The perfect persona - the unacceptable me. A psychodynamic exploration of neurotic perfectionism from the perspective of the experienced clinician

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McMahon, Ciaran
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BA (Hons) Counselling and Psychotherapy
Dublin Business School
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With aetiological roots in obsessional neurosis, neurotic perfectionism is the self-destructive branch of the dichotomous perfectionism construct. The most distinguishing characteristics of this phenomenon include the persistent striving to achieve completely unattainable self-imposed standards, and relentless, most often cruel, punitive self-criticism. In this perpetual pursuit of perfection, it is psychopathology that is inevitably found around every corner. The primary research aim of this study is to conduct a psychodynamic exploration of neurotic perfectionism from the perspective of the experienced clinician. As extant psychotherapeutic research has long focused on quantitative methodological approaches, this study seeks to gain a fresh new insight into the qualitatively untapped area of neurotic perfectionism. A qualitative research study was therefore carried out using the data collection method of semi-structured interviews, with 5 extensively experienced Irish accredited psychotherapists, regarding their clinical work with neurotic perfectionists. Interview transcripts were analysed using thematic analysis to translate the participants‟ subjective experiences into objective qualitative data. Three prominent superordinate themes consequently emerged from this analysis: 1) The Unacceptable Me; 2) A Sick Destiny; 3) Therapy- The “Imperfect” Struggle. This research ultimately showed that neurotic perfectionism is a phony “perfect” persona that is unconsciously constructed, when the true self is rejected in childhood, as a defensive mask of survival to gain love and acceptance from significant others. Comorbidity was found to be positively associated between neurotic perfectionism and psychopathology, resulting from the continued repression of the true self. The therapeutic encounter was found to be an incredibly tempestuous, and pressurised, see-saw experience for the psychotherapist working with neurotic perfectionists, as it is littered with a multitude of obstructive negative transference and countertransference reactions. This qualitative study undoubtedly highlights the unequivocal destructive power of the phenomenon of neurotic perfectionism. Author keywords: Neurotic perfectionism, maladaptive perfectionism, perfectionism, neurotic, false self, psychopathology, transference, countertransference, insecure attachment, psychodynamic