How Does Perfectionism Affect the Therapeutic Relationship - Literature review Example

How does perfectionism affect the therapeutic relationship? Table of contents Introduction..........................................................................................................3 My personal reasons for researching this topic....................................................3 Defining therapeutic counselling........................................................................4 Literature review.................................................................................................5 Perfectionism in the client...................................................................................7 Related theory and approaches............................................................................8 BACP ethics of counselling in regards to protecting the clients........................9 Importance of supervision in counselling.........................................................10 Conclusion........................................................................................................11 References........................................................................................................13 Introduction In this essay I will be undertaking a Literature Review on my chosen subject, which explores the impact of perfectionism within the therapeutic relationship between counsellor and client. This can be taken to mean not only perfectionism on behalf of the counsellor but on behalf of the patient also; although my emphasis will be on the prior as it is my particular area of interest. I will be displaying my findings through the analysis of a variety of literary sources including books on academic theory, online journals, and internet and magazine articles from publications such as BACP. Therefore, add my own understanding of these issues and knowledge gained as a trainee therapist, which may include experiential and anecdotal evidence rather than qualitative or quantitative data, in order to fully investigate the subject matter at hand. This essay will begin with outlining the terms of my essay subject, most importantly the concept of therapeutic counselling. After this, I will be talking about the reasons behind my decision to use this particular word, “perfectionism”. Next, I will move on to evaluating and reviewing articles regarding my chosen subject and then I will conclude by summarising how this will have an impact on my being and also as a therapist in counselling with my clients. My Personal Reasons for Researching This Topic My decision to explore “perfectionism” in therapeutic counselling was a deeply personal one. Choosing a subject matter for my pensive inquiry never came out as expected and did take me weeks to decide what I was drawn to. The pursuit of perfection is something that has affected me even from childhood, and as an adult has had an impact on my life; as a result not only my behaviour but also my thinking has been altered through this fixation with setting and trying to attain unobtainable goals. This has been on two levels: not only experiencing the emotional fallout of feeling failure when perfection was not achieved, but also feeling failure when the perfect method or process of achieving such goals was not met. Defining Therapeutic Counselling According to Judith Green, therapeutic counselling is the working alliance formed between you, the counsellor, and your client. This working alliance relates not only to the real physical space that the counselling takes place in, it is also framed by the temporal space which reflects the exact hour or period during which therapy occurs and the exchange of information between counsellor and client. The success of this working alliance relies on the patient being honest and truthful (Ashby, 2005). However, by far the largest responsibility for a successful working alliance lies with the counsellor. A counsellor can help to ensure success by fostering trust in the client in the most basic sense: for example making sure not to change the appointment and being consistent is important to a stable working relationship and during the session it is vital that the counsellor puts aside all of his or her prejudices and concerns and entirely focuses on the client and the material they bring on that particular session. The counsellor must also follow the BACP guidelines and ethics. Literature Review Perfectionism and its expenses, their description has been for many years. For instance, Fred’s ideology on the aspect of superego is inclusive of two approaches: an introverted social approach and an ego-deal which is an emphasized picture comprising of approved and acclaimed behaviors (John, 2008). The ego-ideal has a perfect of personal brilliance towards which an individual strives and hence avails an ideology of how a person thinks he or she can be. Later it became reviewed (Hohn, 2008). A distinction resulted between the own self and the portrayed self. The self-signified what we are, the inner self of personality which is inclusive of the ability for growing and realizing own goals. The portrayed self symbolizes what we think we can be and can be utilized as a model to aid us in creating our potential and attaining self-realization (John, 2008). In the normal person, the portrayed self and the own self immensely correlate since the portrayed self can be based on an actual analysis of a person’s abilities and capabilities. However, in some persons the actual identity and the acclamation of one’s capabilities can be discrepant and independent. Such persons have a belief that there are specific traits they could be living up to. Arps (1920) carried out an interview on a sample of 36 perfectionists at a US college and Aden and Alexander (1999) interrogated six students and faculty staff at the College of Washington in the USA, who termed them to be perfectionists. When the participants in both samples outlined perfectionisms and the traits linked with it, they stressed having high personal quality for performance and many also advocated for a sense of logicality and systematic aspect. They observed their high standards and nature as vital factors to their achievements in life. Although most of them made an