Psychotherapy Volume 22/Fall 1985/Number 3

THE QUEST FOR PERFECTION:AVOIDING GUILT OR AVOIDING SHAME?

BEN SOROTZKINYeshiva University

The cognitive style of perfectionists isnoted together with the emotional andbehavioral outcome of their irrationalthinking patterns. Perfectionism innarcissism is viewed as an attempt toavoid shame and humiliation for notliving up to an archaic grandiose view ofthe self. In contrast, neuroticperfectionism is an attempt to avoidguilt for not living up to the demands ofa harsh, internalized, and differentiatedsuperego.

Cognitive researchers have found perfec-tionism to be a major feature in obsessive-compulsive and mood disorders (Beck, 1976;Burns, 1980; Burns & Beck, 1978; Ellis, 1962;Meichenbaum, 1974; McFall & Wollersheim,1979). Several cognitive styles are character-istic of those who strive compulsively and un-remittingly toward goals beyond reach andreason (in contrast to a healthy pursuit ofexcellence see Hamachek, 1978 and Pacht,1984).

Dichotomous thinking. The perfectionisttends to view the world in a polarized fashion.Events are labeled "black or white," "won-

The work on this paper was supported in part by grantsfrom the Youth Aliyah Department of the Jewish Agencyfor Israel, The Memorial Foundation for Jewish Culture,and Hadassah, The Women's Zionist Organization ofAmerica.

The author wishes to express his gratitude to Dr. RobertStolorow, Professor of Psychology at Yeshiva University,for introducing him to many of the ideas discussed in thispaper and for his many helpful suggestions.

Requests for reprints should be sent to Ben Sorotzkin,24 Tudor Terrace, Brooklyn NY 11224.

derful or horrible," and underlying assump-tions are likewise in absolute terms, such as"always or never" and "all or nothing" (Beck,1976; Burns & Beck, 1978; Mahoney & Arn-koff, 1979).

Over generalization. The perfectionist illog-ically generalizes on the basis of a single in-cident (e.g., concluding from failing one testthat one will fail all other tests) (Beck, 1976;Burns & Beck, 1978).

An overly active system of self-commands,termed by Karen Homey (1950) "the tyrannyof the shoulds." Some of the common self-commands are: "I should be the perfect par-ent, friend, spouse, etc.," "I should never getangry," "I should always achieve my goalswithout any difficulty" (Beck, 1976; Mahoney& Arnkoff, 1979).

Overly moralistic self-evaluation. Perfec-tionists measure their self-worth in terms ofunachievable goals of accomplishment andproductivity, and thus any deviation from theperfectionistic goal is likely to be accompaniedby moralistic self-criticism and lowered self-esteem (Burns & Beck, 1978; Mahoney & Arn-koff, 1979).

Many detrimental behavior patterns andemotional states have been attributed to per-fectionistic tendencies. According to Beck(1976), perfectionists tend to have disturbedinterpersonal relationships, related to antici-pation of rejection when they inevitably fallshort of their perfectionistic standards, and aconcomitant hypersensitivity to criticism and/or withdrawal from meaningful social inter-action. When they notice, in fact, that no oneis interacting with them this is used as evidenceof their own worthlessness and undesirability;thus establishing a self-perpetuating viciouscycle (Burns & Beck, 1978). As would be ex-pected, a withdrawal from interpersonal re-lationships and the repeated recognition of a

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gap between performance and perfectionisticgoals and grandiose expectations often leadsto lowered self-esteem and depression (Beck,1976; Burns & Beck, 1978).

Chess & Hassibi (1978) note that "for somechildren, fear of failure and an obsessional de-sire for perfection may act as an emotionalblock against learning" (p. 305). Burns (1980)reports that perfectionists tend to procrastin-ate, as they attempt to avoid the dreaded con-sequence of less than perfect performance.Likewise, Mahoney & Arnkoff (1979) assertthat the dichotomous and overgeneralizedthinking of the perfectionist is most detrimen-tal to self-regulation of smoking, drinking, andeating habits. The first lapse in the perfec-tionist's typically overambitious program isviewed as indicating total failure which usuallyresults in binge smoking, drinking, or eating(the "saint or sinner" syndrome).

The Etiology of Perfectionism

Beck (1976), using a learning theory ap-proach, states that emotional disorders "arederived largely from certain distortions ofreality based on erroneous premises and as-sumptions which originated in defective learn-ing during the person's cognitive develop-ment" (p. 3).

