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THE PROBLEM OF PERFECTIONISM IN EATING DISORDERS
By Betty Hughes, Ph.D., LMHC

The problem with perfectionism is that it seems so perfect.  The quest for excellence is instilled in us throughout schooling, and probably during our early home life.  So a lot of people will describe themselves as perfectionistic—and they’ll give lip service to wanting to change—but if you’ll listen closely you may hear an element of pride in their voices. And if you explore even further, you may get a hint that it’s not perfectionism that needs to be eradicated—but rather the need is to learn better ways to achieve perfection—to learn to actually be perfect as opposed to the painful struggle to attain the goal.

          And it certainly is logical.  And our culture certainly approves.  And nobody wants to be mediocre.  We learned early that excellence was rewarded—and that if you try hard enough excellence can be attained.

          But for many of us, excellence got turned into perfection, and the real problem of perfectionism is that the goal is humanly impossible to attain and therefore can only result in failure.

          But let’s look at this tendency.  What’s it all about and where did it come from?  What does it have to do with an eating disorder?  And is there a solution?

          First, let’s look at the definition from the American Heritage Dictionary: Perfectionism is “a propensity for setting extremely high standards and being displeased with anything else.”  I added the underlining to emphasize the problem portion.  It’s the all or nothing phenomenon.  Either the standard is high, or it is low and low is unacceptable.  Either the goal is attained and proclaimed a success, or it’s imperfect—and thus bad and unacceptable.

          As with all psychological labels, the difference between a normal or healthy manifestation of a trait and a problematical one is a difference of degree, of course.  No one is saying that striving for excellence is bad or something to be shunned in any form.  But there is a world of difference between choosing to excel, say, in a career, always doing your best and feeling proud and satisfied with your accomplishments, on the one hand, and feeling absolutely driven to be the best at everything, in every aspect of your life, and having your entire self-esteem suffer any time the absolute best is not accomplished.  One is choosing to do the best we can, and the other is feeling compelled to be number one.  It’s a matter of choice and a matter of degree.  And it’s the difference between going on a healthy diet and achieving a slender weight that is a matter of choice because society and you have determined that you look and feel better—compared to the absolute compulsion to maintain control over your weight, in fact to get more slender than anyone else or at least anyone you know, and if you don’t you’ve failed, are not worthwhile and are determined that you’ll do anything to lose weight, including unhealthy practices.

          Going back to the “all or nothing” phenomenon, some extremes are:  Perfect – imperfect.  Fat – skinny.  Success – failure.  All or nothing.  And maybe you realize that you can’t really be perfect at anything, but you have a standard in mind that’s as close as possible, and you draw a line just under perfection—at say the point that you know for sure that you’ve done your very best—and everything under that line is simply regarded as failure.  A “B+” has no meaning:  it’s still not an “A”.  A “C” is absolutely shocking and not to be tolerated at any cost.  Etc.

          It gets to be a matter of control.  If you control your study habits, you can get an “A”.  If you rewrite your paper two or three times, it improves.  And to carry it to the extreme, you can keep rewriting it and improving it so that finally you miss the deadline because you couldn’t turn in an imperfect piece of work.  That’s the extreme, but it happens.  And if not to that extent, then the paper gets turned in just at the deadline, but then come the self-incriminating thoughts, including “If I were smarter and faster, I could have done it perfectly and on time.”  Maybe someone else will think it’s good enough, but you know it was not your best and that’s the feeling of having let yourself down, of having lowered your standards, of having lost control. 

          The issue of control appears again and again when working with eating disorders.  And control seems to be at the bottom of perfectionistic tendencies.

          According to Dr. Leon Saltzman (Saltzman, 1977), the issue of control is a universal problem.  Everyone has to deal with existential issues such as the fact that we have a “limited span of existence” and a very limited physical and mental capacity.  To quote: “Not only does he have limited control over the forces of nature (despite the scientific advances in the last century) but he is also incapable of controlling his own intellectual and emotional responses.  He is often at the mercy of the “out-of-awareness” ideas and impulses that propel him into action.  The existential problems that face him constantly and the knowledge of his limited span of existence and the certainty of his own death are things about which he can do very little – except to construct illusions” (p. vii).

