Thursday, November 27, 2014

Intervention tidbit #4: The perfectionistic client

In the spirit of winding down, while The Pessimistic Shrink prepares for the odious national counselor clinical exam,* re-licensure and eventual relocation, it seems felicitous to present a micro-tidbit of an intervention, light of context and free of the drag of theory.  (If I were to dive into the many meanings of perfectionism, we’d be looking at anxiety and obsessiveness, absence of self and self-esteem, part-fuel for mania, facet of narcissism and psychosis, and probably more.)

The client, a STEM school teacher, had always been pulled by the need for perfection or excellence.  This had to be baby-shaken because she could feel that it was anxious, depressing and a substitute for whatever her real self was.  Before some theory was presented, I offered her the following opportunity, an opportunity for perfection.

Your favorite television show is “Bones.”  Imagine that you want to be the perfect watcher of this show.  You deeply desire to exceed excellence and reach perfection in your prosecution of this task, present episode and every episode.  You make your attention rapt; your discernment of all is steely-eyed and rocket-fueled.  You take copious notes, intuitive and microscopic, on the plot, subplots, actors’ expressions and body language and hair and dress, thoughts said and unsaid.  You watch, perceive, imagine and instantaneously build, test, and discard theories of meaning – episode-specific, cultural and pop-cultural, aesthetic, philosophical and personal meaning.  You master the story, then write an exegesis which you hone through further thought, consultations and readings.  Finally you re-watch the show through your refined eye, rigorously challenging all your tentative wisdom.

The client, of course, realized there would be no enjoyment if she watched her show as a perfectionist.  To enjoy, she needs to be a person, to do by feeling not by ego, or false ego.  Could this apply to other areas of life, where you smell the roses unselfconsciously and become them, become the world . . . and thereby become you?

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* The NCMHCE tests a psychotherapist’s gifts primarily by forcing him to determine what client factors are not relevant (according to the test creators) to a consensus psychiatric diagnostic label.  My view is that the long-experienced clinician should see every client factor as relevant to an actual diagnosis and therapy: if he listens to weather reports; is unemployed and owns a smartphone; grows a beard, shaves it off then grows it again; attends therapy twice, skips three weeks then returns with no explanation; has two cats or five; wears one of those rubbery nondescript wristbands; uses words like "nondescript"; has a child who is a straight-A student; likes The Big Bang Theory; has a hangdog face or childish inflection or saucy lilt, low neckline, jeans with holes in them, ad infinitum.  The test, in other words, is the apotheosis of concrete thinking (a milestone on the way to maturity, according to Piaget).

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Comments are welcome, but I'd suggest you first read "Feeling-centered therapy" and "Ocean and boat" for a basic introduction to my kind of theory and therapy.