In classical psychoanalytic theory, perfec-tionism is viewed as one of the common symp-toms of obsessional neurosis (Freud, 1926/1959). The threatened return of repressed oe-dipal impulses and conflicts results in a defen-sive regression to anal fixation of the ego (re-sulting in an archaic mode of cognition), andsuperego (reviving sadistic superego forerun-ners), while the id threatens to erupt with sa-distic impulses. The obsessive-compulsivesymptoms are viewed as a compromise, mask-ing aggressive impulses in the form of punitiveand exhaustive self-corrective tendencies whichtestify to the individual's need to counteractand set right his or her aggressive tendencies(Fenichel, 1945). "Guilt feelings are almostconstant companions . . . . A childish con-ception of evil joins battle with a childish con-ception of righteousness and punishment"(White & Watt, 1981, pp. 201-202).

The role of the superego in obsessional neu-rosis is emphasized by Freud (1926/1959), whostates that "the super-ego becomes exception-

ally severe and unkind, and the ego, in obe-dience to the super-ego, produces strong re-action formations in the shape of con-scientiousness, pity and cleanliness" (p. 115).

The importance of the role of the superegoin perfectionism is, in fact, also emphasizedby the cognitive behaviorists who prefer to re-fer to an "overly moralistic self-evaluation"(Mahoney & Arnkoff, 1979), or to Horney's(1950) tyranny of the shoulds which Beck(1976) concedes has "much in common withFreud's conceptualization of the superego"(p. 257). Indeed, in both the cognitive ap-proach and classical psychoanalytic conflicttheory the perfectionist's lowered self-esteemis viewed as the result of a harsh superego.

The Narcissistic Striving for Perfection

Kohut's pioneering work on narcissism(1971, 1977), in which he contrasts neuroticdisturbances with narcissistic personality dis-orders ("disorders of the self"), necessitatesconsidering a different concept of perfection-ism with a different "meaning" than the onediscussed above.

The central pathology in neurosis relates tointrapsychic conflict over forbidden wishes"which emanate from a well-delimited, co-hesive self and are directed toward childhoodobjects . . . fully differentiated from the self"(Kohut, 1971, p. 19). Anxiety results from thefear that giving expression to the wishes willresult in punishment (castration anxiety) orlosing the love of the object.

Since the self is differentiated, the feared lossof object love does not threaten the cohesive-ness of the self and so any loss of self-esteemis only secondary. Likewise, since the superegois well developed, the threat of giving expres-sion to the forbidden wishes is experienced asa transgression of a moral/ideal and thereforearouses feelings of guilt.

In contrast, the psychopathology of the nar-cissistic personality, according to Kohut (1971,1977), concerns primarily the poorly differ-entiated self—its cohesiveness, stability, andaffective coloring. The anxiety of a narcissisticpersonality is a result of a realistic appraisalof the vulnerability of the self to fragmenta-tion ("disintegration anxiety") and/or intru-sion of archaic forms of grandiosity. The nar-cissistic disturbance cripples the regulation of

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self-esteem which may range from archaicgrandiosity to severe shame.1

Since the objects in the narcissist's world are"selfobjects" (Kohut, 1971, p. 3), i.e., objectspoorly differentiated from the self which serveto maintain the sense of self, the loss of theiradmiration (as opposed to love) can result ina serious blow to the cohesion of the self and/or to the sense of self-esteem. This may causefeelings of overpowering shame.

Kohut asserts that, in the normal course ofdevelopment, a child establishes a grandioseimage of the self, i.e., "I am perfect" and agrandiose image of the selfobject (idealizedparent imago), i.e., "you are perfect and I ampart of you." According to Kohut, this is doneto replace the state of perfection enjoyed dur-ing the stage of primary narcissism when alllove is directed toward the self and which isthreatened by normal parental shortcomings(Kohut, 1971).

Stolorow & Lachmann (1980) point out thatat this early stage of development, before ob-ject constancy is established, it makes littlesense to speak of primary narcissism since lovecan neither be directed toward the self nor to-ward an object, since at this point they are un-differentiated from each other. In their view,these early grandiose and idealized imagesserve to consolidate the infant's rudimentaryself-representation which is lacking in cohe-siveness and stable boundaries.

