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Approaching Perfectionism with Schema Therapy: A Case Study

Year 2019, Volume: 6 Issue: 3, 312 - 333, 01.10.2019

Bahar Köse Karaca Mustafa Gürsoy

https://doi.org/10.31682/ayna.558846
Cited By: 3

Abstract

Perfectionism is defined as the tendency to have extremely high standards, leading to significant
distress and deterioration of functioning in the clinical sense. In this study, a case with
perfectionism was the focus of the complaints especially in work and work related areas. The aim
of the study was to illustrate how perfectionism could be studied with schema therapy formulation
and techniques. Within the scope of schema therapy supervision course in Istanbul Arel University
Clinical Psychology Doctorate Program, 11 sessions were conducted once a week for 50 minutes.
During assessment stage, Young Mode Inventory, Young Schema Questionnaire, Young Parenting
Inventory, Young-Rygh Avoidance Inventory and Young Compensation Inventory were applied to
the patient. Accordingly, failure, insufficient self-control, unrelenting standards, pessimism and
punitiveness schemas, demanding parent, punitive parent, detached protector, detached soother,
vulnerable child schema modes, and maladaptive coping styles were identified. These schemas,
schema modes and coping styles were aimed to be weakened, whereas the strengthening of the
healthy adult mode was determined as the goal of the therapy. In order to achieve these goals,
interventions were performed using relational, experiential and cognitive strategies of schema
therapy. As a result, it was found that perfectionism-based schema therapy achieved the proposed
goals which was also supported by the self-report of the patient.

