What Is Perfectionism, and How Can It Affect Your Mental Health?

What is a perfectionist?

Do you endlessly rewrite emails before hitting send? Or do you consider yourself a failure if a colleague or classmate performs better at a task?

This intense need to avoid mistakes is called perfectionism—and it doesn’t just limit people in their daily lives.

Although perfectionism isn’t a medical condition itself, these tendencies can have serious impacts on our mental and physical health, says Gail Saltz, MD, a clinical associate professor of psychiatry at New York Presbyterian Hospital and host of the How Can I Help? podcast from iHeartRadio.

And it’s different from achievement-based traits like ambition.

“Ambition works as an energizer, driving us toward success and inspiring us to do more,” explains Sarah Kaufman, LMSW and psychotherapist at Cobb Psychotherapy.

However, sometimes our goalposts start to move—like if you reach a goal, but you’re immediately dissatisfied with your performance.

“When your self-worth starts to become entangled with reaching your goals or getting everything just right, that’s when ambition could be entering a perfectionistic territory,” she explains.

Here’s what you need to know if you identify with being a perfectionist.

Can perfectionism be a good thing?

Perfectionism can be healthy in the sense that it drives people to set and reach lofty goals, Dr. Saltz says. “They can be highly creative in trying to pursue those things—and that’s all a good thing.”

But she says perfectionism becomes a problem when someone focuses on avoiding failure at all costs.

“It makes them very self-castigating, leading to feelings of self-worthlessness if they do fail at something, if they do make a mistake, or if they don’t achieve certain levels of perfection,” Dr. Saltz says.

“They can become very limited in their day-to-day life.”

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Are there different types of perfectionists?

“There’s a wide spectrum of perfectionism, and individuals can become perfectionists in one, a few, or many areas of their lives and for varied reasons,” says Alissa Jerud, licensed clinical psychologist, a clinical assistant professor of psychology in the department of psychiatry at the University of Pennsylvania, and host of the Anxiety Savvy Podcast.

The Multidimensional Perfectionism Scale (MPS) is an assessment tool first developed in 1990, and measures tendencies like someone’s concern over making mistakes, sense of responsibility to parental expectations, and need for order and organization.

This scale has since been re-evaluated and refined, now defining three distinct types of perfectionism:

The socially prescribed perfectionist

This type of perfectionism comes from a belief that others demand flawlessness from you.

Dr. Jerud says this trait can compel people to desperately aim for perfection, fearing anything less will result in others rejecting them or judging them negatively.

A 2017 study published in the journal Psychological Bulletin found that rates of perfectionism of every form are on the rise, but increases are especially high for this variety—and particularly among young people. The study found that between 1989 and 2016, rates of socially prescribed perfectionism rose 33 percent.

Research from Frontiers in Psychology also links socially prescribed perfectionism with serious conditions like disordered eating and depression.

The other-oriented perfectionist

Demanding this perfection from your peers—and becoming overly critical if they fall short of your expectations—is known as other-oriented perfectionism.

This trait is often rooted in feelings of discontentment and insecurity, and research from the Journal of Psychopathology and Behavioral Assessment shows that other-oriented perfectionism can limit someone’s ability to form nurturing bonds, develop intimacy with others, or meet social development goals.

The self-oriented perfectionist

“Some conscientious and goal-oriented people set the bar high for themselves and find joy in working hard and doing whatever they do well,” Dr. Jerud says.

But this appetite for success might lead people to set impossibly high standards for themselves—a habit that can devolve into a cycle of self-oriented perfectionism.

“It’s important to understand that perfection is rarely, if ever, attainable,” Dr. Jerud says.

“If our goal is to do or be perfect in some way, shape, or form, we are likely to become frustrated with ourselves when we inevitably fall short of this goal.”

This repeated sense of frustration can, in turn, fuel anxiety, depression, and other mental health problems, she says.

Can you be afraid of imperfection?

At the extreme end of the perfectionism spectrum lies atelophobia—a paralyzing fear of imperfection.

This ingrained fear goes beyond setting high standards, says Natalie Capano, MHC-LP and psychotherapist at Cobb Psychotherapy.

