Background: Perfectionism and eating disorders make cozy bedfellows, as both are driven by passions of strict control and maintenance of rigid expectations. The impact of each disorder on the other further drives the passion to reach unattainable levels of performance. Eating disorder professionals have seen this in practice for years, and studies have shown correlations of perfectionism to both bulimia and anorexia. This presentation combines didactic and experiential techniques to provide evidence based recommendations on how to identify and address perfectionism in in eating disorder patients. Participants will leave with tools to increase flexibility and emotional awareness with their perfection-driven clients.
Objectives:
- Identify 3 traits of perfectionism in eating disorder clients
- Educate clients and families on the synergistic nature of eating disorders and perfectionism
- Implement two tools that help students respond flexibly in the face of perfectionistic tendencies
- Introduction and rationale
- Case examples of ED and perfectionism
- Clinicians have known for a while that perfectionism is an issue for ED clients
- Research literature is now catching up
- This topic is important so we can catch early and address underlying causes of perfectionism
- Experiential: case conceptualization of ED and perfectionism client
- Perfectionism defined
- Maladaptive nature of perfectionism
- Potentially ego-syntonic nature of perfectionism
- Perfectionism vs. self improvement/achievement striving
- Cycle of perfectionism
- Types of perfectionism
- Self oriented perfectionism
- Socially prescribed perfectionism
- Other oriented perfectionism
- Impact of perfectionism
- Prevalence of perfectionism in non-treatment population
- Diversity and cultural impacts of perfectionism
- At risk populations
- Understanding the complementary presentation of eating disorders and perfectionism
- Prevalence of perfectionism in ED treatment population, broken out by diagnosis
- How perfectionism and ED feed off of each other to increase symptomology of both
- Using tools to identify clients that struggle with clinical levels of perfectionism
- Child Adolescent Perfectionism Survey (CAPS)
- The Big Three Perfectionism Scale (for adults) (BTPS)
- Validity of diagnostic tools CAPS and BTPS
- Experiential: practicing utilizing tools in a small group setting
- Increasing flexibility in eating disorder clients with perfectionistic traits
- Present moment awareness
- Clinical Mindfulness defined and demonstrated
- Clinical rationale for present moment awareness to treat ED and perfectionism
- Mindfulness experiential
- Emotional literacy
- How to cultivate emotional literacy didactic and demonstration
- Using mindfulness to experience and understand triggers, emotional responses, and consequences of being fused with emotion
- Emotional literacy experiential
- Values oriented action
- Clinical rationale for values as an important, evidence based treatment for ED and perfectionism
- Examples and demonstration of values exercises
- Video clip showing client using values to guide action
- Values experiential
- Conclusion
- Questions and Answers
- Present moment awareness
While clinicians in the field have long had this awareness, the research literature has not meaningfully explored this connection until recently. As more research is being done into perfectionism and eating disorders co-occurring, we can turn our attention to how to treat both effectively. This presentation will first explore the definition of perfectionism and how it presents in an eating disorder population. While many individuals display perfectionistic characteristics, the ability to tell problematic perfectionism from helpful self-striving is important for clinicians. Participants will become familiar with two common diagnostic assessments that they can implement into their practice to help understand the level of perfectionism of their client.
We will then turn to helping clinicians solidify their ability to effectively treat clients who present with perfectionist personalities and eating disorder diagnoses. Using case examples from both the presenter’s work and those of the participants, the underlying causes of both perfectionism and eating disorders will be explored. Three ways to treat these underlying causes will then be presented: present moment awareness (mindfulness), emotional literacy, and values-oriented work. While many experienced clinicians are familiar with these three interventions, how to expand on foundational knowledge to target both the eating disorder and perfectionist symptoms will be addressed through didactic and experiential work.
By combining the passion and lived experience of clinicians who have been treating perfectionism in eating disorder clients with recent increased attention to perfectionism in eating disorders in the research literature, this presentation aims to consolidate the expertise of both to help improve treatment outcomes for clients.
Jancey Wickstrom, AM, LCSW is a Clinical Training Specialist at The Renfrew Center. She has worked in residential, partial, and outpatient eating disorder treatment settings. Ms. Wickstrom is intensively trained in Dialectical Behavioral Therapy (DBT) and Acceptance and Commitment Therapy (ACT) and well as Renfrew's Unified Treatment Model. She contributed a chapter titled ‘Healing Self Inflicted Violence in Adolescents with Eating Disorders’ in the book Treatment of Eating Disorders: Bridging the Gap Between Research and Practice. Ms. Wickstrom is also an adjunct lecturer at The University of Chicago's School of Social Service Administration.
