Guardian: Dr. Dillner (BMJ) - Should I stop being a perfectionist?

[Firestormm]

All the 'research' in this article is old. Pathetic article using 'science' to support it.

Should I stop being a perfectionist?
Striving to be the best you can is often positive, but studies show that this personality trait can cause stress and depression if taken too far


Luisa Dillner
The Guardian,
Sunday 20 April 2014 17.00 BST

Jump to comments (67)

Do you set yourself high standards? Did receiving anything less than an A grade at school trigger a meltdown? If you stress out about being anything less than truly excellent, you may be a perfectionist.

Rather than being a cause of celebration and high achievement, this trait can put you at risk of emotional pain and cause you to procrastinate. While striving to be the best you can be sounds laudable, research increasingly suggests that this pattern of behaviour is frequently linked to depression, anxiety, obsessive-compulsive disorders, eating disorders and chronic fatigue syndrome.

Research by Brook University in Ontario examining the relationship between perfectionism and physical health in 492 men and women aged between 24 and 35 years of age has found that perfectionists were more likely to feel unwell and complain of upset stomachs, poor sleep, shortness of breath, pain and fatigue, and that they took more sick days.

Perfectionists may also fear failure so much that they put off doing their work until it is too late. As psychologist David D Burns wrote in a 1980 article in Psychology Today, by "reaching for the stars, perfectionists may end up clutching at air"...

Read more: http://www.theguardian.com/lifeandstyle/2014/apr/20/should-i-stop-being-a-perfectionist

Not that I personally have a problem with the concept, I think - speaking as someone who always strove to do his best (which may not mean I was a perfectionist of course), can be hard to maintain: which is why you avoid it becoming obsessive and keep it real (man )

Can OCD or something that might lead to this implied 'perfectionism' as an obsessive pursuit, lead to illness? Well, I would imagine if you are dogged enough at trying to achieve and overachieve even at times when your body is telling you to stop, or when you are simply not cut out (intellectually or physically) for the job or sport or hobby etc. then yeah: I can imagine it would run you down and leave you open for something - or run you down and make you feel unwell.

But to suggest in this article that the research quoted supports the notion appears nuts to me, and to further suggest perfectionism is a way to gain a diagnosis of CFS, is not only outdated as a concept: but has never to my knowledge been more than a psychologists wet-dream

This Doctor (the author) if you click the link, is apparently part of BMJ research group or something. How very sad It's not really the way to use 'science' is it?

 

[Cheesus]

While I don't think perfectionism is part of the pathogenesis of CFS/ME generally, I do know that I drove myself into the ground getting the degree classification I wanted and I fell ill soon after that. I was also, funnily enough (funny in a I'm going to cry myself to sleep kind of way), suffering from severe obsessional anxieties at the same time. The link between psychological trauma and physical decline is hard to deny for me, even though it is unlikely to tell the entire story.

Well, I would imagine if you are dogged enough at trying to achieve and overachieve even at times when your body is telling you to stop, then yeah: I can imagine it would run you down.

Call me Rover, because I was dogged as hell!

 

[alex3619]

ME? A perfectionist? Learn how to perfectly pace yourself. Issue over.

 

[A.B.]

Rather than being a cause of celebration and high achievement, this trait can put you at risk of emotional pain and cause you to procrastinate.

Of course, it's always the fault of the patient. Notice how a correlation is taken as evidence that A causes B (that B might cause A is never considered). They don't outright say it, but it is suggested.

It could also be the other way around: that declining health causes changes in behavior. I think it is very plausible that during the earlier stages of illness, people will try to compensate for their declining ability to function productively, and the illness itself could affect behavior. For example, low blood sugar can easily cause irritability and aggression because the body's response to low blood sugar is among other things adrenaline. Who knows what the body does to counteract problems in energy production in the earlier stages of ME/CFS.

