Explore clinical perfectionism as a maintaining mechanism — mapping the cycle and testing perfectionist rules.
Clinical perfectionism maintains eating disorders by making self-worth contingent on meeting impossible standards. Map your perfectionist cycle and test what happens when you deliberately lower your standards in a specific area.
Use in broad CBT-E when clinical perfectionism has been identified as an additional maintaining mechanism. Typically introduced in Stage 3 after the core eating disorder psychopathology has been addressed.
Explain how perfectionism and eating disorders interact — perfectionism drives dietary restraint, body dissatisfaction, and self-criticism following perceived 'failures.' Frame the module as addressing a pattern that maintains eating difficulties and affects other life areas.
For clients where perfectionism is the primary maintaining mechanism, this module may need more sessions than typically allocated. For those with comorbid OCD, distinguish perfectionism from obsessional checking and address both.
If the client's eating disorder is not yet behaviourally stable (regular eating not established, ongoing dangerous compensatory behaviours), prioritise stabilisation before addressing perfectionism. The module requires sufficient cognitive flexibility to examine thinking patterns.
Use behavioural experiments to test perfectionistic predictions (e.g., deliberately submitting 'good enough' work and observing consequences). Help clients identify the costs of perfectionism — it often masquerades as a strength while maintaining distress and eating pathology.
Suitable for clients working with eating disorder, perfectionism, cbt-e, maintaining mechanism, standards. This tool can be used as a standalone worksheet or as part of a structured homework plan.
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Track body checking and body avoidance behaviours, their triggers, and function.
Identify rigid dietary rules and design experiments to test what happens when you break them.
Explore how difficulty tolerating emotions drives eating disorder behaviours — and develop alternative ways to manage intense feelings.
Track weekly weight to observe natural fluctuation and reduce the power of daily weighing.