          One of these illusions is the belief that we have more control of our inner and outer world than is possible. But to not have this illusion is to give in to the feeling of helplessness and powerlessness and despair.  In order to function adequately and optimally, we must have at least a relative sense of being effective—that what we do can make a difference.  And the more out of control we feel—the greater will be our need to prove that we are in control in order to allay the existential anxiety.  And from there is just a short step to believing that if we could attain perfection, we could live in an anxiety-free world.

          So it becomes a vicious circle, an even tighter circle.  Anxiety propels us to try to gain control so that anxiety will be removed and as the illusion becomes more believable the anxiety is lessened somewhat. But reality keeps intruding, because we cannot control all circumstances.  It becomes then important that we predict all future possibilities so that we can foresee them and know how to deal with them.  And there’s always something we missed.  And so then if we cannot control a large segment of our lives, maybe we can control a smaller portion.  Maybe we can control our grades in school at first, but as the need to be more and more perfect makes its demands—because anxiety is still there so obviously we have to try harder—then it takes longer and longer to account for all possible circumstances until finally deadlines are missed and grades suffer.

          Imagine this cycle on many different levels until finally the portion of the world under total control is how much you weigh and you see why it becomes so important to hang on to that one certainty.  At least in one area, one can have control and not have to deal with anxiety.  But it’s all illusion, and sooner or later illusions break down.  The body starts demanding food and creates its own anxiety.  Binges result and the feeling of being out of control returns.  So the damage has to be undone in some way.  Control has to be re-established.  One has to have more discipline, has to be punished for all failures.

          This is a very simplistic view of what happens, and is by far only a small portion of the dynamics underlying eating disorders.  But it’s a very important aspect, and part of our reality is that concepts have to be oversimplified in order to grasp them.  And then the need is to integrate small concepts into a unified whole—and somehow understand that an infinite number of interactions take place—and that it’s okay that we not perfectly understand in an absolute fashion why perfectionism is so important to people with eating disorders.

Perfectionism and the need for control are widely accepted components of eating disorders, as well as other psychological problems and indeed in varying degrees with everyone, no matter how healthy.  It’s a defensive behavior, something learned which originally helped to improve some area of functioning, but which somehow became distorted and became more of a problem than a solution.

          Or to put it another way, perfectionism always brings about  a sense of failure because it is an impossible task, that failure is usually punished and the result is so painful that withdrawal occurs and a narrowing of vision ensues.  Risks are too painful, and fewer and fewer options become available.

Perhaps the punishment that is dealt as a safeguard against repeating failure is more damaging than any other aspect of perfectionism.  Dr.Theodore Isaac Rubin (1982) notes that “each of us contains two opposing forces of enormous power and effect” (p. 4).  One extreme is compassion and the other is self-hate.  Despair is directly related to the self-hatred and may be vital to understanding the punishing mechanism that is such a part of perfectionism.

Because we are capable of memory long past the time an incident took place, and because we are subject to so many levels and degrees of reactions from the time we are infants, and because as infants we are so totally dependent, the mechanism of self-hatred is a part of us all.  No matter how responsive and loving our parents try to be, there will be times when we are frustrated and left feeling powerless and helpless and out of control.  A child has to be taught right and wrong and must learn that some things are okay and some are not.  In this process, it’s inevitable that the child starts to observe and judge himself or herself and to reject certain aspects of himself or herself.  And the child learns that unacceptable behaviors are punished.

