Cognitive Behavioral Model of Perfectionism (Shafran, Egan, Wade, 2010)

People with perfectionism pursue high standards in one or more areas of their life, and base their self-worth on their ability to achieve these standards, despite this having negative consequences (Shafran et al., 2010). Perfectionism can arise in various life domains, including work, appearance, bodily hygiene, social and romantic relationships, eating habits, health, time management, hobbies, leisure activities, sports, orderliness, and several others (Stoeber, & Stoeber, 2009). 

Working with perfectionism is complicated by the overlap between positive perfectionism (sometimes referred to as normal, adaptive, or healthy perfectionism) and negative perfectionism (sometimes referred to neurotic, maladaptive, or unhealthy perfectionism). Shafran and colleagues (2002) suggest that the perfectionism observed in clinical groups (referred to as ‘clinical perfectionism’) can be distinguished from the functional pursuit of excellence (positive perfectionism) by an “overdependence of self-evaluation on the detrimental pursuit of personally demanding, self-imposed standards in at least one highly salient domain, despite adverse consequences”. Thus,

“It would be helpful if we could explore and understand how your perfectionism has developed and what is keeping it going. I wonder if we could explore some of your thoughts, feelings, and behaviors to see what kind of pattern they follow?”

1. Inflexible standards. Help the client identify one or two life domains in which they set high, inflexible standards for themselves. If the client struggles to do this, explore general life domains where high standards might exist (e.g., work, relationships, appearance, weight, finances, etc) or where difficulties are reported. Next, help the client specify some of their high standards in each domain. Perfectionistic standards usually take the form of strict and inflexible ‘should’ or ‘must’ rules related to achievement and performance.
   • Can you tell me about one or two areas of your life where you set yourself high standards?
   • In what situations does your perfectionism seem strongest?
   • Do set yourself high standards in

• Egan, S. J., Wade, T. D., & Shafran, R. (2011). Perfectionism as a transdiagnostic process: A clinical review. Clinical Psychology Review, 31, 203-212.
• Egan, S. J., Wade, T. D., Shafran, R., & Antony, M. M. (2014). Cognitive-behavioral treatment of perfectionism. Guilford Press.
• Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. Guilford Press.
• Lee, M., Roberts-Collins, C., Coughtrey, A., Phillips, L., & Shafran, R. (2011). Behavioral expressions, imagery and perfectionism. Behavioural and Cognitive Psychotherapy, 39, 413-425.
• Limburg, K., Watson, H. J., Hagger, M. S., & Egan, S. J. (2017). The relationship between perfectionism and psychopathology: A meta-analysis. Journal of Clinical Psychology, 73, 1301-1326.
• Maloney, G. K., Egan, S. J., Kane, R. T., Rees, C. S. (2014). An etiological model of perfectionism. PloS One, 9, e94757.
• Riley, C., & Shafran, R. (2005). Clinical perfectionism: A preliminary qualitative analysis. Behavioural and Cognitive Psychotherapy, 33, 369-374.
• Shafran, R., Cooper, Z., &