Keywords

Perfectionism schema therapy cognitive strategies experiential strategies

References

  • Antony, M. M., & Swinson, R. P. (2009). When perfect isn't good enough: Strategies for coping with perfectionism (2nd ed). Oakland, United States of America: Harbinger Publications.
  • Beck, J. S. (2011). Cognitive behavior therapy basics and beyond (2nd ed). New York, US: The Guilford Press.
  • Burns, D. D. (2000). Feeling Good: The new mood therapy the clinically proven drug-free treatment for depression. New York, US: HarperCollins Publishers.
  • Deas, S., Power, K., Collin, P., Yellowlees, A., & Grierson, D. (2011). The relationship between disordered eating, perceived parenting, and perfectionistic schemas. Cognitive Therapy and Research, 35(5), 414-424. doi: 10.1007/s10608-010-9319-x
  • Druss, B. G., Marcus, S. C., Rosenheck, R. A., Olfson, M., Tanielian, T., & Pincus, H. A. (2000). Understanding disability in mental and general medical conditions. American Journal of Psychiatry, 157(9), 1485-1491.
  • Earley, J. (2016). Self-therapy, a step-by step guide to using IFS for eating issues, procrastinaton, the inner critic, depression, perfectionism, anger, communication, an more (Vol 3). Larkspur: Pattern System Books.
  • Egan, S. J., Wade, T. D., & Shafran, R. (2011). Perfectionism as a transdiagnostic process: A clinical review. Clinical Psychology Review, 31(2), 203-212. doi: 10.1016/j.cpr.2010.04.009
  • Egan, S. J., Wade, T. D., & Shafran, R. (2012). The transdiagnostic process of perfectionism. Spanish Journal of Clinical Psychology, 17(3), 279-294.
  • Egan, S. J., Wade, T. D., Shafran, R., & Antony, M. M. (2014). Congnitive-behavioral treatment of perfectionism. New York / London: The Guilford Press.
  • Farrell, J. M., Reiss, N., & Shaw, I. A. (2014). The Schema Therapy Clinicians Guide: A Complete resource for building and delivering individual, group and integrated schema mode treatment programs. New York: Wiley Blackwell.
  • Flett, G. L., Hewitt, P. L., & Hallett, C. J. (1995). Perfectionism and job stress in teachers. Canadian Journal of School Psychology, 11(1), 32–42. doi: 10.1177/082957359501100105
  • Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14(5), 449-468.
  • Gnilka, P. B., McLaulin, S. E., Ashby, J. S., & Allen, M. C. (2017). Coping resources as mediators of multidimensional perfectionism and burnout. Consulting Psychology Journal: Practice and Research, 69(3), 209-222.
  • Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social sontexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60(3), 456-470. doi: b60. 456-70. 10.1037/0022-3514.60.3.456
  • Kırdök, O. (2004). Olumlu ve olumsuz mükemmeliyetçilik ölçeği geliştirme çalışması. Yayınlanmamış Yüksek Lisans Tezi. Adana: Çukurova Üniversitesi.
  • Klibert, J., Lamis, D. A., Naufel, K., Yancey, C. T., & Lohr, S. (2015). Associations between perfectionism and generalized anxiety: Examining cognitive schemas and gender. Journal of RationalEmotive and Cognitive-Behavior Therapy, 33(2), 160-178. doi: 10.1007/s10942-015-0208-9
  • Köse, B. (2009). Early maladaptive schemas and well- being with the moderator effect of balanced integration differentiation model. Unpublished Master’s Thesis. Middle East Technical University, Ankara, Turkey.
  • Köse Karaca, B. (2014). The effects of young schema domains, young maladaptive coping styles, and young parenting styles on working alliance among supervisors, therapists, and the clients. Unpublished Doctoral Dissertation. Middle East Technical University, Ankara, Turkey.
  • Köse Karaca, B. (2015). Therapeutic alliance among supervisor, therapist, and client trio and schema concept as the affecting factor: A Case analysis. Ayna Clinical Psychology Journal, 2(2), 13-39.
  • Köse Karaca, B., & Ateş, N. (2019). Yaygın Kaygı Bozukluğu ve Öfke Kontrol Probleminde Şema Terapiyi Kullanmak: Bir Vaka Üzerinden Anlatım. Ayna Klinik Psikoloji Dergisi, 6(2), 169-182.
  • Loose, C., Graaf, P. & Zarbock, G. (2018). Çocuk ve ergenler için şema terapi. İstanbul: Psikonet.
  • Luck, A., Waller, G., Meyer, C., Ussher, M., & Lacey, H. (2005). The role of schema processes in the eating disorders. Cognitive Therapy and Research, 29(6), 717-732. doi: 10.1007/s10608-005-9635-8
  • Maloney, G. K., Egan, S. J., Kane, R. T., & Rees, C. S. (2014). An etiological model of perfectionism. Plos One, 9(5), 1-9, doi: 10.1371/journal.pone.0094757
  • Pinto, A., Dargani, N., Wheaton, M. G., Cervoni, C., Rees, C. S., & Egan, S. J. (2017). Perfectionism in obsessive-compulsive disorder and related disorders: What should treating clinicians know?
  • Journal of Obsessive–Compulsive and Related Disorders, 12, 102-108. doi: 10.1016/j.jocrd.2017.01.001
  • Powers, T. A., Koestner, R., Zuroff, D. C., Milyavskaya, M., & Gorin, A. A. (2011). The effects of selfcriticism and self-oriented perfectionism on goal pursuit. Personality and Social Psychology Bulletin, 37(7), 964–975. doi: 10.1177/0146167211410246
  • Rafaeli, E., Bernstein, D. P., & Young, J. (2011). Schema therapy distinctive features. London/ New York: Routledge.
  • Rice, K. G., & Preusser, K. J. (2002). The adaptive/maladaptive perfectionism scale. Measurement and Evaluation in Counseling and Development, 34(4), 210-222.
  • Sassaroli, S., Lauro, L. R., Ruggiero, G. M., Mauri, M. C., Vinai, P., & Frost, R. (2008). Perfectionism in depression, obsessive-compulsive disorder and eating disorders. Behaviour Research and Therapy, 46(6), 757-765. doi: 10.1016/j.brat.2008.02.007
  • Shafran, R., & Mansell, W. (2001). Perfectionism and psychopathology: A review of research and treatment. Clinical Psychology Review, 21(6), 879-906.
  • Simpson, S., Simionato, G., Smout, M., Vreeswijk, M. F., Hayes, C., Sougleris, C., & Reid, C. (2018). Burnout amongst clinical and counselling psychologist: The role of early maladaptive schemas and coping modes as vulnerability factors. Clinical Psychology and Psychotherapy, 26(1), 35- 46. doi: 10.1002/cpp.2328
  • Smith, M. M., Vidovic, V., Sherry, S. B., Stewart, S. H., & Saklofske, D. H. (2017). Are perfectionism dimensions risk factors for anxiety symptoms? A meta-analysis of 11 longitudinal studies. Anxiety, Stress and Coping An International Journal, 31(1), 4-20, doi: 10.1080/10615806.2017.1384466
  • Soygüt, G., Karaosmanoğlu, A., & Çakır, Z. (2009). Erken dönem uyumsuz şemaların değerlendirilmesi: Young şema ölçeği kısa form-3'ün psikometrik özelliklerine ilişkin bir inceleme. Türk Psikiyatri Dergisi, 20(1), 75-84.
  • Stoeber, J., & Otto, K. (2006). Positive Conceptions of perfectionism: approaches, evidence, challenges. Personality and Social Psychology Review, 10(4), 295–319. doi: 10.1207/s15327957pspr1004_2
  • Vreeswijk, M., Broersen, J, & Nadort, M. (2012). Handbook of schema therapy. UK: Wiley Blackwell.
  • Young, J. (1990). Cognitive therapy for personality disorders: A schema–focused approach. Sarasota, FL: Professional Resource Press.
  • Young, J. E., & Klosko, J. S. (1994). Reinventing your life: The breakthrough program to end negative behavior and feel great again. New York: Penguin Group.
  • Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy a practitioner's guide. New York/London: The Gulford Press.

