1.       What is perfectionism?

The type of perfectionism we are referring to in this article is striving very hard to achieve goals and standards, accompanied by self-criticism when standards are not achieved. The reason for such striving can be explained by self-esteem being too reliant on striving or achievement. For your perfectionism to be a problem, it would need to cause you problems. This type of perfectionism is referred to by professionals as ‘clinical’ perfectionism and people with clinical perfectionism persist in striving to meet unrealistic standards despite unpleasant consequences because of the importance of achievement to their self-esteem.

It is important at the start to understand that there are different aspects of perfectionism.  One part of perfectionism consists of striving hard to achieve personal goals and standards.  There is nothing wrong with striving to achieve standards but it can be problematic for people with anxiety.

Perfectionism can impact on a number of areas in life.

Feelings

• Anxiety
• Sadness
• Nervousness
• Stress
• Frustration
• Anger

Thoughts

• Self-criticism
• Focus on mistakes and discount successes
• Rumination over failure and mistakes
• Focus on thoughts of being ‘not good enough’
• Judging performance in an ‘all or nothing’ way e.g., as a ‘complete’ failure as a person when making a mistake
• Frequent thoughts of ‘should’ and ‘must’ e.g., ‘I should always be the best’, ‘I must not make a mistake’ (Perfectionism has also been called ‘musterbation’)

Behaviours

• Excessive time spent on achieving goals at the expense of other areas of life (e.g., working very long hours and rarely socialising)
• Checking work excessively (e.g., reading over an email many times before sending it)
• Redoing tasks (e.g., rewriting sentences many times to get perfect)
• Spending a lot of time making lists
• Procrastination
• Avoidance of doing tasks (e.g., not sitting an exam due to worry of not doing well)
• Comparing how well you do at tasks to other people
• Asking others for reassurance about how well you are doing at meeting your standards

Physical Consequences

• Exhaustion
• Muscle tension
• Insomnia
• Tight chest
• Tiredness

Perfectionism can be maintaining anxiety and it can also be maintained by it. Two examples are given below:-

• Social Anxiety – Social anxiety is when someone is constantly worrying that they will do something embarrassing or wrong in a social situation and that others will notice that they are anxious and think badly of them.  When someone is worried about how well they do in social situations, and that others will notice their anxiety, then they often aim for a perfect performance, for example thinking ‘My speech should be perfect and I must never stumble over my words’; ‘I should not make a mistake in a social situation or others will reject me’.

• Obsessive-Compulsive Disorder (OCD) – OCD involves having repeated thoughts that are distressing (e.g., of harming someone, or harm coming to a loved one, spreading germs) that cause a great deal of anxiety, and often people do things to prevent the thoughts from happening or harm occurring (e.g., washing hands excessively, checking locks, praying).  People with OCD often think they have to do things in a perfect way (e.g., wash hand in perfect sequence or they will not be clean, arranging items in a perfect way) to prevent something bad from happening or to try and reduce anxiety.

A useful way to start identifying if you have the unhelpful aspects of perfectionism is to answer the following questions;

1. Do you base your view of yourself on how well you do at meeting your standards?
2. Do you ignore what you have achieved and instead focus on what you have not achieved?
3. Do you spend a lot of time striving to meet your standards, even if it means it causes problems or you miss out on things like socialising?
4. Do you avoid or procrastinate over tasks due to worrying you will not do them well?
5. Do you repeatedly check out how well you are doing at meeting your standards?
6. Are you very worried about failing to meet your standards?

2.       Why do people develop perfectionism?

People can develop perfectionism for a range of reasons that involve both ‘genes’ which are factors that are inherited from parents, and also what they have learned from their experiences in life.  In general, we do not completely what causes perfectionism from a scientific point of view.  Some studies show us that there is a genetic part to perfectionism in which it is passed down from parents.  Most of the studies however show that it is our environment and what we learn about from our life experience that accounts for most of why perfectionism develops.  Common factors that are associated with people developing perfectionism are the styles of parenting that people experience.  Some experiences that people with perfectionism have reported being linked to developing perfectionism are;

• Parents holding excessively high standards for their performance
• Parents being very critical or punishing them if they did not meet the parent’s standards

It is important to realise however that not everyone who has perfectionism reports that their parents held high standards for them, or that they were critical. In fact, some people report that their parents were not like this but from a young age they had a personal and internal drive for perfection.  Also even if a person with perfectionism recalls that their parents had high standards for their performance and were critical of them that it might also be the case that their own level of perfectionism caused them to interpret their experiences in this way.