When the parent's shortcomings are at anoptimal level the child's perfect self-image istoned down and internalized as part of apsychic structure supplying ambition and mo-tivation for activities while the idealized parentimago is internalized as ideals and morals (ego-ideal) which serves to regulate self-esteem, rel-atively independent of external factors. How-ever, if the child experiences severe narcissistictrauma (e.g., a lack of mirroring of the child'sgrandiose needs because of the parent's ownnarcissism), the development of a mature,

'In The Restoration of the Self (1977), Kohut proposesdoing away with the distinction between neurosis (conflictover impulses) and narcissistic disorders (archaic selfob-ject relations). Kohut suggests that impulses are a path-ological product of deteriorated object relations. Mitchell(1979) asserts that this conceptualization resulted fromKohut's unfortunate attempt to reconcile his innovativeapproach with classical drive theory.

cohesive, and stable feeling of self is notachieved. As a result, the archaic grandiosityis not integrated into the adult personalitystructure and the person continues to strive forultimate perfection or for merger with a per-fect selfobject (Kohut, 1971).

Shame versus GuiltThe distinction between shame and guilt,

elaborated upon by Piers & Singer (1953), Ja-cobson (1964), and Lewis (1971), is extremelyrelevant to our discussion.

Piers & Singer (1953) distinguish betweenguilt reactions to transgressions of prohibi-tions and feelings of shame resulting from thefailure to reach goals or live up to expectations.

Lewis (1971) stresses that shame, in contrastto guilt, is more profoundly related to primi-tive feelings of the past and is more likely todisturb the sense of identity. Likewise, Jacob-son (1964) asserts that shame has earlier in-fantile narcissistic origins and is related to fearof exposing one's defects (physical, emo-tional, or intellectual) to others. Shame is usu-ally related to visible and concrete deficienciesrather than moral deficits. Therefore, shameand humiliation in relation to intellectual def-icits would reflect the person's reaction to per-formance which does not live up to perfec-tionistic expectations.

The standards which are not being lived upto are related to pride and superiority and thesedeficiencies are felt to be beyond remediationand a threat to the self-representation.

In Jacobson's (1964) view, shame is an all-encompassing feeling with "a self-annihilatingoverwhelming effect" (p. 144). In contrast,guilt is a more developmentally advanced feel-ing related to verbal demands and moral pro-hibitions usually related to feelings of hostilityto others.

The psychic structures involved in shameand guilt are also contrasted by Jacobson.Shame reactions arise from not living up to anego-ideal according to which the self is eval-uated in terms of archaic grandiose conceptsof physical self-achievements, power and con-trol. Kohut (1972) makes a similar point, thatshame as a result of a "slip" is often relatedto a feeling of a defect in the omnipotent gran-diose self and not to guilt over the unconsciousimpulses which are revealed. In contrast, guiltfeelings arise from the more mature superego

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which has internalized the (differentiated) par-ent's moral demands and prohibitions and isrelated to transgression of these prohibitions.

Since narcissistic personalities have not de-veloped an adequate superego structure theyare not yet able to be affected by guilt feelings,although they often attempt to portray theirshame reactions in terms of high moral ideals(Kohut, 1971).

Kohut (1971) refers to two forms of shamereactions prevalent in narcissistic personali-ties. One form of shame is a self-conscious re-action to a breakthrough of archaic aspects ofthe grandiose self accompanied by anticipa-tion of faulty mirroring by significant others(where the shame may function as protectionagainst the loss of self-boundaries implicit ingrandiose fantasies). A second yet related formof shame is a reaction to not living up to thearchaic grandiose image of the self. The nar-cissist's striving for perfection in this secondcase reflects the need to avoid the shame ofnot measuring up to grandiose standards.

Neurotic Perfectionism versus NarcissisticPerfectionism

Jacobson's distinction between shame andguilt and Kohut's distinction between neuroticand narcissistic disorders suggest that a dif-ferentiation between two forms of perfection-ism would be useful.

Perfectionism in neurosis is a reaction to thedemands of a harsh superego acquired as a re-sult of learning and/or as a result of repressedhostility. As such, perfectionism is a defenseagainst intrapsychic conflict (related to feel-ings of guilt around issues of morals and ideals)and an attempt to retain the love of differ-entiated objects in the individual's "represen-tational world" (Sandier & Rosenblatt, 1962).The failure to live up to the superego's de-mands results in lowered self-esteem.