Something that is sometimes forgotten is that many illnesses are associated with "psychiatric" symptoms. One example would be Addison's disease:

A review of the literature indicates that disturbances
in mood, motivation, and behavior are associated
with Addison’s disease. Psychosis occurs less fre-
quently, but can be the presenting symptom of a
life-threatening adrenal crisis. Potential mecha-
nisms for the neuropsychiatric symptoms of Addi-
son’s disease include electrophysiological, electro-
lyte and metabolic abnormalities, glucocorticoid
deficiency, increased endorphins, and an associ-
ated Hashimoto encephalopathy. Physicians must
be aware that Addison’s disease may present
solely with psychiatric symptoms and maintain a
high index of suspicion for this potentially fatal
condition.

http://neuro.psychiatryonline.org/data/Journals/NP/3948/06JNP450.PDF

Viewing behavioral changes solely as sign of a psychological problems will set patients on the wrong path if the cause is actually an underlying pathology.

I also notice a certain self-centered metaphysical aspect to the psychological view. The mind is seen as separate entity ruling over the body, rather than being the result of biological processes in the body.

 

[justinreilly]

There are certainly anecdotes of perfectionistic people getting ME "CFS." Because I think anecdotes have some value, I would guess that perfectionism is correlated with ME. However, it seems to me almost all doctors and scientists do not value anecdotes at all (except sometimes their own).I've read in plenty of places about this supposed link. Does anyone know if there were any valid studies done on this topic and what they said.

This "study" was a survey of 27 women with Oxford (i.e. merely idiopathic CF, not ME) or Fukuda "CFS" and 30 female controls. This teeny survey of Oxford and Fukuda "CFS" gets published and quoted while the multiple surveys of several thousand patients each all showing GET to be the most harmful and least helpful 'treatment' for ME are dismissed as having no value because they were surveys.

Note that none of the "CFS" patients were depressed, yet I saw no mention in the conclusions of this fact (only in the method) and none at all that this was "proof" that "CFS" was negatively correlated with depression.

Method

[Subjects were] clinically evaluated to establish that they fulfilled either the Centre for Disease Control (Fukuda et al., 1994) or the Oxford (Sharpe, Archard, & Banatvala, 1991) criteria for CFS.

50 patients were approached; 33 agreed to take part; and 27 completed and returned the study questionnaires. All but four fulfilled both criteria for CFS and those four fulfilled the Oxford criteria. From their clinical letters, none was clinically depressed, though, as usual in this patient group, there was some low mood attributable to the illness.

 

[Legendrew]

I read something a while back that commented on this and concluded that it may be those who strive ever forwards are more likely to get diagnosed as they are the most likely to frequently visit the doctor insisting that something is not right when they feel so lousy, while others may perhaps go through the basic testing and then believe doctors when they say that perhaps they're just depressed or anxious...

Either-way this isn't a helpful anecdote as you cannot change someones fundamental personality traits and I don't think I'd be alone in doubting that personality has much effect upon triggering such a complex condition but it could provide a problem in coping with it.

 

[alex3619]

Alternative hypothesis: people with mild ME have big issues coping. They have to focus more, pay more attention, or things don't get done. So they create skills to pay more attention and get things right. Suddenly they have perfectionist traits. Because of ME.

See what I did? I turned the association around and provided a justifiable explanation for why ME patients might have perfectionist traits. Can anyone prove my hypothesis wrong? (Aside from proving that we are not perfectionists, that might be doable.)

 

[Firestormm]

The Internets expert in all things: Wikipedia:

Perfectionism, in psychology, is a personality trait characterized by a person's striving for flawlessness and setting excessively high performance standards, accompanied by overly critical self-evaluations and concerns regarding others' evaluations.[1][2] It is best conceptualized as a multidimensional characteristic, as psychologists agree that there are many positive and negative aspects.[3] In its maladaptive form, perfectionism drives people to attempt to achieve an unattainable ideal, and their adaptive perfectionism can sometimes motivate them to reach their goals. In the end, they derive pleasure from doing so. When perfectionists do not reach their goals, they often fall into depression....