          In some households, the child may also learn that certain feelings are bad and therefore that certain aspects of the self are bad and must be punished.  Those aspects are unacceptable, must be punished, and hatred of parts of the self begins.  This self-hatred is both conscious and unconscious.  As parts of ourselves are considered “bad” they are split-off from awareness and repressed.  Self-hatred is painful, and painful feelings start to get covered up.  Relating to eating, Dr. Rubin suggests that food may be used as a sedative and as a way of anesthetizing ourselves so that the pain of self-hatred is lessened.  “But this becomes a way of inundating and drowning oneself in self-hate in order to escape self-hate.  If an individual is beaten into insensibility, temporarily he no longer feels the effects of the beating.” (p. 54)

          And so coming back to the idea of perfectionism, we see that it’s a very complex issue and one which is pervasive and not easily unraveled.  However, it is relatively easy to pinpoint.  It’s not so easy to give up.  Because the solution to perfectionism can only involve a letting go, an acceptance that we have only so much control – that it can’t be absolute.  And remember control is the underlying issue. But also part of the problem of letting go is that perfectionism is so often rewarded.  The almost superhuman effort that gets put into a project can many times result in astounding success.  Painful as the effort is, it feels good to be told that something we did was by far better than what anyone else did.  It feels good to be unique and admired and number one.  What does not feel good is that anything less than excellent is not pointed out and one is left with a sense of having failed.  It’s the belief that anything less than excellent is to be rejected and that any attempt to overcome perfectionism is a lowering of standards.  The pain comes from failure and self-hatred and the need to punish.

          So what is a person to do?  There is no perfect solution.  There are no straightforward, guaranteed answers.  Some solutions are:

  1. A willingness to look at the limitations of being human.
  2. A willingness to take risks, and to refrain from punishing behaviors when a risk results in failure.
  3. A tolerance for anxiety.  An acceptance of the fact that there’s no such thing as an anxiety-free life.
  4. An honest distinction between what you produce and who you are.  Having failed at an occupation does not mean you have failed as a person.
  5. Develop and encourage the opposite force of self-hatred – that of compassion, not just for others but for yourself as well.

 According to Dr. Rubin, compassion is the healthy state of human beings.  Self-hatred is learned; compassion is actually inborn and can be regenerated and highlighted.  Anything which is not a true evaluation of the actual self is a form of self-hatred.  That includes punishment for not being perfect.  But it also includes the illusion of perfection because that is a denial of the reality of the actual self.

Briefly, Dr. Rubin’s suggestions include (pgs. 131-141):

  1. “The self-hating mechanism must be recognized for what it is.”  Punishment in any form is damaging and the opposite of compassion.
  2. Blocking.  Replace negative thoughts and punishments with positive behaviors and compassionate acceptance of realities.
  3. Surrender of special status.  Acceptance that as a human being you have limitations.
  4. Giving up illusions, but at the same time recognize that as a human being you automatically have self-worth.

In conclusion, let me suggest that your attempt at solving your problems of perfectionism, as well as other problems, focus on giving up the “all or nothing” demands.  Progress is measured one step at a time.  Complex destructive patterns are not easily solved, and one slip must not be used as an excuse to binge uncontrollably.  A little binge is better than a big binge, etc.

          But perhaps most important of all is to bring humor back into your life.  Resolving an eating disorder is a serious business.  But seriousness can be taken too seriously.  Learn to laugh at your demands to be perfect.  See the illusion for what it is, but allow yourself to enjoy your reality rather than giving up in despair.

References:

Rubin, T. I. (1982)  Compassion and Self-hate.  An
          Alternative to Despair.  New York: Ballantine Books.

Salzman, L. (1977).  The Obsessive Personality (2nd edition).
          New York: Jason Aronson, Inc.
 

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The above article was taken from a speech by Betty Hughes, prepared for the January 30, 1985, AABA Fifth Wednesday Lecture Series, and subsequently published in the Fla. AABA Newsletter, Volume III, Winter-Spring, 1985.

Later it was published in the National Newsletter of the American Anorexia/Bulimia Association, Inc., Vol. VIII, No. 5, November 85-February 86, pp. 11-13.  Used with permission.

 

 


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