This chapter presents an extension of perfectionism social disconnection model (PSDM), with reference to treatment situation, to shed light on clinical challenges that different components of perfectionism pose in process of seeking, initiating, and maintaining psychotherapy. The PSDM accounts for the ways in which interpersonal and intrapersonal processes associated with perfectionism can ultimately foster disconnection in therapeutic relationships. The chapter includes an explication of how perfectionism traits and self-presentational facets influence treatment negatively and an overview of research supporting the pernicious role of perfectionism in treatment. It describes behaviors that individuals with perfectionism exhibit in a relational context that reflect either the overt repellent processes that contribute to objective disconnection and the more internal interpersonal sensitivity-related processes that lead to subjective disconnection. The essence of self-oriented perfectionism is a relentless concern with perfection and an avoidance of imperfection at all costs.