Last week, I had the pleasure of interviewing Dr. Sarah Berger, a 
psychology associate from the Center for Cognitive Therapy and Assessment in Falls Church, VA (www.centerforcbtva.com). I was very interested in talking to her because she and the owner of the practice, Katie Hennessy, have a special interest in perfectionism. As an educator, I’ve seen this issue over and over again. With the heightened pressure on kids to perform academically in the Washington DC area, it doesn’t seem to be getting any better. Read on to find out more about perfectionism and what to do about it.
Ann: What causes perfectionism? Are kids born with it or is it a product of parenting?
Sarah: It’s a mix of both. We don’t know for certain exactly what causes it, but research does show that it can be genetic as well as the environment. But the environment isn’t just the home; it can be the school as well.
Ann: Let’s say a parent has a seventh grade daughter who constantly rewrites an essay she’s been assigned. How should the parent handle this type of behavior when the child never thinks her writing is good enough?
Sarah: The main thing a parent can do is to be empathic, but also provide limits. For example, the parent may say, “I know this is hard for you. Instead of six drafts like last time, how about getting it done in four drafts?” Cutting down on the behavior, even just slightly at first, is helpful. Later on, you can cut down to maybe two or three drafts, but take it slow. It’s also okay to put a time limit on work in the evening so that your child isn’t working into all hours of the night. If your child is pushing back and is insisting on perfecting the homework, ask questions like, “What have you done in the past that has helped you get it done? How can you move forward?” Students don’t realize that they are hearing a “worry brain” talking, not a “smart brain.”
Ann: Can you elaborate? What are a worry brain and a smart brain?
Sarah: The worry brain is the brain that focuses on the “what ifs” and constantly thinks of the worst case scenario such as getting an F or the teacher not liking the project or homework. It becomes a negative cycle. The smart brain asks, “What can we do about this?” The smart brain is the problem solver and doesn’t get wrapped up in the cycle of negativity.
Ann: How can therapy help?
Sarah: Our practice uses Cognitive Behavioral Therapy which stems from the idea that thoughts, behaviors, and feelings all interact and feed on each other. So, in the case of a child with perfectionism, the student is thinking, “I can’t do this” or “I’m going to fail”. Those kinds of thoughts perpetuate the anxiety and make the behaviors worse. In therapy, we meet the student at the level of those thoughts and we challenge the thoughts. So the language becomes “I’m going to work on this for a half hour and see where I’m at” which is far different than “I can’t do this well enough.” Kids need parents to help them set those limits. At the half hour point, a parent can check in to see how it is going.
Ann: It seems like kids are often so scared of the “what ifs” that they work their fingers to the bone in order to make the assignment perfect. Is there ever a time when you, as a therapist, say, “Let’s see what it feels like to turn in an assignment that’s not perfectly done.” Do you ever encourage kids to see what might happen?
Sarah: Absolutely! Some of that is learning to live with uncertainty, which is part of life. We also want them to see what it feels like to not get an A. It’s called exposure therapy. We have them do it for homework, but we also practice it in session. Although we can’t practice it exactly how it will be in the classroom, we can model it to some degree. So, for example, I might say, “I know reading perfectly aloud is important to you. This time, I want you to read aloud and make mistakes and then let’s sit for a moment and see how that feels.” This type of exposure is something that we encourage parents to practice with their child as well.
Ann: Can perfectionism ever be fixed or is it typically a life-long problem to some degree?
Sarah: People have tendencies towards perfectionism; however, it can absolutely be modified. The issue is how much it affects day-to-day life. Sometimes the student doesn’t see the impact, but the parents do. When a child is doing hours upon hours of homework, it is a problem. The parent has a right to say, “This is interfering with our lives and we’re going to do something about it as a family.” Parents have the right and responsibility to help their child learn differently.
Ann: One issue that we often see in tutoring is avoidance. Sometimes, kids are so afraid of messing up, that they won’t even start in the first place. Can you talk about this avoidance mechanism?
Sarah: Avoidance looks like laziness, but it is not laziness. Kids are afraid to get started and just try the work. When they’re feeling very anxious, they won’t even begin the task. Here, the parent can say, “I want you to work for 15 minutes, and then I’ll answer any questions you might have.” Set a very reasonable and realistic goal that the child can obtain.
Ann: During my parent workshops, parents often ask when to get help? How does a parent know if this behavior is just garden-variety or a real issue that requires outside assistance?
Sarah: There are two key indicators. One is whether the behavior is interfering with day-to-day functioning. Is the stress level so high that daily tasks are impacted? If so, that’s a sign. And this stress doesn’t have to be just with the child, it can be the family, too. If families are on the fence, they have to ask themselves whether this is a priority, because it will not get better without intervention. Sometimes, parents will say, “This isn’t a priority now, but we’ll keep an eye on it.” And that’s okay, too
Ann: Can you recommend some resources for parents?
Sarah: Yes, one of my favorite websites is www.worrywisekids.org. It’s not specific to perfectionism, but is a great resource for dealing with anxiety. Dr. Tamar Chansky and her group run the site and she is also the one who uses the term “worry brain.”