While perfectionism has been associated with guilt dynamics, the form of perfectionism that is most frequently discussed by psychologists is connected to self-condemnation for perceived failures to reach the high standard set for personal achievement. There is therefore a strong link between perfectionism and inferiority shame. Psychotherapists have given quite a bit of attention to shame-based perfectionism; it has been largely neglected by pastoral psychologists. Three approaches to the pastoral care of shame-based perfectionism are developed. The first approach is based in cognitive therapy. It is argued that perfectionism is grounded in a faulty core belief about the self—namely, “I am what I achieve.” The second method makes use of strategies developed by John Bradshaw for accepting and affirming all one’s sub-selves. Bradshaw’s approach is critiqued, however, for the way in which shame-based and guilt-based perfectionism are confused. The third method is a modification and adaptation of Heinz Kohut’s strategy of “mirroring” (empathy, admiration, and approval) that he developed for use in work with clients with narcissistic personality disorder.