Mükemmeliyetçiliği Şema Terapiyle Ele Almak: Bir Vaka Üzerinden Anlatım

Year 2019, Volume: 6 Issue: 3, 312 - 333, 01.10.2019

Bahar Köse Karaca Mustafa Gürsoy

https://doi.org/10.31682/ayna.558846
Cited By: 3

Abstract

Mükemmeliyetçilik, klinik anlamda kişinin işlevselliğinde önemli düzeyde sıkıntıya ve
bozulmalara yol açan, aşırı yüksek standartlara sahip olma eğilimi olarak tanımlanmaktadır. Bu
çalışmada şikâyetlerinin odağı mükemmeliyetçilik olan ve özellikle iş ve çalışma alanlarında buna
dair sıkıntı yaşayan bir vaka ele alınmıştır. Çalışmanın amacı şema terapi formülasyonu ve
teknikleriyle mükemmeliyetçiliğin nasıl çalışılabileceğini örneklemektir. İstanbul Arel
Üniversitesi Klinik Psikoloji Doktora Programı şema terapi süpervizyon dersi kapsamında
danışanla haftada bir, 50 dakika olmak üzere toplamda 11 seans yapılmıştır. Değerlendirme
evresinde, danışana Young Mod Ölçeği, Young Şema Ölçeği, Young Ebeveynlik Ölçeği, YoungRygh Kaçınma Ölçeği ve Young Telafi Ölçeği uygulanmıştır. Kuramsal açıdan
mükemmeliyetçiliğin mekanizmasında daha fazla rol aldığı belirtilen, başarısızlık, yetersiz
özdenetim, yüksek standartlar, karamsarlık ve cezalandırıcılık şemaları, talepkâr ebeveyn, kopuk
korungan ve kopuk kendini avutan şema modları ve uyumsuz başa çıkma biçimleri tespit
edilmiştir. Bu şemalar, şema modları ve başa çıkma biçimlerinin zayıflatılması buna karşın sağlıklı
yetişkin tarafın güçlendirilmesi, terapi hedefi olarak belirlenmiştir. Bu hedeflere ulaşabilmek için
şema terapinin ilişkisel, yaşantısal ve bilişsel stratejileriyle müdahalelerde bulunulmuştur. Sonuç
olarak, danışanın şikayetçi olduğu belirtilerdeki azalmalara ilişkin özbildirimleri
değerlendirildiğinde mükemmeliyetçiliği köken odaklı şema terapiyle çalışmanın öngörülen
değişim hedeflerine ulaşılmasını sağladığı tespit edilmiştir.

