Susan N. Schriber Orloff, OTR/L FAOTA
“He’s just a little perfectionist, like me!” explains the parent when the teacher says that the child cannot be corrected easily. And with that it is blown off as something that either the child will “outgrow” or will learn as part of coping skills later in life.
Perfectionism is more complex than that. Normal perfectionism involves the striving for the accomplishment of a skill or task. This perfectionism is natural and innate in everybody. Healthy perfectionism is the motivation to acquire attainable goals. These children can make errors and still feel they are “OK” and be proud of their effort.
However, when perfectionism impacts life skills, learning, emotional stability and socialization it can be considered maladaptive. These children are hypersensitivity to “mistakes” and interpret them as “attacks” on their self-esteem. They exhibit an often-unquenchable need for admiration from others.
With healthy perfectionism the child can tolerate some mistakes and still feel good about trying. With unhealthy perfectionism the child demands of him/her self an extremely high level of performance in every situation. These children can find it as hard to take a compliment as they do a criticism. For these children the emphasis is on what was done wrong rather than what was done right.
Their feelings of well being are tied to their performances and so when they do well feelings of “superiority” can emerge particularly in group and/or classroom situations. These children have to be first in line, have to be chosen first for the team, often lose attention when the “spotlight” is not on them, rush to start work without waiting for directions (which is counter-productive to their desired outcomes), equate “first done” with “smarter”/”better”, and tend to think that their work will never be good “enough” so why try.
These behaviors are frustrating for both the teacher and the child. The teacher sees the child as sabotaging his own work and “tuned out” and the child is using avoidance to detach himself from what is seen to them as a stressful situation.
It is important to understand that these children do not feel safe. They have generalized feelings of inadequacy to be all consuming for them. Irrespective of the realities of a given situation, their over-riding emotion is a hypersensitivity to (even the potential of) a negative evaluation of themselves. Often theses children are poor risk takers and will only enter into novel situations when assured of success.
The sooner these behaviors are addressed the more effective the remediation. Left unaddressed, these behaviors in children can evolve into more severe manifestations as the child matures.
The Diagnostic Statistical Manual of Mental Disorders-5 places “perfectionism” as a characteristic within the realm of related anxiety and depressive disorders.
Anxiety is not just the purview of the adult world. Children experience anxiety as well. Recognizing this can prevent its exacerbation and serve as an initial calming force for the child. Letting the child know they do not have to retreat, hide behind an exterior of false bravado or become defensive.
Occupational Therapy with its focus on function, organization, processing and graded self-regulation is the ideal treatment modality for helping these children. Here are some goals that might be included in a treatment plan for children experiencing “perfectionism”:
- Recognize their accomplishments through graded successful task experiences creating more realistic and secure self-esteem
- Teach self-regulation techniques specific to when a child is experiencing anxiety and/or stress so that they can recognize what is happening instead of retreating from the tasks
- Provide realistic task situations to foster prioritizing
- Predict outcomes with a variety of alternative choices in order to choose the best one
- Differentiate a “criticism” from a suggestion on how to improve results of a given task
- Revise original choices, learn self-correction and express appropriate pride in what was accomplished
- Employ graded risk-taking to increase participation with tasks that do not have an assured outcomes
- Formulate techniques and methods that allow the child to enter into novel tasks more readily
- Create methods to inventory tasks and their component parts for both problem-solving and self-evaluation
- Design routines that facilitate the ability to follow specific directions and sequences.
Understanding that there are not hard and fast rules for remediating perfectionistic behaviors and that there is no cookbook or GPS for navigating through these emotional waters. However, here are some ideas for parents and others within the community including teachers.
- Make task expectations very specific: A first them B and you will be done, etc.
- Goals should be short term and easy initially with gradually increased complexity
- Make sure the child understands the process and recognize him/her for following the steps
- Do not emphasize the outcome—focus on the process, required steps/ sequences to be followed, etc.
- Pace performance—these children tend to “go fast” make it rewarding to see how slowly they can go—try this first with a familiar task
- Create and/or play games that are completely by chance with no strategy and practice “losing”
- Talk about “good” mistakes (post-it notes, Penicillin, etc.)
- Have fun—watch bloopers on YouTube and laugh together about the “mistakes” that individual(s) made
- Practice with something your child will have to work at—in other words practice practicing –do the task together –avoid competition –novel things music, voice-overs to commercials (there is an app for that), etc.
- Demonstrate what is needed to be done
- Emphasize “your best” and not “perfect”—your best can be excellent and still not be perfect–talk about YOUR mistakes children tend to think their parents are “perfect”
- Discuss the worst possible result of not being totally right (perfect)
- Snacks—important tension breakers and help keep energy up
- Take breaks
But most of all, as we encourage relaxation in our children we need to practice what we preach. Parents and other adults in this child’s life need to relax as well. We only get one day at a time so pushing harder cannot make change come faster.