In summary, we cannot be sure exactly what causes perfectionism.  The good news is though it does not really matter what causes perfectionism, it is what keeps it going that is the important part, and that can be changed.  It is like when a doctor treats a broken leg, he does not need to know the cause of the broken leg to be able to fix it. Psychological problems are similar, it is what is keeping the problem going that is important to know so that it can be changed.

3.       What keeps perfectionism going?

There are various factors that can result in people getting locked into a pattern of perfectionism.  The exact factors that are keeping perfectionism going will be different for each person, which is of course not surprising as everyone is unique.  But there are some common factors that we often see keep perfectionism going, so if you can identify and change these, it will help to break the pattern of the unhelpful parts of perfectionism.

The important factors are the following;

• Self-worth overly dependent on striving and achievement – People base their sense of self-worth on hard they work towards their goals and standards, and what they achieve.
• Inflexible standards – Because of basing self-worth on meeting standards, people then set many rules that are rigid about how they should perform e.g., ‘I must always get distinction grades’, ‘I should always speak perfectly in social situations’, ‘I must weigh 50kg to be the perfect weight’.
• Cognitive biases – This refers to ways of thinking that keep perfectionism going.  Common ones are;
• All or nothing thinking:  This is a thinking style that involves judging things in an all-or-nothing manner for example ‘If I eat one chocolate biscuit my whole diet is ruined’; ‘If I weigh 51kg kilograms and not 50kg I am a complete failure as a person’; ‘If I do not get all distinction grades I then I am a failure as a person’
• Shoulds and musts – These are thinking styles characterised by berating one’s self as a way of pushing to meet standards e.g., ‘I should always be pushing myself to meet my goals and do not have time to relax’
• Noticing the negative and discounting the positive – This involves focusing on every mistake and error no matter how small (e.g., one spelling mistake in an email) and forgetting all of the positive aspects of performance (e.g., boss commenting about how well you are performing at work). 
• Overgeneralising – This is when a person takes one instance to indicate something about him/herself overall (e.g., ‘Because I made one spelling error in an email it means I am failing at work’).
• Double standards – This is when someone holds a different set of standards for themself than others (e.g., ‘It is ok for other people to make mistakes but I should never make a mistake’).
• Performance-related behaviour:  This is a range of things that someone does to check out how well they are going at meeting their standards, including seeking reassurance from others, comparing their performance to other people, avoidance and procrastination.
• Evaluation of standards –

–        Failure to meet standards:  When someone thinks they have not met their standard then they engage in intense self-criticism (e.g., thinking ‘I am a failure’), which makes them further think their worth as a person is based on how well they are going at meeting their standards.  People with perfectionism are often terrified of ‘failing.’ This is because it means so much to achieve and because they are often very harsh to themselves when goals are not met.

–        Avoidance of meeting standards – Sometimes due to worrying so much about meeting standards, people will give up trying and completely avoid situations that test their performance (e.g., not sitting an exam due to worry it will not go well; not writing Christmas cards because each one cannot be personalised).  This usually results in self-criticism and further reinforcement that their self-worth is based on meeting standards.

–        Temporarily meet standards – Sometimes people meet their standards, but the problem is that they discount it and see that it was no big deal, or that they still could do better next time. They often just describe relief rather than anything more positive when standards are met, indicating that they are relieved they have avoided failure rather than being able to really enjoy success. Often when goals are met, the bar is set even higher next time.  This further reinforces their view of him/herself as being based on meeting standards (e.g., thinking ‘I won the race but I could do it in 5 seconds less next time’).

4.       Preparing to change perfectionism

If you think perfectionism might be a problem for you and you think you might like to change, then we suggest:-

1)     Reading more about it e.g., by buying a booklet from Oxford Cognitive Therapy Centre (www.octc.co.uk) or buying a self-help book (e.g., Shafran, R., Egan, S., & Wade, T.D. (2010).  Overcoming perfectionism: A self-help guide using cognitive behavioural techniques.  London, UK: Constable & Robinson.)

2)     Discussing it with No Panic

3)     Talking to your Doctor or Therapist

We have treated many people with perfectionism and while they continue to have high standards, they are no longer ruled by the ‘shoulds’, ‘oughts’, ‘musts’ and are no longer crippled by a sense of failure. For us and them, that’s success.