Keywords

Mükemmeliyetçilik kaygı şema terapi bilişsel stratejiler yaşantısal teknikler

References

  • Antony, M. M., & Swinson, R. P. (2009). When perfect isn't good enough: Strategies for coping with perfectionism (2nd ed). Oakland, United States of America: Harbinger Publications.
  • Beck, J. S. (2011). Cognitive behavior therapy basics and beyond (2nd ed). New York, US: The Guilford Press.
  • Burns, D. D. (2000). Feeling Good: The new mood therapy the clinically proven drug-free treatment for depression. New York, US: HarperCollins Publishers.
  • Deas, S., Power, K., Collin, P., Yellowlees, A., & Grierson, D. (2011). The relationship between disordered eating, perceived parenting, and perfectionistic schemas. Cognitive Therapy and Research, 35(5), 414-424. doi: 10.1007/s10608-010-9319-x
  • Druss, B. G., Marcus, S. C., Rosenheck, R. A., Olfson, M., Tanielian, T., & Pincus, H. A. (2000). Understanding disability in mental and general medical conditions. American Journal of Psychiatry, 157(9), 1485-1491.
  • Earley, J. (2016). Self-therapy, a step-by step guide to using IFS for eating issues, procrastinaton, the inner critic, depression, perfectionism, anger, communication, an more (Vol 3). Larkspur: Pattern System Books.
  • Egan, S. J., Wade, T. D., & Shafran, R. (2011). Perfectionism as a transdiagnostic process: A clinical review. Clinical Psychology Review, 31(2), 203-212. doi: 10.1016/j.cpr.2010.04.009
  • Egan, S. J., Wade, T. D., & Shafran, R. (2012). The transdiagnostic process of perfectionism. Spanish Journal of Clinical Psychology, 17(3), 279-294.
  • Egan, S. J., Wade, T. D., Shafran, R., & Antony, M. M. (2014). Congnitive-behavioral treatment of perfectionism. New York / London: The Guilford Press.
  • Farrell, J. M., Reiss, N., & Shaw, I. A. (2014). The Schema Therapy Clinicians Guide: A Complete resource for building and delivering individual, group and integrated schema mode treatment programs. New York: Wiley Blackwell.
  • Flett, G. L., Hewitt, P. L., & Hallett, C. J. (1995). Perfectionism and job stress in teachers. Canadian Journal of School Psychology, 11(1), 32–42. doi: 10.1177/082957359501100105
  • Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14(5), 449-468.
  • Gnilka, P. B., McLaulin, S. E., Ashby, J. S., & Allen, M. C. (2017). Coping resources as mediators of multidimensional perfectionism and burnout. Consulting Psychology Journal: Practice and Research, 69(3), 209-222.
  • Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social sontexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60(3), 456-470. doi: b60. 456-70. 10.1037/0022-3514.60.3.456
  • Kırdök, O. (2004). Olumlu ve olumsuz mükemmeliyetçilik ölçeği geliştirme çalışması. Yayınlanmamış Yüksek Lisans Tezi. Adana: Çukurova Üniversitesi.
  • Klibert, J., Lamis, D. A., Naufel, K., Yancey, C. T., & Lohr, S. (2015). Associations between perfectionism and generalized anxiety: Examining cognitive schemas and gender. Journal of RationalEmotive and Cognitive-Behavior Therapy, 33(2), 160-178. doi: 10.1007/s10942-015-0208-9
  • Köse, B. (2009). Early maladaptive schemas and well- being with the moderator effect of balanced integration differentiation model. Unpublished Master’s Thesis. Middle East Technical University, Ankara, Turkey.
  • Köse Karaca, B. (2014). The effects of young schema domains, young maladaptive coping styles, and young parenting styles on working alliance among supervisors, therapists, and the clients. Unpublished Doctoral Dissertation. Middle East Technical University, Ankara, Turkey.
  • Köse Karaca, B. (2015). Therapeutic alliance among supervisor, therapist, and client trio and schema concept as the affecting factor: A Case analysis. Ayna Clinical Psychology Journal, 2(2), 13-39.
  • Köse Karaca, B., & Ateş, N. (2019). Yaygın Kaygı Bozukluğu ve Öfke Kontrol Probleminde Şema Terapiyi Kullanmak: Bir Vaka Üzerinden Anlatım. Ayna Klinik Psikoloji Dergisi, 6(2), 169-182.
