The Cost Benefit Analysis for Perfectionism

Tuesday TEAM Training Group at Stanford In 1980 I published an article entitled "The Perfectionist's Script for Self-Defeat" in Psychology Today Magazine, in an attempt to get some publicity for my (then) new book, Feeling Good. At the time, it was the cover feature and became the most popular article in the history of that magazine. Perfectionism is definitely one of the most common themes I have confronted in my clinical work and teaching over the past many decades. If you would like to take a look, you can check it out at this link. They had fantastic colorful illustrations, including a bleeding dart board wtih a dart in the bullseye, and sadly you'll only get the text in black an white at the link. It seems that almost everyone succumbs to this mindset from time to time, and it can cause many negative moods. But at the same time, the attempt to be perfect brings many benefits at the same time. This can be a dilemma. The next several podcasts will be based on a two-week perfectionism class I developed for the weekly Stanford TEAM-CBT training group that I direct along with my esteemed colleague, Dr. Jill Levitt. This podcast class is suitable for therapists and non-therapists alike. These podcasts will give you the opportunity to “attend” the group and witness the procedures we use to train therapists. You will have the opportunity to practice the same techniques the students will practice when we break into small groups. I would encourage you to turn off your podcast temporarily so you can practice the exact same techniques on your own when we break into small groups for practice. For example, in the first class you are about to hear, we will spend 20 minutes doing a Cost-Benefit Analysis for perfectionism. You will find a blank CBA if you click HERE. I would encourage you to practice the same thing for 20 minutes during each practice group. During the first breakout group, you can spend 20 minutes listing the advantages and disadvantages or perfectionism. Ask yourself, “how might this mindset help me? And how might it hurt me?” You can use this blank CBA. After listing the advantages and disadvantages, weigh them against each other on a 100-point scale, and put two numbers adding up to 100 in the two circles at the bottom. For example, if the advantages are greater, you might put 75 and 25 in the two circles. If they are about equal, you can put 50 and 50. And if the disadvantages are somewhat stronger, you might put 40 and 60 in the circles. Remember, it’s not the number of items in the columns, but how you feel about them overall. Sometimes, one powerful advantage might feel much more important than the five disadvantages, and sometimes one powerful disadvantage might feel more important than numerous advantages. Part of the fun (hopefully) of this podcast is that you’ll get to hear the questions and suggestions of many of the 45 or so students in the class that night. As you will hear, we have a multi-cultural rainbow group with therapists from around the world. We started Part 1 of the Perfectionism Master Class with these important two questions:

• What is perfectionism? How would you define it?
• What is the difference between perfectionism and the healthy pursuit of excellence?

Then we went on to the Cost-Benefit Analysis (CBA) in small groups. I forgot to record my small group, but you will hear a long list of advantages and disadvantages discussed when the large group reconvenes. As I mentioned about, I would encourage you to do your own CBA while we are in the small group. When we reconvened in the large group, we talked about the therapeutic strategies you would use once the patient has balanced the advantages against the disadvantages of perfectionism, including Sitting with Open Hands with patients who are reluctant to give up their perfectionism. I also discussed my strategy of aiming for “average” or even “below average,” as opposed to perfection. As I’ve aged, I’ve actually lowered my standards so low that everything looks pretty awesome to me! And my productivity, as well as the quality of my work, has actually improved greatly as a result. This paradoxical strategy may seem foolish to many devoted perfectionists at first, but it has proven exceedingly powerful and helpful in my life since I screw up so often! Seeing failures and mistakes as opportunities to learn and grow, rather than signs of failure or inadequacy, has been huge for me. Joy seems to spark my creativity and productivity way better than feelings of shame and anxiety. After the CBA exercise, we used the Semantic Technique to revise the perfectionistic belief, like, “I should always try to be perfect,” or “My worthwhileness as a human being depends on my performance (or achievements, etc.). The goal, as you will see, is to reword the belief with this goal in mind: Your new belief can reduce or eliminate most or all of the disadvantages or perfectionism while preserving most or all of the advantages. We DID record Jill’s small group, so you can hear her students working on the Semantic Revision of their perfectionistic belief, but I would strongly recommend that you turn off your podcast and see if you can revise your own perfectionistic belief while we are doing our small group work. Again, this was a 20-minute exercise. I am attaching some of the feedback from the first Tuesday group on perfectionism, Part 1. Next week, you’ll hear Part 2 of the Master Class on Perfectionism. If you are a therapist, you might want to join one of our weekly training groups. The group I conduct with Dr. Jill Levitt is the Tuesday group, and we meet from 5 to 7:30 (PST) on Tuesdays. In addition, Dr. Rhonda Barovsky and Richard Lam have a Wednesday training group that meets from blank to blank PST. Both groups involve an introductory 12-week curriculum for individuals who are not familiar with TEAM-CBT. After that, you may join the advanced group, learning with 40 to 50 colleagues every week. Both groups are free, but you will be required to:

• Sign the consent form for group membership and agree to the terms on it.
• Purchase the required course materials, including my psychotherapy eBook, Tools, Not Schools, of Therapy.
• Purchase the Therapist’s Toolkit and use the assessment instruments with every patient / client at every session. These tools are for sale in the shop at feelinggood.com, and discounts are available for therapists who want but cannot afford the tools.
• Practice during sessions using role-playing techniques and receive immediate specific feedback on what you did effectively and ineffectively so as to refine your skills.
• Do homework and use the techniques with your patients between sessions.
• Attend at least ¾ of the training groups. These are NOT drop-in groups.

The free weekly training is available to licensed health / mental health professionals as well as graduate students in mental health who are studying to become psychiatrists, psychologists, counselors, clinical social workers, and so forth. TEAM-CBT is immensely powerful and looks easy, but it’s not. A great deal of commitment, time, and training is always needed to develop expertise. Many of our group members have continued with the group for many years, and we encourage that. Part of the training involves live personal work, which is recommended but not required. Jill and I believe that doing your own personal work is vitally important on the road to world class therapy skills. As you probably know, Rhonda and I publish many of those sessions as two-part podcasts, but only with the permission of the participants who are in the “patient” role on one of the evenings when we do personal work. Probably 15% or 20% of the sessions feature personal work with members who volunteer and ask for help. Social anxiety and feelings that “I’m not good enough” as well as relationship problems are popular themes for the individuals doing personal work on any given night. The personal work does not involve the development of an actual therapeutic relationship. It is simply a one-session, 3.5 hour experience in front of the group which is part of your personal development, so you can experience the TEAM-CBT in action in real time. If you have loose ends or unresolved issues at the end of your session, you can continue working on them with your own therapist. Dr. Levitt and I will not be involved in the development of an ongoing therapeutic relationship with you. The focus of the class is training, not treatment. After each class, members provide negative and positive feedback. The following are selected excerpts from tonight’s group, with light editing to improve readability. I think you will enjoy reviewing the feedback, especially if you are thinking of joining one of our training groups. The feedback is used to improve the teaching methods. Contact Information:

If you want to join David and Jill's Tuesday group, that meets from 5:00-7:00 pm PST, please contact Ed Walton: edwalton100@gmail.com

If you want to join Rhonda and Richard Lam's Wednesday group, that meets from 9:00-11:00 am PST, please contact Ana Teresa Sliva: ateresasilva6@gmail.com

Thank you for listening,

David, Jill and Rhonda