The cognitive style of perfectionists is noted together with the emotional and behavioral outcome of their irrational thinking patterns. Perfectionism in narcissism is viewed as an attempt to avoid shame and humiliation for not living up to an archaic grandiose view of the self. In contrast, neurotic perfectionism is an attempt to avoid guilt for not living up to the demands of a harsh, internalized, and differentiated superego.

This article discusses issues related to understanding and treating perfectionism in religious adolescents. To do so, the author discusses the distinction between the quest for perfection and the pursuit of excellence, some of the disorders associated with perfectionism and grandiosity (e.g., narcissism, obsessive-compulsive disorders), and the underlying affects (shame, guilt). The impact of parenting on perfectionistic tendencies is discussed at length as is the influence of adolescence and of religious beliefs. The unique challenges of treating religious perfectionists and the question of the advisability of a religiously similar therapist are explored. A case example drawn from the author's clinical experience with an Orthodox-Jewish population is presented. This article will examine issues unique to the treatment of religious adolescents, with a focus on a problem prevalent among Orthodox-Jewish adolescents, namely perfectionism, which often leads to severe depression and other emotional An earlier version of this article was presented at the annual meeting of the American Psychiatric Association on May 9, 1996, in NYC.The author wishes to acknowledge the encouragement and support of the members of his peer supervision group; Drs.

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