indication that their perfectionism can be seldom related to distress, they also suggested that they would not give up their aspect of perfectionism when given an opportunity. These outcomes seemed to avail back up for the indication that perfectionism has not only disastrous effects, but also has some positive attributes. It can be concluded that high standards and nature do accentuate positive attributes. Based on the research that some specific perfectionists did report an alleged inability to attain their own set high standards, it can be proposed that such a discrepancy resulting between high standards and alleged performance entails a negative trait of perfectionism. Furthermore, maladaptive perfectionism can be related to the challenges experienced in putting up with and emotional reactions, such that maladaptive perfectionists do react with emotional intensity and sensitiveness to environmental factors (Dunkley, 1997). Aden (1999) made a discovery that perfectionism can be linked with increase in the levels of putting up with intense emotions. Dunkley (1997) discovered that maladaptive perfectionists tend to have feeble strategies for putting up with perceived emotions and stress, and that such a factor did account for the link between perfectionism and anguish. In other researches, emotional based became linked with maladaptive issues regarding to perfectionism, whereas the other resultant factors and issues link to adaptive perfectionism (Ashby, 2002). Ashby (2005) advocated that such type of coping with matters relating to denial, drugs abuse just to name a few, made a prediction on the emotional adjusting for the perfectionists who can be taken as adaptive in nature. In a research making an exploration on the mediating task of emotional regulation in the linkage between perfectionism and mental anguish, Annett (1969) submitted a report which suggested that maladaptive perfectionism can be definitely related to emotional regulation operating within boundaries of emotional reaction. The report also suggested that adaptive perfectionism can be found to have indirect and crucial linkages with emotional adjustments and psychological stress. It can also back up whole mediating influence of emotional adjustments. Another signal for self-regulation can be largely and negatively linked to maladaptive perfectionism (Arps, 1920). Moreover, other research discovered that self-esteem brokered the link between maladaptive perfectionism and the way persons fall into the state of depression. It is evident that maladaptive perfectionism needs to be guided by a firm obligation to make failure a part of history which, fused with their incompetence to exemplify success, resulting to self-perception of themselves as persons who are not worthy and meaningless. Thus, in this essay, I will be discussing on perfectionism from a broader perspective rather than making a specification between maladaptive or adaptive perfectionism. This I strongly believe it is the way therapeutic counseling identifies the issue of perfectionism that is considered vital, rather than the type. Perfectionism from a Client’s Point Of View It is essential to identify if it is known to the client and even it is known to the therapist and obviously that could be understood by inquiring more about what they have brought to that particular counselling session. Recently I had a client that even though she had a good well paid job and more importantly she loved her career path that she had decided to take in her life but she somehow she felt that she could still do better because all through her childhood she was told to do more and then there was a point that even more was not good enough for her father and obviously that had an enormous effect on her relationships with her partner that they were not good enough for her (Fred, 1993). She had ended her last relationship for the same reason. How Do Other Approach’s Look at Perfectionism? Psychodynamic Therapy Approach: At first I started researching and reading books about how Psychodynamic therapy deals with Perfectionism. Why I chose this particular one because my personal therapist practices Psychodynamic approach and I felt closer to it. Psychodynamic approach believes that the root of mostly all of our issues and problem are coming from our childhood and in order us to fully comprehend what we are and what we pretend to be (Aden, 1999). The quote in this book says that Perfectionism can be often the most apparent of the traits in this constellation or personality type. Gestalt Therapy Approach: In Gestalt therapy and as it is very much talked about in Gestalt books that the importance of the I-thou and the here and now that if the relationship between client and the therapist is such that there is enough respect and mutual understanding then change occurs through encountering each other. It essentially talks about dealing with the clients here and now is important with dealing with perfectionism or any other issues that the client may have. It is also suggested that Gestalt therapy works well for clients that have Perfectionist and depressed tendency and the client’s willingness to change and take responsibility for their emotion and physic reactions to anything that is discussed in the therapy room (Aden, 1999). Bacp Ethics of Counselling In Regards To Protecting the Clients The aspect of trust The aspect of trust can be regarded to be basic to comprehending and finding a resolution on ethical matters. Practitioners who tend to adopt this principle, act in relation with the trust conferred unto them. They regard the aspect of being confidential as a mandate emanating from the client’s trust. There is also a restriction to any revealing of vital information concerning the clients to enhancing the motive for which it can be initially disclosed (Horney, 2003). Respect of the client’s rights concerning self-governance This principle stresses the usefulness of the clients being committed to being a participant in matters relating to counseling and psychotherapy, normally on a voluntary position. Practitioners who admire and safeguard their clients anatomy, ensure proper ethics in any promotional or information passed in advance of the services availed. In other words this implies that they seek a