Normal vs. neurotic perfectionists
Hamachek was one of the first psychologists to argue for two distinct types of perfectionism, classifying people as normal perfectionists or neurotic perfectionists. Normal perfectionists pursue perfection without compromising their self-esteem, and derive pleasure from their efforts. Neurotic perfectionists strive for unrealistic goals and consistently feel dissatisfied when they cannot reach them.[5] Today researchers largely agree that these two basic types of perfectionism are distinct.[6] They have been labeled differently, and are sometimes referred to as positive striving and maladaptive evaluation concerns, active and passive perfectionism, positive and negative perfectionism, and adaptive and maladaptive perfectionism.[7] Although there is a general perfectionism that affects all realms of life, some researchers contend that levels of perfectionism are significantly different across different domains (i.e. work, academic, sport, interpersonal relationships, home life).[3]

 

[justinreilly]

I commented on the article and also emailed the author at ldillner@bmj.com. I encourage you to send a short email to her endorsing my call for a look into this problem at BMJ.

I know it probably won't go anywhere, but I think it would be good to raise awareness there about the problem or at least that we are on to them. Thanks!

Dr. Luisa Dillner
Chief
BMJ Group Research and Development
ldillner@bmj.com

re: "Should I Stop Being a Perfectionist?"
The Guardian, Sunday 20 April 2014
http://www.theguardian.com/lifeands...ld-i-stop-being-a-perfectionist?commentpage=1

Dear Dr. Dillner,

I enjoyed your above-referenced article. Though I am no expert in this area, everything in your article made great sense to me… except one point.

You stated that "research increasingly suggests that [perfectionism] is frequently linked to depression, anxiety, obsessive-compulsive disorders, eating disorders and chronic fatigue syndrome."

The paper you cite is not valid support for this proposition and further it is generally fatally flawed. I skimmed this paper and a bunch of problems leapt out at me as always with Chalder's papers.

This mistake is not your fault. There has been an intentional campaign to muddy and warp the science by the "Wessley School" of psychiatry, of which Trudie Chalder, the author of this paper, is a member.

For one, this "study" was a survey of 33 women with Oxford (i.e. mere Idiopathic Chronic Fatigue, not ME) or Fukuda "CFS" (a much less flawed, but still significantly flawed definition), of which 6 "dropped out", leaving only 27 female patients and 30 female controls.

This teeny survey of women with Oxford and Fukuda "CFS" gets published and quoted while the multiple surveys of several thousand ME patients each showing Graded Exercise "Therapy" to be the most harmful and least helpful 'treatment' for ME are dismissed by the profession as having no value because they were surveys. This shows the general bias of medicine in favor of psychogenic explanations of ME.

Coming back to the instant study, patient subjects were all taken off the waiting list of the notorious Kings College Fatigue Clinic headed up by the most inaccurate (to put it charitably) ME 'scientist', Prof. Simon Wessley. True ME patients try to avoid this place like the plague, thus skewing the sample toward those with Idiopathic Chronic Fatigue rather than ME.

None of the "CFS" patients in the study were depressed, yet I saw no mention in the Conclusions of this fact (only in the method) and none at all that this was "proof" that "CFS" was negatively correlated with depression. This shows Chalder's obvious bias in favor of psychogenic explanations for ME.

There are certainly anecdotes of perfectionistic people getting ME "CFS." Because I think anecdotes have some value, I would guess that perfectionism is correlated with ME. However, it seems to me almost all doctors and scientists do not credit anecdotes at all.

However, there are no valid studies, to my knowledge, showing such a link.

I strongly urge you to please retract this statement from your article unless you can show that there is in fact a correlation.

Further, I ask more generally that you be, and encourage your colleagues to be, more vigilant of these type of invalid statements about ME. Copious and excellent information on the Wessley School by Prof. Em. Malcolm Hooper, PhD can be found on his website, meactionuk.org.uk.

BMJ has published a few valid papers on ME to my knowledge, for which I must give credit. However, generally speaking BMJ has been the worst group of journals in terms of publishing invalid ME studies from the Wessley School. Also, Fiona Godlee has written some very inaccurate things about ME in BMJ which she refuses to correct. This is a deep-seated problem at BMJ.

