When “Perfectionism” Isn’t Just Perfectionism: A Cultural Lens |
Perfectionism may reflect loyalty, gratitude, and honour—not just internal pressure or pathology.
Anxiety may arise from fear of disappointing family, shaped by cultural meaning and responsibility.
Attending to content, process, and relationship creates space without invalidating cultural values.
In a recent interview, I was asked: How might filial piety or family duty show up as anxiety or perfectionism in children at international schools?
The question stayed with me. It echoed something I am often asked in clinical teaching: How do we work with the Unrelenting Standards schema in Asian clients?
These questions are clinically relevant—but they also reveal something about how we, as therapists, are already framing what we see.
Over the past two years, I have been writing and teaching about adapting psychotherapy to Asian cultural contexts. Through supervision and training, I have increasingly found ways to help Western-trained therapists adjust not only their techniques, but also their language and clinical stance. Much of this learning has been shaped by supervisees who bring complex and challenging questions into the room.
In the process of preparing to teach, I reflected on and consolidated my clinical learning into the Content–Process–Relationship (CPR) framework—a way of organising our attention in psychotherapy, particularly when working with forms of emotional self-restraint that are not immediately visible.
This work is grounded in an understanding that, as I have written in Culture as Predictive Infrastructure: A Constructionist Account of Emotional Access in Schema Therapy (Ng-Kessler, in press), “culture is........