Today we examine how the very trait that drives many of us to excellence—perfectionism—can become one of our greatest clinical obstacles.

The Immaculate Session Fantasy

Every perfectionist therapist knows this scene: You've prepared extensively for your session with a client struggling with chronic depression. You've reviewed your notes, planned thoughtful interventions, and visualized the session flowing smoothly toward therapeutic breakthrough. Instead, your client arrives twenty minutes late, clearly a little intoxicated, and announces he's thinking about dropping out of therapy because "it's not working fast enough."

Your carefully planned session crumbles. Your interventions feel clumsy. The hour ends with more chaos than clarity. As your client leaves, your inner critic launches its familiar assault: "A competent therapist would have handled that better. You should have seen the relapse signs. That session was a complete disaster."

The Inner Critic in the Consulting Room

The Uninvited Guest

There's a voice that follows many of us into the consulting room. It sits quietly during easy sessions but becomes increasingly vocal when the work gets challenging. It has opinions about everything we say, critiques our interventions, and offers a running commentary on our inadequacies.

This voice has a name: the inner critic. And it has a lot to say about how we practice therapy.