In contrast, perfectionism in the narcissisticpersonality is less related to morals and ideals.Rather it is an attempt by the individual to liveup to a grandiose self-image in order to avoidhumiliation and shame and the loss of the ad-miration of poorly differentiated selfobjects.The function of the perfectionism is to restoreor maintain precarious self and object repre-sentations and not to defend against intra-psychic conflict (as in neurosis). This can beviewed as a "prestage of the defense" (Sto-

lorow & Lachmann, 1980), i.e., a remnant ofa developmental arrest at, or regression to, astage where a perfectionistic view of self andselfobjects is necessary to develop a cohesiveand stable sense of self. As such, the disturb-ance in self-esteem is the cause of the perfec-tionism and not the price.

The concrete outcome of a perfect perfor-mance in the narcissistic personally can beconceptualized as a "transitional selfobject"(Kohut, 1971) which, to paraphrase Atwood &Stolorow (1981, p. 204), gives the individualreassurance that while the sense of self mayvanish on a temporary basis, it will not be per-manently annihilated. The concrete nature ofthe performance provides a feeling of convic-tion and validity to the image of the grandioseself.

The obsessive redoing, characterisic of theperfectionist, may be the way a narcissisticpersonality assures himself or herself contin-ued contact with the "almost-perfect" selfob-ject. Likewise, the tendency toward perfec-tionism may be more prevalent when anarcissistic personality is separated from thosewho normally function as his or her selfobjects(e.g., when leaving home for college.)

While the cognitive styles discussed at thebeginning of this article (dichotomous think-ing, overgeneralization, etc.) apply to all formsof perfectionism, the cognitive ideation in-volved depends on the the underlying etiology.For example, the "tyranny of the shoulds" ofthe narcissistic perfectionist focuses on the self("I should be perfect"). The failure to live upto the dictates of the "shoulds" evokesthoughts of "I am worthless," "I am a no-body" (shame). In contrast, the focal point ofthe neurotic individual's "should" is the ac-tion to be done or not done ("I should neverget angry"). The failure to live up to this ex-pectation evokes thoughts of "I am bad"(guilt). As Lewis (1971) points out, while bothguilt and shame may be evoked in the contextof a moral transgression, the ideations in-volved are distinctly different. The shame-prone individual would be obsessed with thequestion "How could / have done that?"whereas the guilt-ridden person is more likelyto wonder "How could I have done thatV

The way in which the need for perfection isexperienced is also different in the variouspathologies. A neurotic may be capable of ex-

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periencing some satisfaction from a less-than-perfect performance (although feeling guiltyfor not performing better). In contrast, thenarcissistic personality expects to control hisor her performance (experienced as a selfob-ject not fully differentiated from the self) ashe or she expects to control the parts of his orher body. The inevitable failure to live up tothe perfectionistic standards results in pro-found shame and narcissistic rage (Kohut,1972). This failure attacks the very fabric ofthe self and so is much more threatening thanthe neurotic's failure to live up to the demandsof the superego.

Implications for TreatmentIn real life, most perfectionists are likely to

experience both neurotic and narcissistic ele-ments of perfectionism. It is the therapist'stask to assess the "motivational priority"(Stolorow & Lachmann, 1980, p. 174) of eachneed at any given stage of treatment.

When perfectionism is predominantly neu-rotic, atempting to diminish the power of the"harsh superego" or overly strong idealswould be a legitimate goal of treatment for an-alytically oriented therapists (Salzman, 1980)and especially with cognitively oriented ther-apists, (see McFall & Wollersheim, 1979).2

In contrast, this approach is not indicatedwhen the perfectionism is predominantly nar-cissistic in its root, since it is the lack of stronginternalized ideals capable of regulating self-esteem which is at the core of the disorder.Rather than being related to morals and ideals,the perfectionism is desperately needed formaintaining the sense of self. Questioning thisgrandiose belief system or suggesting that otherpeople suffer from the same type of problemwould be extremely threatening to the patientand would most likely be experienced as a se-vere narcissistic injury and may provoke thepatient to leave therapy. On the contrary, oneof the major goals of therapy would be to fa-

2See Salzman (1980) for an extensive discussion of thedifficulties involved in treating the perfectionist. In thisauthor's opinion, many of these problems result from notdistinguishing between neurotic and narcissistic perfec-tion. It is also interesting to note, in this context, Cole-man's (1968) comment about therapists who "cherish anexaggerated ideal of personality structure and function anddeplore anything less than perfect" (p. 1).

cilitate the development of moral ideals as partof a process of helping the patient develop dif-ferentiated and integrated self and object rep-resentations, by understanding and transform-ing the vulnerabilities that make the perfec-tionism necessary, and reinstating the thwarteddevelopmental process (Stolorow & Lach-mann, 1980).

