind of, uh, um, to care for you, accept you, to see all the stuff that's bad, and try to be helpful to you. So, i- that's the process, uh, of it. So it's not, it's not a, a, 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, (clears throat) we just published a paper wh- which really pissed off (laughs) a, a good bunch of people, which is great, I kind of like doing that, um, to really show, uh, what the evidence is for a CBT-based approach for perfectionism and-

    13. CWChris Williamson1:16:51

        How did it perform?

    14. PHDr Paul Hewitt1:16:51

        ... it's not good. Um, well, when they wrote about this stuff, it, it was wonderful, but when we actually looked at it, we saw that, um, the majority of people drop out from it, which means they don't tolerate, it's just no good to have a treatment that people don't continue in. Uh, there's, there's good, uh, 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, the changes disappear. Uh, so it, it's not maintained. Um, there's very good evidence that s- only certain elements of perfectionism change from a CBT perspective, not the traits that we talked about, not the self-relational, those i- 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, but suicide, uh, early death, uh, anorexia nervosa, depression, exa- So those pernicious pieces don't seem to change with CBT. In, in the work that we do, um, you, it's gonna come as a surprise I'm sure, but w- we try to deal with those underlying issues and show the changes in the more pernicious elements. And there's, um, three different, uh, f- five different studies that have shown, yeah, there's changes that are made in that. The way we do the treatment research is, uh, you know, develop the treatment, we'll do a study, and we'll show the effects. W- we then try to figure out, okay, well, how can we refine 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, it's, it's pretty good, uh, or very good. How, how can we improve it even more?"

    15. CWChris Williamson1:18:59

        Mm.

11. 1:19:00 – 1:23:55

    If You Have a Perfectionist in Your Life...

    1. CWChris Williamson1:19:00

       What would you say to somebody who has a perfectionist person in their life? Uh, how can those around perfectionists show up in a way that helps them to, uh, improve their world view?

    2. PHDr Paul Hewitt1:19:16

       I, (clears throat) I, I would encourage them to f- to find somebody to work with them on it, to find a professional to work with it. Um, d- 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, um, (clears throat) is easily changeable. Um, but I would be encouraging of people to try to find a therapist that they can work with that-... that, that they trust and that they could connect with to deal with those issues.

    3. CWChris Williamson1:19:49

       What is the, what is the school, or is there an accreditation body that you guys ratify, uh, to say this person is perfectionism certified to be able to do this at a standard and doing a, a-

    4. PHDr Paul Hewitt1:20:01

       Oh, we're in the process, we're in the process of doing that actually, with, uh, uh, again, we're at a, a place now where we're pretty confident that the kind of, the, the kind of approach that we do actually is, is helpful, uh, 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, uh, 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, um, and it's kind of the idea, like, with your knee (clears throat) , if you fix the problem in your knee, as soon as they fix it there still might be pain there, but as it, it, 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 is very good evidence that that's what happens, and it's just to know if you get rid of the cause, the symptoms kind of go away.

    5. CWChris Williamson1:21:04

       Mm, that's interesting. What's the role of mattering in all of this?

    6. PHDr Paul Hewitt1:21:10

       Um, uh, uh, uh, mattering is one of the, (clears throat) one of the ways that those relational needs can show up. Uh, so some people, um, well, I think for everybody it's kind of a foundational part of, 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 it, uh, so generally mattering, but at an idiosyncratic level with, with people, it can be, uh, that can be manifest, like, I, you know, I have a voice, that I, I grew up in a family where n- n- n- nobody cared. I d- I couldn't say anything that anybody would ever hear or listen to, uh, and the, the only way of understanding that was, well, if I was more important, they might actually hear my voice, or, and, uh, one of the ways to be a, to, to solve that is, okay, well, I can be, I can be narcissistic and tell everybody how wonderful, or I can try to be perfect in everything that I do. So mattering is, is one piece of the relational needs, but other people might need to be respected, to be, uh, to be seen, to be heard, not to be invisible, um, to be l- loved, and to have a sense of being lovable, uh, n- two different pieces there. Um, so it, it all kind of fits in very generally in, in, uh, sort of some of the basic needs that we need to navigate the world, so...

    7. CWChris Williamson1:22:47

       Mm. Are we becoming more perfectionist over time? Is this, uh, have you done any longitudinal stuff?

    8. PHDr Paul Hewitt1:22:52

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

12. 1:23:55 – 1:25:41

    Dive Deeper

    1. CWChris Williamson1:23:55

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

    2. PHDr Paul Hewitt1:24:12

       Oh, good. (laughs)

    3. CWChris Williamson1:24:13

       ... uh, accused today. Where should people go to keep up to date with your work?

    4. PHDr Paul Hewitt1:24:17

       Um, well, I have a, a, I mean, I have a, I have both a clinical website where s- s- to, with, with more clinically relevant information, but also a website at, uh, at, at the University of British Columbia. So, um, there is a website. Um, uh, we've published books. I just, I, I'm, uh, my agent said I should do this. I don't know. (laughs) But, uh, we're just signing a contract with Norton to do a trade book on... Gord Flett 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, uh, kind of see the way we think about it, understand it, the problems, and how to deal with it.

    5. CWChris Williamson1:25:02

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

    6. PHDr Paul Hewitt1:25:06

       Thank you very much. It was, uh, wonderful meeting you, Chris. So you have very good listening skills. I've done (clears throat) numerous podcasts where I get the questions and then the person is busy trying to figure out what the next question is.

    7. CWChris Williamson1:25:18

       (laughs)

    8. PHDr Paul Hewitt1:25:20

       Rather than having a dialogue, so it's, it's, it's very nice that way. So I appreciate, I, I appreciate that.

    9. CWChris Williamson1:25:27

       Thank you.

    10. PHDr Paul Hewitt1:25:28

        Okay.

    11. CWChris Williamson1:25:29

        Congratulations, you made it to the end of an episode. Your brain has not been completely destroyed by the internet just yet. Here's another one that you should watch. Go on.

Episode duration: 1:25:41