| Letters to the Editor | ||||
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Its influence upon the navigation of life, its dysfunctional subvarieties, the means of its measurement, and its implications for psychopathology are topics undergoing thorough scientific progress (2–6). The description of its phenemenology, however, is hampered by a poverty of terminology. Pathological perfectionism is associated with a range of disorders, including eating disorders and depression (2,4–6), and, rather especially, with obsessionality (7,8). Salzman’s treatise on the obsessional personality depicts an ascendent motivation in its myriad forms and guises: control, power, achievement, omniscience, and virtuousness (9). Cognitive models of obsessive–compulsive disorder (OCD) refer to an elusive seminal subjective state along these lines (10–14). Items contained in psychometric scales of perfectionism have a decidedly obsessional flavour, in one case (3) sharing item content with the Maudsley Obsessive–Compulsive Inventory (15). The anxious personality substrate of obsessionals is long-recognized (15). Perfectionism measures also correlate with measures of anxiety in both clinical and nonclinical samples (6,8). A commentator on the psychopathological correlates of a large disparity between ideal and actual self-images noted that “when individuals’ goals, aspirations or hopes, as embodied in the ideal self-image, do not match perceptions of their actual attributes or accomplishments, as reflected in the real self-image, an unpleasant state of internal conflict may result” (16). |
Considering the plasticity of the anxiety construct (17), the vogue for the word “mood,” and the facility and frequency of their measurement, this “unpleasant state” could be speciously labelled as anxiety or dysphoria. The personality theories of Horney (18) and Rogers (19) are germane. Horney’s “neurotic pride” and “tyranny of shoulds” entail the difference between the despised real self and the idealized self-image. Rogers’ self-actual and self-ideal discrepancy is analogous. Cognitive therapy pioneers (20,21) essentially took this path, highlighting the irrational sanctioning of stringent levels of competence and faultlessness, followed by a critical internal dialogue when the inevitable failure to match them is weighed. This contemporaneous distress was expressed in terms of anxiety and depression. Perfectionists, obsessional personalities, and many yearning psychotherapy clients with diverse presenting problems often experience fluctuating levels of an unpleasant state of ascendent anxiety. The lack of a word for this is a gap in the psychological lexicon, leading to circumlocution. Horney’s and Rogers’s terms may be too proprietary to their theories and too trait-like. Anxiety is over general, and connotes timidity; as a discussion about the item content of a commonly used psychometric scale highlights, it is usually used to emphasize physiological overarousal, rather than as a persistent longing for self-elevation (22). The noun yumpity, (adjective, yumpitous or yumptious), is offered as a potential solution. |
Having a word for ascendent anxiety—the discomforting subjective state of perfectionism—could assist in the development of parsimonious cognitive models of OCD. It is comforting, too, for patients, if there is a name for their distress (23). References 1. Tilley, MP. A dictionary of proverbs in England in the 16th and 17th centuries. Ann Arbor: University of Michigan Press; 1950.
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