The following clinical vignette illustrates therupture of an incipient therapeutic alliance be-cause of an empathic failure due to the ther-apist's failure to distinguish between the twoforms of perfectionism.

Case HistoryDan was a 16-year-old student in the tenth

grade of a fairly exclusive Midwestern board-ing school at the time of his referral to the au-thor for biweekly psychoanalytically orientedpsychotherapy.

The reason given for referral was "problemswith interpersonal relations which affects hismotivation for academic achievement." Theteacher indicated that Dan had an extraordi-narily strong motivation for a high level of ac-ademic success, which had recently been dis-rupted by frequent squabbles with his peers.Dan frequently accused the other youngstersof ridiculing him, an accusation that the teach-ers asserted was often "made up." In fact, Danoften "makes fun of himself" and "verballyabuses his peers" and then cried when theyreacted.

Dan's relationship with his parents was de-scribed as "good." Both parents worked theirway up from lower socioeconomic back-grounds. The father attained a college degreeand held a responsible position in a social wel-fare agency in the small town where the familylived. The mother was described as "cultured"in the referral form.

From the beginning of therapy, Dan madeit clear that he agreed to accept treatment onlyout of compliance with his teacher's wishes.He displayed a great deal of nervousness andmade a mostly successful attempt to remain ata distant and intellectualizing level. One of thefirst things that struck my eye when Danwalked in was his slightly deformed arm. He"announced" his name, grade, and problem:"I have interpersonal problems and the teacherthinks it is worthwhile for me to come and getadvice." Nonetheless, Dan took some tenta-

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tive steps during the first months of therapytoward presenting some interrelated areas ofhis subjective world, as if to test for myreaction.

He spoke a great deal of his father, alwaysin idealized terms, and never mentioned hismother. For example, he described his fatheras having worked his way up the socioeco-nomic ladder to become a "director of re-search," as "super-orderly" and "super-so-ciable," and as a harsh disciplinarianintolerant of weakness: "By my father thereis no such thing as fear."

Dan was only willing to hint at all the wayshe imagined he disappointed his father (es-pecially since he was the only male child). Thefirst act of disappointment was being born witha defective arm. This was a taboo topic inDan's house and he had no idea what exactlywas wrong with his arm. At times the fatherserved as a guide during nature hikes in whichDan's class participated and he insisted thatDan participate regardless of his handicap.Given the prevailing emotional attitude of hisfather, Dan experienced this as a denial of hisdefect and his related fears, rather than as en-couragement to overcome a handicap. Dan feltcompelled to prove himself by fully partici-pating in all the physical activities his class-mates were involved in, yet was terrified offailing and thus "humiliating himself." Whenhe inevitably failed to perform at the same levelas his peers he concluded that he was "a zero."

Dan also spoke of other areas of endeavorwhere his imperfections stood in contrast tohis idealized father, such as being extremelydisorderly and nonsociable. Even his academicachievements were experienced as worthless,in the light of paternal comments such as,"Someone who gets a 90% can surely get100%!"

These defects were perceived as humiliatingand unpardonable. Dan felt that he shouldsucceed and thus achieve social status. Heshould be very sociable and loved by everyone.His failure to achieve perfection was perceivedto be glaring proof of his worthlessness. Hisshame at not achieving these "minimal" goalswas especially glaring since he was "spoiled"as a child, i.e., he was given every opportunity.Dan also clearly indicated that he felt loved byhis parents. It was his father's longed-for ad-miration that he failed to merit.

Dan's interpersonal problems were also re-lated to his feelings of being defective. Hispeers were perceived by him as exemplifyingperfect, nondefective (especially nonde-formed) human beings. In his subjective worldthese people were constantly "ridiculing him"for his imperfections, and so he was only re-taliating when he verbally abused them. Like-wise, if he allowed himself to be close to themhis deficits would be highlighted.

As indicated above, these feelings of beingdefective and disappointing to his father wereonly hinted at and were usually denied. In fact,at one point he asserted that "I do not fearanything, except for a while when I was afraidof heights."3

One of the striking features in the therapywas the almost total lack of affective expres-sion. I misinterpreted this as a repression ofresentment and hostility toward his father (forrejecting him) in order to avoid the feelings ofguilt and anxiety associated with the expres-sion of hostility (i.e., intrapsychic conflict).His resistance to the transference was inter-preted as a conflict over hostility and guilt. Theself-demand for perfection was misunderstoodas being a result of an internalization of thefather's harsh superego (as a resolution of theoedipal conflict).

