Presentation on theme: "Porcelain Dolls Dr. Carly LeBaron, LMFT"— Presentation transcript:
1Porcelain Dolls Dr. Carly LeBaron, LMFT A Cognitive-Behavioral Approach to BreakingThrough Perfectionism and People-PleasingIn Women
2Presentation outline What is a Porcelain Doll? Perfectionism DefinitionHow it presentsPeople-PleasingContributing Gender IssuesSocializationCultural roles, rules, & expectationsCompassionate CBT Treatment Approach
3Porcelain dolls What do they look like? What do they do? DemographicsWhat do they do?Common behavioral signsWhat are their presenting problems?Depression, anxiety, EDs, low self-esteem, body image issues, etc.Don’t get taken in by them!They will very frequently be some of your favorite clients (even though we don’t play favorites, right?). Why?
4perfectionism Definition How it Manifests The Core of Perfectionism Setting excessively, sometimes impossibly, high performance standards accompanied by overly critical self- evaluations and fears of others’ evaluations of them.How it ManifestsHigh functioning perfectionistsStrong achievement orientationHighly Successful (straight A’s, scholarships, rapid job promotions)Pedestals, golden childrenLow functioning perfectionistsLack of follow-throughFailing out of schoolQuitting before completionLosing jobsThe Core of PerfectionismIf people see who I really am, how flawed I really am, they will reject me and/or abandon me.
5Perfectionism The Benefits of Perfectionism The Costs of Perfectionism Get things doneLots of praise/reinforcementAchievementsProtection from being realThe Costs of PerfectionismParalysisExhaustionNever feeling good enoughRide the high of one achievement, but it never lastsConstantly seeking external sources of self-esteem
6perfectionismWhy is perfectionism so difficult to treat and hard to beat?Reinforced in our culture (capitalism, individualism)Friends, family members, professors, church leadersPerfectionists serve a purpose for the rest of usLDS contextBe ye therefore perfect…People love a perfectionistWhy?
7People-pleasing Definition How it Manifests An intense focus on behaving only in ways that please others, regardless of personal wants/needs/opinions/thoughts and an overwhelming concern with how others perceive you.How it ManifestsThe Yes WomanDon’t rock the boatUndifferentiatedDon’t get angryAlways be nice!!!!!!!!!!!!!! (Did I put enough exclamation points?!...)Oh, yeah, and always checking to see if what they say/think/feel is okayThe Core of People-PleasingI have to go out of my way to please people or they won’t like meI have nothing else to offer but to please others, so if I don’t please them, they won’t accept me
8People-pleasing The Benefits of People-Pleasing Others respond positively to youYou make people happyYou avoid confrontationYou avoid hurting people’s feelingsThe Costs of People-PleasingYour needs get ignoredYou can become a doormatYou develop resentmentTend towards passive-aggressive to get needs metWhen people refuse to be pleased, it must be your faultPeople lose respect for youYou sacrifice self growth and genuine relationships
9People-pleasing Why is it so difficult to treat and hard to beat? Reinforced by conservative, traditional culturesReinforced by most people in our clients’ lives and our own livesPeople like it when they get what they want and people-pleasers deliver!People pleasers are convinced that to do things any other way would be “mean,” “creating contention,” or “un-Christlike.”Counteracting years of gender socialization
10Gender issues Women as relationship monitors Women garner their self-esteem from success in relationshipsSuccess in relational rolesSocialized to be more attuned to social cues, social control, especially from other womenRelational aggressionMean girls, Queen Bees and WannabesComparison (upward and downward)What else can you think of?
11Gender issues GIRL RULES: Other rules you can think of? Be Nice! Don’t call attention to yourself.Put others needs first.You can do better than that.Indirect queries to get needs metManipulation, subversiveMind-readingEmphasis on looks, imageOther rules you can think of?Both implicit and explicit rules
12Self-of-the-therapist Why do I love working with this population so much?Mary PoppinsMy externalizationOnce a compliment, now an insultWhat about you?Self-checkPerfectionismPeople-pleasing
14Treatment approach Core Beliefs Positive and NegativeOkay to have both, need balanceMessages from FoO, other memorable instancesCognitive Distortions (Burns, Feeling Good)AoNTOvMFDtPJtCMR, FTM&MERSSL&MPe
15Treatment approach Fight back against CDs Reality Checking (All) “Is that really true?”Living in the Gray (AoNT)Empowerment (O)The Lawyer Technique (MF)Reinforce PCBs (DP)10 Possible Alternatives (JtC)Apples to Apples, Oranges to Oranges (M&M-Comp)Relaxing Rigidity (SS)The Confessional (ER)Would a Teenage Girl Say This? (L&M)I Have the Power! (P)
16Treatment approach STOP, It’s Narrative Time! The Mask Activity The importance of EXTERNALIZINGThe Mask ActivityWhat Perfect Looks Like/Feels Like,What Real Looks Like/Feels Like
17Treatment approach Practicing Imperfection (aka Deperfectifying) Start with little things:Spill on purpose, don’t clean it up for 10 minutesPaint every fingernail but oneQ-tip exampleMove on to bigger thingsBe late to a lunch date with a friendDeliberately flub a few words during a presentation or while talking to coworkersDon’t wear makeup for a whole day outDare to be Average and the Mediocre Bucket ListForget the 5- and 10-year plans, let’s get mediocre!The Velveteen RabbitEncourage them to read it. Just do it. You’ll thank me later.
18Treatment approach Assertiveness Training Learning to say “No” Step 1: Convince her that assertiveness=/= being meanTeach difference between passive, assertive, and aggressiveStep 2: Repeat step one until you are blue in the faceStep 3: Practice real life situations with her using role playsSwitch roles so she learns to be both voicesStep 4: Give her homework to practice in real lifeLearning to say “No”“Let me check my schedule…”The BacklashSome people will NOT respond well to your client’s changesPrepare her in advanceShe will feel mean initially, validate herOthers may even tell her she is being mean, process thatRemind them: “That’s more about them than it is about you.”Authority figures will be the most difficult to be assertive with
19Treatment approach Self-Compassion and Self-Forgiveness The crux of successful treatment with this populationSpend lots of time hereModel self-compassion, self-disclosureThe Best Friend TechniqueThe Internal Cheerleader (or Therapist)WWCS?Permission to temporarily internalize my voice until it can become their ownForgiveness is a process“Will the world end/anything spontaneously combust if I do X?”“Will this matter in a year? 6 months? 2 Months? Next week? Tomorrow?”Only give it as much power as it deserves
20Treatment approach Homework Imperfect practice makes imperfect! Let’s talk about strategery…The cool part about every homework you EVER give a perfectionist: THEY CAN’T FAIL!!!...or is that bad?Imperfect practice makes imperfect!Test the watersBe ready for them to come back unhappy, in pain, scaredProvide support and encouragementAllow them to be imperfect with youCatch them in people-pleasing with youGive them permission to disagree, be angry, etc.Carly Voodoo Doll
21Questions or commentsContact Information:Dr. Carly LeBaron, LMFTUtah Valley Counseling2230 N. University Parkway,Suite 11D, Provo, UT(801)(Feel free to grab one of my cards with my contact info!)