  • Loose, C., Graaf, P. & Zarbock, G. (2018). Çocuk ve ergenler için şema terapi. İstanbul: Psikonet.
  • Luck, A., Waller, G., Meyer, C., Ussher, M., & Lacey, H. (2005). The role of schema processes in the eating disorders. Cognitive Therapy and Research, 29(6), 717-732. doi: 10.1007/s10608-005-9635-8
  • Maloney, G. K., Egan, S. J., Kane, R. T., & Rees, C. S. (2014). An etiological model of perfectionism. Plos One, 9(5), 1-9, doi: 10.1371/journal.pone.0094757
  • Pinto, A., Dargani, N., Wheaton, M. G., Cervoni, C., Rees, C. S., & Egan, S. J. (2017). Perfectionism in obsessive-compulsive disorder and related disorders: What should treating clinicians know?
  • Journal of Obsessive–Compulsive and Related Disorders, 12, 102-108. doi: 10.1016/j.jocrd.2017.01.001
  • Powers, T. A., Koestner, R., Zuroff, D. C., Milyavskaya, M., & Gorin, A. A. (2011). The effects of selfcriticism and self-oriented perfectionism on goal pursuit. Personality and Social Psychology Bulletin, 37(7), 964–975. doi: 10.1177/0146167211410246
  • Rafaeli, E., Bernstein, D. P., & Young, J. (2011). Schema therapy distinctive features. London/ New York: Routledge.
  • Rice, K. G., & Preusser, K. J. (2002). The adaptive/maladaptive perfectionism scale. Measurement and Evaluation in Counseling and Development, 34(4), 210-222.
  • Sassaroli, S., Lauro, L. R., Ruggiero, G. M., Mauri, M. C., Vinai, P., & Frost, R. (2008). Perfectionism in depression, obsessive-compulsive disorder and eating disorders. Behaviour Research and Therapy, 46(6), 757-765. doi: 10.1016/j.brat.2008.02.007
  • Shafran, R., & Mansell, W. (2001). Perfectionism and psychopathology: A review of research and treatment. Clinical Psychology Review, 21(6), 879-906.
  • Simpson, S., Simionato, G., Smout, M., Vreeswijk, M. F., Hayes, C., Sougleris, C., & Reid, C. (2018). Burnout amongst clinical and counselling psychologist: The role of early maladaptive schemas and coping modes as vulnerability factors. Clinical Psychology and Psychotherapy, 26(1), 35- 46. doi: 10.1002/cpp.2328
  • Smith, M. M., Vidovic, V., Sherry, S. B., Stewart, S. H., & Saklofske, D. H. (2017). Are perfectionism dimensions risk factors for anxiety symptoms? A meta-analysis of 11 longitudinal studies. Anxiety, Stress and Coping An International Journal, 31(1), 4-20, doi: 10.1080/10615806.2017.1384466
  • Soygüt, G., Karaosmanoğlu, A., & Çakır, Z. (2009). Erken dönem uyumsuz şemaların değerlendirilmesi: Young şema ölçeği kısa form-3'ün psikometrik özelliklerine ilişkin bir inceleme. Türk Psikiyatri Dergisi, 20(1), 75-84.
  • Stoeber, J., & Otto, K. (2006). Positive Conceptions of perfectionism: approaches, evidence, challenges. Personality and Social Psychology Review, 10(4), 295–319. doi: 10.1207/s15327957pspr1004_2
  • Vreeswijk, M., Broersen, J, & Nadort, M. (2012). Handbook of schema therapy. UK: Wiley Blackwell.
  • Young, J. (1990). Cognitive therapy for personality disorders: A schema–focused approach. Sarasota, FL: Professional Resource Press.
  • Young, J. E., & Klosko, J. S. (1994). Reinventing your life: The breakthrough program to end negative behavior and feel great again. New York: Penguin Group.
  • Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy a practitioner's guide. New York/London: The Gulford Press.
There are 38 citations in total.

Details

Primary Language Turkish
Subjects Psychology
Journal Section Case Report
Authors

Bahar Köse Karaca 0000-0001-5316-6985

Mustafa Gürsoy This is me 0000-0001-9322-051X

Publication Date October 1, 2019
Submission Date April 29, 2019
Acceptance Date September 17, 2019
Published in Issue Year 2019 Volume: 6 Issue: 3

Cite

APA Köse Karaca, B., & Gürsoy, M. (2019). Mükemmeliyetçiliği Şema Terapiyle Ele Almak: Bir Vaka Üzerinden Anlatım. AYNA Klinik Psikoloji Dergisi, 6(3), 312-333. https://doi.org/10.31682/ayna.558846

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