Because you are in a leadership position at BMJ, I humbly request that you take a close, thorough look into this problem or refer this matter to someone you trust to be honest who can do so. Patient experts and health care professionals have brought these problems up repeatedly with BMJ, but they have not been addressed at all.

Honestly, this is a human rights issue. BMJ has abetted the Wessely School in its warping of the science, resulting in a tremendous amount of iatrogenic morbidity in ME patients. It must stop.

I request the favor of a reply. And if you have any questions or comments about ME on this or other subjects, I would be happy to correspond with you. Thank you for your consideration.

Sincerely,
Justin Reilly, esq.
New York, NY 10128 USA

 

[chipmunk1]

Psychology behaves like a sect:

1. Make up rules that classify actions and behaviour as good or bad.

2. Tell people they're flawed and induce guilt.

3. Tell them their sins will have serious consequences and if they want to avoid them they need to get rid of their sinful behaviour.

4. If disease or misfortunes happen blame the people and point out their sinful behaviour.

5. Target the desperate or gullible and promise relief if they join their cult and adopt their belief system.

6. Loot the converted.

 

[alex3619]

Psychology behaves like a sect:

1. Make up rules that classify actions and behaviour as good or bad.

2. Tell people they're flawed and induce guilt.

3. Tell them their sins will have serious consequences and if they want to avoid them they need to get rid of their sinful behaviour.

4. If disease or misfortunes happen blame the people and point out their sinful behaviour.

5. Target the desperate or gullible and promise relief if they join their cult and adopt their belief system.

6. Loot the converted.

7. Set up a codified set of rules.

8. Use and guard those rules dogmatically.

9. Go after heretics that question those rules.

10. Revere specific individuals who practice these beliefs as special ... once up a time it was Freud, today it is .... ?

The sect observation is not new. Richard Webster wrote a book on it: Why Freud Was Wrong.

 

[Jonathan Edwards]

Sometimes I can see more than one way of looking at things when it comes to stuff like this discussed on PR. But this really is just drivel. Moreover, it seems to me to be irresponsible drivel. Sadly the Guardian health page mostly is. Let's see if there is a reply!

 

[NK17]

Oh no another piece of C.R.A.P., which for me stands for:
Continuos
Relentless
Awful
Propaganda
In any case it's not about ME.

 

[NK17]

Sometimes I can see more than one way of looking at things when it comes to stuff like this discussed on PR. But this really is just drivel. Moreover, it seems to me to be irresponsible drivel. Sadly the Guardian health page mostly is. Let's see if there is a reply!

Thank you @Jonathan Edwards for always speaking clearly.
Your honesty is a very precious quality for any human being, even more for a doctor and scientist.

 

[Wildcat]

.

Yet another Guardian Pop Psychology article to delight the Mind-Body Fashionistas.
.

 

[Snow Leopard]

There is something that still confuses me though. Where are these "perfectionists" and why have I never met one?

 

[Firestormm]

There is something that still confuses me though. Where are these "perfectionists" and why have I never met one?

Maybe because you are one and nobody else matches up to you?

 

[alex3619]

Well, I must fess up. I have perfectionist tendencies. Yet I can cope with things not being right, only OK, as I have pragmatic tendencies too, though to a large extent it was my experience from ME that taught me not to be too much of a perfectionist. Which makes me wonder: if ME can teach us to be less of a perfectionist, how can perfectionism have anything to do with maintaining illness?

I am however a pancritical rationalist. I wonder if a psych would consider a philosophical perspective as evidence of perfectionism?

 

[alex3619]

.

Yet another Guardian Pop Psychology article to delight the Mind-Body Fashionistas.
.

The very definition of psychobabble?

 

[Hell...Hath...No...Fury..]

I have no need to be an active perfectionist. I'm already perfect in every way Having a hideous, debilitating illness is just my perfect body's way of stopping me dying or something. Its hard being this perfect