In retrospect, it is clear that Dan made re-peated subtle attempts to reveal his subjectiveexperiencing of these issues. Dan's descriptionof his family life revealed a father who de-manded total success from Dan as a means ofvalidating his own worth. Dan's relationshipwith his father was symbioticlike, where thefather would constantly instruct Dan on howto maintain a socially acceptable facade. Thissuggests that Dan's father related to him as aselfobject necessary for the regulation of hisown self-esteem. Therefore, Dan never expe-rienced himself as totally differentiated fromhis father. Since successful children in Dan'stown went on to exclusive boarding schools,Dan's father felt compelled to send him also.While at first Dan enjoyed the reflected glory(thus allowing himself to feel more acceptableto his father), any evidence of being less per-

3Kohut (1971) asserts that acrophobia in the narcissisticpersonality is caused by the reality ego's anxiety reactionto the grandiose belief in one's ability to fly.

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feet than his idealized peers was experiencedas a severe blow to his self-esteem. His defectsbecame his father's defects and highlighted hishumiliation and shame. As the cause of his fa-ther's imperfection, how could he be worthyof his admiration?

The "dread to repeat" (Ornstein, 1974) therejection experienced at home and the neces-sity of not showing weakness was clearly themajor motivational force behind the resistanceand not the defense against intrapsychic con-flict. Already in the first session Dan tried tomake clear his fear of treatment; "nothing willcome from it and then I will just give up" (i.e.,being rejected again will be too much to bear).

When discussing his perfectionistic ten-dency I again mistakenly attributed this toconflict involving hostility and a harsh super-ego. When I questioned the need for perfec-tion and interpreted it as a defense against hos-tile feelings toward his father, he exhibitedemotion for the first time. His mood turneddepressive, and he indicated that he experi-enced my suggestion as criticism, as I was in-sinuating that he was not worthy of being per-fect. Likewise, he clearly felt threatened by anexpression of hostility against the self object(father), and at this point the patient termi-nated treatment.

In retrospect, it is clear that encouraging theawareness of hostility against a person expe-rienced as a self object is contraindicated. AsStolorow & Lachmann (1980) point out:To promote the emergence of hostility while the self rep-resentation is still insufficiently structured, vulnerable, andin need of selfobjects for the maintenance of its cohesionand stability places the patient in an intolerable dilemma.In effect, the patient is encouraged to bite the hand thatsustains him (p. 165).

While Dan's relationship with his father wasa mostly selfobject one, enough differentia-tion had developed to have allowed a "pres-tage of therapeutic alliance" (Stolorow &Lachmann, 1980) to progress rapidly to a ther-apeutic alliance proper had there been correctempathic understanding of his need for per-fection as a narcissistic avoidance of shamerather than interpreting it as a neurotic avoid-ance of guilt. Unfortunately, I fell victim to"a specific failure in empathy, wherein the an-alyst misunderstands and misinterprets themeaning of the patient's archaic states byamalgamating them to his own much more dif-

ferentiated and integrated world of self andobject representations" (Stolorow & Lach-mann, 1980, p. 190).

Had I correctly recognized and clarified thepatient's developmental need for perfection-istic strivings, a stable "selfobject transfer-ence" most likely would have developed. Ac-cording to Stolorow & Lachmann (1984) aselfobject transference facilitates the reinstat-ing of the developmental process of self-ob-ject differentiation that had been aborted orarrested during the patient's formative years.This transference relationship can, therefore,promote the process of psychic structureformation.

While the therapist attempts to avoid repeat-ing the trauma that caused the developmentalarrest, there will inevitably occur ruptures inthe selfobject transference relationship. It is ofutmost importance to clarify the patient's ex-perience of this rupture, thus reestablishing theselfobject tie and permitting the resumption ofthe developmental process. (For a detailed ex-ploration of the treatment of developmentalarrests, see Stolorow & Lachmann, 1980,Chapter 9, Stolorow & Lachmann, 1984).

In this case, the constant, incorrect inter-pretation of Dan's perfectionistic strivings asa defense against intrapsychic conflict whileremaining unaware of its developmental sig-nificance led to an obstruction of his attemptto develop a selfobject transference relation-ship and consequently to his leaving treat-ment. This experience underscores the criticalimportance of understanding the specificmeanings of perfectionism for the unfoldingtherapeutic process.

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