What Is Perfectionism And How Is It Treated?

People who consider themselves “perfectionists” or are identified as perfectionists by mental health professionals are those individuals who find it extremely challenging to deal with personal mistakes. Perfectionists tend to be overly self-critical and regularly seek approval from others. The pursuit of excellence tends to compel a crippling fear of failure and can cause overreactions to (what they may see as) personal errors. Perfectionists tend to feel nothing they do is good enough, and therefore, they are not good enough. Perfectionism may show up in childhood, or emerge later on in life.

Those who struggle with perfectionism usually experience “all-or-nothing” thinking, translating that to the world around them. This means they see things, and people, as right or wrong, perfect or flawed, successful or unsuccessful, beautiful or ugly, fat or skinny, etc. Although perfectionists may logically understand the impossibility of perfection, the standard they hold for themselves supersedes that logic, often causing significant negative impacts.

Perfectionism can afflict anyone, yet some may be more prone to struggle with it than others.

What Makes Someone More Susceptible?

  • Coming from a family of over-achievers: some research shows evidence about family patterns of over-achieving and perfectionism; families often create expectations of children (spoken or unspoken) and model perfectionist behavior (social learning).
  • Desire to hide deficits: everyone struggles with self-perceived flaws or deficits. Some people learn how to cope with these or even embrace them, while others experience embarrassment or shame. Those who feel uncomfortable with their flaws tend to overcompensate to cover them up. This can spiral into perfectionism.
  • Feelings of inferiority: many studies have explored the connection between feelings of inferiority (or weakness) and perfectionist attitudes. Results show that elevated levels of inferior feelings are an indicator for increased emotional and mental distress, often leading to a push toward being “perfect”.
  • Positive reinforcement: as a child, many learn through positive reinforcement and reward. Appropriate or “right” behavior is encouraged through praise, recognition, and rewards, solidifying a belief that to receive these things, one must be successful. Often, this idea can grow into something rigid and unyielding, leading to perfectionism in the future.

Common Assumptions of Perfectionists

  • “I must do everything perfectly”: the perfectionist cannot fail, otherwise others will think negatively of him or her;
  • “I will be rejected”: the perfectionist fears presenting his or her ideas, thoughts, opinions, creations, etc. to others due to assuming the response will be distressing.
  • “I must check it, and check it again”: the perfectionist tend to go over their work time and time again, prior to feeling it is complete, in an effort to flush out any and all mistakes.
  • “I must know the plan”: the perfectionist seeks control, wanting to know what is going on and what will happen at all times, so he or she can be prepared.
  • “I cannot rely on anyone else”: the perfectionist does not want to give tasks to others, fearing something may go wrong or not be up to his or her standards.
  • “I must constantly be doing something, otherwise, I’m lazy”: the perfectionist is compelled to constantly be on the move, always doing something. They do not want to appear lazy, weak, unproductive, etc.

Negative Impacts of Perfectionism

  • Highly critical of others: because perfectionists are very judgmental of themselves, this disapproving thought pattern can become inherent, thus turned to other individuals.
  • Inability to be open with others: due to an extreme fear of failure, perfectionists struggle to express themselves and be vulnerable with other people due to the concern of being judged or not wanting to appear out of control by showing their emotions.
  • Defensive: because perfectionists are so judgmental of themselves, they often assume others are judging them as well. This can cause these individuals to automatically jump to defensiveness, even when there is nothing to defend against.
  • Poor physical health: perfectionism has been linked with physical ailments such as migraines, asthma, and lingering body pains; associated with the increased levels of anxiety and stress that accompany the strive for perfectionism.
  • Procrastination: perfectionists feel compelled to make sure everything they do is perfect, with no trace of any mistake. This means perfectionism often prevents individuals from completing tasks, due to the anxiety from the possibility of imperfection.

Warning Signs of Perfectionism

  • Critical of others
  • Setting unachievable goals
  • Needing to “look perfect” at all times
  • Unwillingness to take risks
  • Struggle over making decisions
  • Irrational fears about potential negative outcomes

Perfectionism Treatment

Treatment for perfectionism is not actually aimed at changing one’s standards. Instead the goal is to decrease the extent to which one bases their self-worth and self-esteem on the perfection (or lack thereof) of their achievements. Treatment is also meant to expand an individual’s realm of areas that contribute to self-evaluation, rather than just the one or two domains the perfectionism is attached to (i.e. – “I am only as good as the reports I produce at work”).


If you struggle with perfectionism and want to move away from the obsessive patterns, there are some things you can try on your own, prior to seeking professional help. Initially, explore the areas of your life where perfectionism is negatively impacting. This could be in your relationships, family life, work, school, etc. Then, create small, attainable goals to work towards in those target areas. For example, if your perfectionism is affecting your ability to work in groups at school, as you tend to take control of the entire project (out of fear that mistake will be made if you don’t), perhaps your goal would be to allow the other group members carry out their assigned tasks without intervening. Ask yourself, “What is the worst that will happen if this group assignment does not turn out perfectly?” Write down everything that comes to your mind, and review the list. Examine which responses are rational, and which are not, labeling them as such along the way. If your anxiety is elevated due to the thought of a mistake being made, verbalize your fears out loud, as this can often help lower worry and nervousness.

Another helpful approach to help you gain more balance in your life is incorporating healthy coping skills. Coping skills help as they serve as both a distraction and a mechanism to deal with the increased anxiety of letting go of some of the control inherent to perfectionism. Some examples of healthy tools for coping are breathing techniques, self-care, challenging your thoughts, and radical acceptance.

Cognitive Behavioral Therapy (CBT)

CBT is an approach frequently used in treating perfectionism as it encourages adaptable thinking, and identifies and challenges negative or unrealistic beliefs. A CBT therapist will assist the client in identifying perfectionist ways of thinking that are damaging to daily life and set specific, achievable, and measurable goals. Increasing awareness of perfectionist thinking through identifying irrational thoughts is also an integral part of the CBT process. With increased awareness, the client can then challenge the negative or irrational thoughts through psychoeducation on perfectionist thinking and exploring the evidence for the thought patterns. Eventually, these negative thoughts can be replaced with more realistic, rational ways of thinking.

CBT not only addresses the cognitive aspect of perfectionism, but also the associated behaviors. For example, if the client struggles with the irrational thought that they must always be doing something, otherwise they are lazy, the CBT clinician might encourage the client to “practice” doing nothing (i.e. – sit in a coffee shop for 30 minutes and read a book).


Mindfulness is a practice where individuals learn to be in the present moment, free from future worries or past stressors. Mindfulness is used to essentially quiet the mind, and allow an individual to be fully focused on the here-and-now. This can prove effective for perfectionists, as it is an inherent stress-reduction technique.

Is Perfectionism Always Harmful?

Being a perfectionist isn’t always a bad thing. For some people, perfectionism pushes them toward goals and achievements in various areas of life. It is when this “push” develops into obsessive thoughts and negatively impacts one’s functioning that it becomes a problem. Basically, many of us have perfectionist tendencies that drive us to challenge ourselves and strive for success, keeping a healthy balance along the way.

If you feel you may struggle with perfectionism and it is affecting your life adversely, do not forget that it treatable.

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