Young people with borderline personality disorder often struggle with feelings that they are not good enough. They may doubt their actions, look for their faults, and be overly concerned with mistakes.
These thoughts and feelings can be linked to maladaptive perfectionism: perfectionist traits that make life more difficult for young people and, in clinical cases, interfere with their ability to navigate daily life. Perfectionism – and particularly socially prescribed perfectionism – is a common characteristic of young people with BPD and associated with a range of borderline personality traits.
This blog explores socially prescribed perfectionism as a trait and feature of borderline personality disorder. It also looks into its connection with other BPD traits and the role it may play in the development of the disorder.
What Is Socially Prescribed Perfectionism?
Perfectionism is a broad concept that contains many different tendencies and behaviours. For example, it includes doubts over actions, a perception of high expectations from others, and high expectations placed on oneself. This means that perfectionism is often conceptualised across different dimensions into various categories.
Experts commonly distinguish three types of perfectionism: self-orientated, other-oriented, and socially-prescribed perfectionism. Self-oriented perfectionism involves placing exceedingly high personal standards on oneself; other-oriented perfectionism involves setting exceedingly high standards for others; and socially prescribed perfectionism involves beliefs that being perfect and striving for perfection is important for other people. These conceptions are often related: for example, someone may internalise other’s expectations (socially-prescribed perfectionism) to form high personal standards (self-oriented perfectionism).
What Is The Link Between Socially-Prescribed Perfectionism and Borderline Personality Traits in Emerging Adults?
Researchers have consistently found that people with borderline personality disorder have higher levels of socially-prescribed perfectionism than those without it. They’ve also found that people with socially-prescribed perfectionism are more likely to have borderline personality traits, such as an unstable sense of self and interpersonal difficulties.
A recent study among emerging adults looked into the way that traits of socially prescribed perfectionism predicted the development of borderline personality organisation. Borderline personality organisation (BPO) are traits and features that are central to several personality disorders, including borderline personality disorder.
BPO involves three distinctive features:
- Identity diffusion, such as an unstable or incoherent sense of self with quickly changing interests and without a clear sense of ‘who I am’
- Primitive defences and maladaptive coping mechanisms such as idealising or devaluing others when feeling hurt by their actions
- Intact reality testing – maintaining a reliable sense of reality most of the time
They found that over a period of time, socially prescribed perfectionism predicted all three features of borderline personality organisation in emerging adults. On the other hand, the features of BPO did not predict future socially-prescribed perfectionism. This suggests that socially prescribed perfectionism traits may cause or contribute to the development of BPO features and borderline personality disorder traits.
How Might Socially-Prescribed Perfectionism Lead to Borderline Personality Traits?
Some experts think that experiences of isolation and alienation help explain the link between socially-prescribed perfectionism and borderline personality traits.
According to the ‘perfectionism social disconnection model,’ people with socially prescribed perfectionism often try to find social approval or belongingness by trying to be—or appear to be—perfect by others’ standards. This might involve attempting to please others by deferring to their interests and wishes at the expense of their own needs.
However, these behaviours can appear to others as withholding, defensive, or ingenuine. Rather than gaining others’ approval, they may create interpersonal problems that can lead to social isolation, rejection, alienation, and abandonment. Over time, these experiences may underpin the development of a sense of self without internal consistency or genuine self-worth that is unlovable to others, alongside a perfection of others as hostile or untrustworthy. These are core features of personality disorders.
Moreover, a study on identity exploration and commitment among late adolescents found that young people with maladaptive perfectionism were less likely to commit to decisions about their identity and more likely to be hesitant, indecisive, or experience ‘imposter syndrome’. This can act as a barrier for a young person to form a coherent sense of identity, making it more likely that personality disorder traits will develop over time.
Research has found that both interpersonal difficulties and self-concept clarity (a clear sense of personal identity) partly explain the link between socially-prescribed perfectionism and borderline personality organisation.
Perfectionism Traits, Personal and Interpersonal Difficulties, and Personality Disorders
A 2015 study explored the emotional and social impact of different perfectionist traits, including on emotional distress, personality disorder traits, and interpersonal difficulties.
They found that:
- Individuals who reported worrying about criticism and having trouble making decisions were more likely to experience emotional discomfort.
- Concern over mistakes, doubts about actions, and parental criticism were associated with a range of personality disorder traits.
- Fear of making mistakes was related to several interpersonal problems, including avoidance of social contact, difficulties co-operating, and sensitivity to criticism.
- Concern about making mistakes was connected to a longing for approval.
- Parental criticism was linked to insociability and social avoidance, a potential coping mechanism for avoiding negative and hurtful comments from others.
For young people with borderline personality disorder, different perfectionist traits may contribute to and underpin some of the thought patterns, feelings, and behaviours that characterise BPD. This means that identifying and addressing perfectionist traits may play a key role in both the prevention and treatment of BPD. It also highlights the importance of interventions that address the causes of socially prescribed perfectionism (such as parental criticism) to prevent future harm and make space for recovery.
Treating Borderline Personality Disorder in Young People
Without effective support, borderline personality disorder can make daily life difficult and distressing for young people – and sometimes coping can feel almost impossible. However, BPD is treatable, and with the right care, young people can recover from BPD and lead productive and fulfilling lives.
Treatment for BPD usually involves a team of professionals to provide support in different aspects of everyday life. This might include a social worker, psychologist, psychiatrist, and occupational therapist.
Psychological support for young people with BPD usually involves dialectical behavioural therapy alongside other approaches like interpersonal therapy and trauma therapy. Dialectical behavioural therapy is an evidence-based treatment initially developed for people with BPD that balances skill learning (such as coping mechanisms for emotional distress) with a radical acceptance and validation of one’s own emotions and experience.
DBT typically consists of group skills sessions supported by individual one-to-one sessions.
Addressing Perfectionism in BPD Treatment
When perfectionist traits are a core experience of a young person with BPD, it’s essential to address the process of perfectionism and personality traits together. Therapists should be aware of perfectionist tendencies in their approach and relationship with a young person throughout the therapeutic process. Therapy sessions should also address and treat perfectionism as part of the pathology of BPD that may lie at the root of other BPD symptoms.
The Wave Clinic: Specialist Recovery Programs for Young People
The Wave Clinic offers specialist mental health support for young people from our treatment spaces in Kuala Lumpur, Malaysia. Our programs make a difference in young people’s lives, helping them recover from mental health disorders, grow in self-confidence, and develop the skills they need for the future.
We offer a diverse range of evidence-based treatment modalities on a residential and outpatient basis. We’re specialists in borderline personality disorder, eating disorders, and complex trauma, drawing on exceptional expertise from around the world. We emphasise the importance of family throughout our programs, building effective support structures that lead to resilient and lasting recovery.
If you’re interested in finding out more about our programs, get in touch today. We’re here to help.
