The Perfectionist Constellation: How Perfectionists Describe, Understand, Experience and Imagine Relationships Alice Georgina Marsh Wordcount: 34,508 (including all quotes and in text referencing) A thesis submitted in partial fulfilment of the requirements of the University of the West of England, Bristol for the degree of Professional Doctorate in Counselling Psychology Faculty of Health and Life Sciences, University of the West of England, Bristol - May 2018 0 1. Contents 1. Contents .................................................................................................................................................... 1 2. Acknowledgements .............................................................................................................................. 3 3. Abstract ..................................................................................................................................................... 4 4. Introduction ............................................................................................................................................ 6 5. Literature Review.................................................................................................................................. 8 a) Definition and Effects of Perfectionism ............................................... ………….8 b) Interpersonal Effects of Perfectionism ............................................................. 10 c) Mental Illness and Perfectionism ........................................................................ 12 d) Suicidality and Perfectionism ............................................................................... 14 e) Early Experience of Perfectionists ...................................................................... 16 Psychotherapeutic Models and Theories applied to Perfectionism ............... 17 f) Cognitive Behavioural Model ................................................................................ 18 Fig. 1 - Cognitive Model of Perfectionism……………………………………….……18 g) Psychoanalytic Theory ............................................................................................ 19 Fig. 2 - Triangle of Conflict and Triangle of Persons…………………………….21 h) Trauma Theory ........................................................................................................... 23 i) Attachment Theory ................................................................................................... 24 j) Attachment and Perfectionism ............................................................................. 26 k) Cognitive Analytic Therapy ................................................................................... 27 l) Schema Therapy ......................................................................................................... 29 m) Therapy with Perfectionists .................................................................................. 31 n) Missing Perfectionist Voices .................................................................................. 37 6. Rationale ................................................................................................................................................. 39 7. Aim ............................................................................................................................................................ 42 8. Methodology.......................................................................................................................................... 43 a) Research Philosophy ................................................................................................ 43 b) Reflexive Statement .................................................................................................. 44 c) Methodological Considerations ........................................................................... 47 Fig. 3 - Data Analysis Spiral……………………………………………………………….. 49 d) Research Design and Strategy .............................................................................. 50 e) Research Ethics .......................................................................................................... 50 f) Interviewee Recruitment ....................................................................................... 50 g) Interviewee Demographics .................................................................................... 51 h) Data Collection ............................................................................................................ 52 i) The Interviews ............................................................................................................ 52 j) Data Analysis ............................................................................................................... 55 9. Analysis and Discussion .................................................................................................................... 58 Fig. 4 -Table of Results – Coded examples within each subtheme………….59 i. Challenging relationship experiences from the past ........................................ 66 1 a) Parents in conflict with one another…………………………………………………66 b) Difficult to understand parent………………………………………………….………70 c.) Difficult to please parent…………………………………………………………………73 d) Difficult to reach parent…………………………………………………….…………….76 e) Traumatic events in relationship………………………………………….………....79 ii. Feeling unpleasant sensations and emotions in the past and present…...….81 a) Feeling disappointed, misunderstood and not listened to by others….82 b) Feeling angry, hurt, sad and vulnerable because of others………….…….83 c) Feelings of anxiety and fear for and of others…………………………………..85 d) Feelings of distress and being in crisis……………………………………………..90 iii. Ongoing habits impacting on relationships ......................................................... 96 a) Expecting disappointment and feeling suspicious of others……………...96 b) Exasperating others through striving………………………………………………98 c) Avoiding others…………………………………………………………………………….104 d) Evaluating, comparing and criticising the self and others......…………...107 Fig. 5 Interaction of Themes and Relationship Outcomes………………………114 Fig 6. Life context mediates relationship experience and response………..120 10. Conclusions ......................................................................................................................................... 133 11. References ........................................................................................................................................... 142 12. Appendices .......................................................................................................................................... 165 Appendix 1 – Journal Article………………………………………………………………165 Appendix 2 – 15-point Criteria for Good Thematic Analysis…………………188 Appendix 3 – Ethical Approval……………………………………………………………190 Appendix 4 – Interview Schedule………………………………………………………..192 Appendix 5 – Local Look Participant Recruitment Advert……………...….....194 Appendix 6 – Participant Recruitment Website Screenshots…….…………..195 Appendix 7 – Facebook & LinkedIn Messages……………………………………...198 Appendix 8 - Participant Consent Form…………………….…………………………199 Appendix 9 - Participant Personal Information Form………………………...…200 Appendix 10 – Participant Research Project Information Sheet………….…201 Appendix 11 – Further Information about Perfectionism……………………...205 Appendix 12 – Examples of the Coding Process……………………………..……..206 2 2. Acknowledgements I would like to thank my research supervisors Zoe Thomas, Nigel Williams and Andrea Halewood; practice supervisors Jenifer Elton-Wilson, Katherine Christie, Jan Robertson and Phil Johnston-Smith; my friends Sandy Cotter, Liz Martins, Anne Suddick, Charlotte Browne, Charlotte Lloyd-Perry, Emily Dawson, Katie Fathers, Mandy Savin, Monica Zuluaga, Morgan Lloyd-Malcolm, Paul Knight, Penny Ricketts and Rachael Browne. Thank you to my twelve interviewees for their bravery and honesty. The experience was humbling and I am indebted to them for their time and the trust they put in me. This thesis is dedicated to Roger and Jennifer Marsh for their support and encouragement and to the bright memory of Lucy Coombs. 3 3. Abstract In this qualitative Counselling Psychology study, I interviewed twelve self-identified perfectionists to explore how they describe, understand, experience and imagine relationships. Nine female and three male interviewees aged between 33 and 67 were recruited through a purpose-built website, social media, press advertising and word-of- mouth. The interviews were qualitative, semi-structured and relational. The interview transcripts were inductively analysed from a critical realist perspective using Braun and Clarke’s guide for thematic analysis (Braun & Clarke 2013). The study sought to give voice to perfectionist relationship experience and illuminate the possible impacts of this for relating and relationships (including therapeutic relationships). The analysis produced three main themes: i. Challenging relationship experiences from the past, ii. Feeling unpleasant sensations and emotions in the past and present and iii. Ongoing habits impacting on relationships. This study considers the interviewees relational experiences in depth and how well available theory applies to, or accounts for these experiences. It also identifies areas of their experience that current theory does not account for. It recommends pragmatic, limited and