May 1st, 2015

“Perfectionism: A Guide for Mental Health Professionals”

“Perfectionism: A Guide for Mental Health Professionals”

By Michael Brustein

Springer Publishing Company, LLC

New York, N.Y., 2014

 

 Book on perfectionism difficult to understand

 

Reviewed by James K. Luiselli, Ed.D., ABPP, BCBA-D
What do you envision when someone is described as being a perfectionist? On one hand, it might be the person who is highly successful, often innovative and considered a “winner.” At the same time, and as described in this book, “perfectionism can be maladaptive and predispose individuals to depression, suicidality, anxiety, eating disorders, personality disorders and numerous psychiatric disorders.” It is these negative effects that led psychologist Michael Brustein to write about the perfectionistic patients he has treated and what he recommends as the most effective psychotherapy.

Throughout the book, Brustein refers to “individuals with perfectionistic traits.” He defines the “self-oriented perfectionist” as setting unrealistic personal standards, the “socially oriented perfectionist” as trying to achieve externally-imposed expectations and the “other oriented perfectionist” as demanding excessively high achievement from other people.

So constructed, and keeping with trait theory, Brustein views perfectionism as a condition that someone “has.” He suggests the late Steve Jobs and former collegiate basketball coach Bobby Knight as examples of “perfectionistic personalities.”

The book rests squarely in the psychodynamic arena and attempts to integrate different perspectives emanating from interpersonal psychology, self-psychology and the psychoanalysis of Melanie Klein. Brustein lays out these conceptualizations, but not convincingly to me because his therapeutic approach is dominated by hypothetical and non-empirical concepts such as “empathic linkage, rupture identification, joining, belief layers and the observing ego.” A good half of the book contains case studies, which in the author’s words, are “to illustrate how to apply these diverse frameworks to perfectionistic patients.”

Theoretical orientation notwithstanding, I found the book difficult to read and understand. Here is one example: “The self-preservation style is thus a separate but overlapping construct often superimposed on perfectionism. In essence, perfectionistic self-preservation is the communication of perfection to others influenced by one or more of the multidimensional motives of perfectionism.” This passage and many others may confuse the reader, do not adequately explain or clarify underlying concepts, and fail to inform practice standards.

I have no doubt that Brustein’s intensions were good but to my thinking, his book will only appeal to the most ardent psychodynamic therapists. Readers that are aligned with evidence-based and empirically supported practices will not find the book helpful. To the author’s credit, he touches on contemporary cognitive-behavioral and mindfulness-based therapies, but all too briefly and with the tenuous conclusion that they “can be superimposed onto psychodynamic approaches.” Regrettably, this tome about perfectionism does not qualify, not can I recommend it, as a guide for mental health professionals.

James K. Luiselli, Ed.D., ABPP, BCBA-D, is Chief Clinical Officer, Clinical Solutions, Inc. and North East Educational and Developmental Support Center, Tewksbury, Mass..

By James K Luiselli EdD ABPP BCBA-D

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