well informed consent, participate in explicit contracting in advance of any commitment arising from the client’s side. They also serve to safeguard privacy and confidentiality. They basically make any disclosures of critical information to be mandatory on the permission of the person concerned, and convey this information to the client in advance of foreseen issues conflicting in nature or as soon as possible after those issues become clear. The principle involving autonomy is contrary to the forceful controlling of clients against their liking, even for benefiting position (Horney, 2003). The aspect of promoting a client’s well-being The aspect of beneficence means acting in the best supportive manner towards the client side on assessment of professionalism. It directs focus to work strictly within the restriction of competence and giving services based on efficient training and expertise. Ensuring that the client’s interests can be attained needs logical monitoring of practice and results by the optimal available methods. It can be considered vital that research and logical reflection make an identity of the task. There happens to be a channel of using regular and ongoing supervising factor to enable the attribute of the services availed and to make a commitment towards updating practice by continual professional development (Horney, 2003). The motive to act representing the interests of other clients can become foremost when working with clients whose capability in the autonomy becomes diminished owing to immaturity, lack of proper comprehension, extreme anxiety, serious damages and other crucial personal issues. Importance of Supervision in Counselling Questions can be asked on how supervision works and how well do we know it. To me these are meaningful questions that we might consider to ask concerning any action we undertake, and specifically a mandatory activity. But how often does one ask such questions? And does one always feel in a stand to do this? In my earlier years as a counsellor, I never reasoned to question what felt to be portion and aspect of practice since I pictured it to be given. Back then I had a way of thinking that supervision is a manner of monitoring oneself, checking that things were done the proper way. Time and practice did change that ideology. It can currently be believed that what we require, what we desire from supervision changes as we acquire experience in this field (Alexander, 1999). The role of supervision is to aid and support the supervisor in all the various tasks that can be evoked during his or her actions. It means to educate, offer guidance, be a mentor, make an assessment and so on and so forth. It also implies the essence of being ethical, humane and showing competency in the service during working with clients. A question can also be raised concerning availability of evidence concerning if supervision can be considered good and key aspect regardless of age, gender and thee level of experience of someone. Are there any evidences available to show demonstration of it being meaningful? Thus in the past ten years; BACP did make a commissioning of two relevant researches. The research relates to managing of counsellors and psychotherapists using English as a language and a logical review of the literature relating to the consequence of clinical management on counsellors and therapists, their ethics and work guidelines. From these and intensive consultations with BACP workers, there did emerge only one outcome. This made a symbolism of the enabling treatment outcomes to which the expertise and knowledge of supervision did contribute. Most of this evidence related to the effect of supervision on those being tutored and there was no mentioning about the requirements and qualifications of experienced practitioners in this field (Alexander, 1999). Therefore we can make a conclusion from all this that there is scarce evidence to back up continual supervision, yet we move on, and it would be believed it is not because we all toe the line (Annett, 1969). Taking a broader perspective on this matter, there is more to this than typically observing client outcome and the level of satisfaction. Indeed, this is all about accountability. Conclusion Is perfectionism in a counsellor always a bad thing? YES! But if a counsellor is aware of it, and puts in boundaries to control it and follows the BACP’s ethical principles that to be non-malfeasance and that means commitment and avoiding harm to the client and self-respect and having self-knowledge of itself and care for herself (Ashby, 2005). I also come to this understanding that there is neither a perfect client nor a perfect therapist and somehow we are all wounded healers that would like to work through our issues through counselling. My Conclusion around this topic is that there are numerous researches which need to be analysed. Literature on this subject and it was really interesting to see all the books that I have used for my research they had at least a page or two that Perfectionism was discussed. References John, B. (2008). Healing the shame that binds us. Thousand Oaks, CA: Sage Publications Inc. Horney, K. G. (2003). The aspect of emotional deregulation in perfectionism and psychological distress. Journal of Counseling Psychology. Aden, L.T. M. (1999). Perfectionism in the context of social fears: Towards a bi-component model. In G. L. Flett (Eds.), Washington, DC: American Psychological Association. Alexander, G. (1999). Regulation of psychology as telemedicine. The California Psychologist. Annett, J. (1969). Feedback and human behaviour. Harmondsworth, Middlesex, England: Penguin Books. Dunkley, M.M. (1997). Dimensions of perfectionism across the anxiety disorders. Behavior, Research and Therapy. Arps, G. F. (1920). Working with comprehension of outcomes versus work without knowledge of results. Psychological Monographs. Ashby, J. S. & Bruner, L. P. (2005).Multidimensional Perfectionism and Obsessive- Compulsive Behaviors. Journal of College Counseling. Ashby, J. & Kottman, T. (1996).Inferiority as a distinction between normal and neurotic perfectionism. Individual Psychology. Ashby, J. S. (2002). Perfectionism, dysfunctional traits, and self-esteem: A structural equation based insight. Oxford Press. Read More