The role of maladaptive perfectionism in suicide.
Could the path to suicide be linked to a persistent and excessive striving for success, combined with an extreme fear of failure, and an urge to keep up the façade?
The present study focuses on a group of men characterized as maladaptive perfectionists, with no history of treatment in mental health care or of suicide attempts (non-clinical suicides). These men were apparently successful and ambitious and took their own life in a determined way. Such suicide comes unexpectedly for family and friends. The study utilizes qualitative data from a psychological autopsy study, based upon non-clinical suicides at the Norwegian Institute of Public Health. From 20 suicides, it was possible to identify a subsample of six men, between 20-60 years of age, who were characterized as maladaptive perfectionists. Interviews with 41 key competent informants, including parents, spouses, partners or girlfriends, siblings, other relatives and close friends, have led to a deeper understanding of the underlying psychological mechanisms that impacted the suicidal process in these men. The information was analyzed using a phenomenological and hermeneutical approach, using the guidelines of Interpretative Phenomenological Analysis. The guiding analytical questions were directed towards how perfectionism may become maladaptive and reduce the capacity to solve problems possibly leading to suicide.
These men’s lives were characterized by a maladaptive form of perfectionism. Whether they were young or old, they fell into a pattern, at a young age, of constantly meeting high demands, and keeping a façade of being competent and successful. They had gradually developed a rigid, inflexible way of dealing with problems. When these men were suddenly faced with unexpected events within significant areas of their life, the façade finally cracked. This was perceived as an indication of a total defeat and as a failure of the self. This yielded to a feeling of shame, stemming from not being able to live up to their idealistic standards or to maintain their competent self-presentation. The act of ending their lives can be viewed as an escape from the unbearable pain of not being able to tolerate major challenges towards the end of their lives; challenges they interpreted as irreversible defeats.
These men took their own life without revealing any suicide plan, and they chose a method that gave a small “risk of failure”. Outwardly they showed a perfect façade without disclosing their vulnerability. This made it difficult for their nearest to see any signs of risk for suicide. Consequently, all the men placed themselves in an isolated position and were very reluctant to ask for help. Their capacity to solve problems and their sense of competence moved from all to nothing over a short period of time. In the end, the suicide became the only way to handle a shamefully perceived, and thus, irreversible failure.
The developmental history of the deceased revealed how negative experiences during their upbringing, may have predisposed these men to develop maladaptive perfectionism as adults. Maladaptive perfectionism seems to be related to an unsolved dependency of being recognized, especially by fathers (or father figures) who neglected and/or rejected the deceased’s needs. This longing for recognition started early in life and continued throughout the whole life of the deceased. Consequently, what counted most for these men was how other and more powerful – or in their eyes more competent – men viewed them. Thus, maladaptive perfectionism became these men’s life project.
Most suicide research is based upon the presumption that suicide is a symptom of mental illness and so the main strategy for suicide prevention has been to treat the underlying disease. However, not all those who die by suicide have previously presented symptoms of mental illness or had previous attempts. This non-clinical type of suicide is largely under-acknowledged and under-researched. This lack of knowledge on non-clinical suicides makes prevention particularly difficult.
Although suicide came as an unexpected outcome to close friends and family, the present study suggests that, in retrospect and after contemplating how this could have happened, those near to the deceased have the potential to detect the risk of suicide related to maladaptive perfectionism. This fact can potentially be utilized to develop better prevention strategies. Our study also demonstrates that in order to better understand suicide, there is a strong need for knowledge from multiple explanatory models of suicidality, where other groups and psychological dynamics, other than mental illness, are taken into consideration.