Fear of imperfection is a type of anxiety disorder, and according to research from BMC Psychiatry, living with a specific phobia like the fear of imperfection can:

• be a risk factor for developing mental disorders such as major depression or anxiety
• increase someone’s risk for physical issues like chronic respiratory conditions, migraines, ulcers, vascular disease, and heart disease

Atelophobia can also cause significant limitations and distress in day-to-day life. For example, someone may:

• completely avoid certain situations for fear of making a mistake
• develop severe anxiety at the prospect of disappointing their peers
• struggle so much to attain perfection that procrastination makes them fall behind at work or school

Is perfectionism harmful to our health?

Perfectionism doesn’t have to be a full-blown phobia to negatively influence our health.

“Perfectionism can make it hard to do daily tasks, such as getting dressed, cleaning the house, sending emails, doing work or schoolwork, or even interacting with friends and family,” Dr. Jerud says.

It can slow people down and steal precious minutes, hours, days, and even weeks, months, and years away from them.

“And given that there really is no such thing as perfect, this unrealistic striving for perfection can negatively impact one’s mental health.”

Perfectionism and mental health problems

A meta-analysis of 284 studies published in the Journal of Clinical Psychology points to a laundry list of mental health concerns driven by high levels of perfectionism, including depression, anxiety, obsessive-compulsive disorder (OCD), and eating disorders.

Multiple studies, including a 2020 report in the International Journal of Environmental Research and Public Health, have also found a relationship between perfectionism and suicidal thoughts. This link is especially strong for people with socially prescribed perfectionism.

Perfectionism’s toll on our physical health

The state of our mental health is intrinsically linked to our physical well-being, Dr. Saltz explains.

She says a need for perfection can cause issues like chronic pain syndrome, high blood pressure, gastric upset, and peptic ulcer disease—all symptoms of chronic stress.

When we’re constantly worried about doing things perfectly, we’re likely to experience physical symptoms of anxiety as well, like muscle tension, heart palpitations, nausea, and headaches, Dr. Jerud adds.

“We may also have difficulty falling or staying asleep, which can lead us to feel sluggish and fatigued during the day.”

Going out of our way to be perfect can also interfere with proper self care. People might get less sleep, so they can endlessly finalize a task at work or push their body too hard to achieve the “perfect” workout or diet.

While aiming for physical or career excellence isn’t necessarily a bad thing, Capano says this drive crosses the line when a mistake or a rest day feels catastrophic.

“Any time we ignore our body and mind asking for a break and push ourselves beyond capacity, we enter a dangerous zone where we create unrealistically high expectations that are not likely to be met,” she says.

“Perfectionism can be a vicious cycle of wanting to do your best, but then needing to be better than your best the next time.”

What causes perfectionism?

Kaufman explains that our beliefs, behaviors, and worldviews are shaped by everything in our lives:

• biological factors like our genetic makeup and neurochemistry
• psychological factors such as our emotions, coping skills, and self-esteem
• social and environmental factors, including our family, religious community, school, work, and socioeconomic status

“The same goes for perfectionism,” she says.

While some people may be genetically predisposed to perfectionism (by way of OCD or anxiety, for example), a wide range of environmental factors also contribute to it.

“For example, it’s long been talked about that people socialized as girls and women receive messages throughout their lives to be perfect, while those socialized as boys are taught to be brave,” Kaufman says.

“We often see perfectionism stem from strained family dynamics,” Capano adds.

“Like a parent giving conditional love to a child who receives only perfect grades or a victim of domestic abuse needing to be perfect to avoid further abuse.”

These extrinsic motivators in early childhood can be reinforced repeatedly and develop into toxic perfectionistic tendencies.

“For instance, when we praise or reward our children for their looks, their artwork, their school work, or their athletic achievements, we may inadvertently send the message that their worth is tied to their appearance and accomplishments,” Dr. Jerud says.

She says this awareness has influenced her own approach to parenting.

“I have moved away from praising my kids and instead try to focus on their process and internal experiences,” she explains. “Rather than say, ‘Wow, you did such a great job coloring that in. It’s beautiful!,’ I might say, ‘Wow, I can tell you worked really hard on that! I’d love to hear how you made it.'”

Can perfectionism be treated?

“The best way to treat or manage perfectionism is to gradually start doing the opposite of what your perfectionism wants you to do,” Dr. Jerud says. “In therapy, we call this exposure therapy, which is a form of cognitive-behavioral therapy (CBT).”

For example, she says if you tend to re-read emails repeatedly before sending them to ensure they’re perfect, start by trying to scale back. See if you can press send right after drafting or just one round of editing.

“Start by sending short emails to loved ones and then work your way up to writing longer emails to colleagues or even supervisors,” she says.

Or suppose you struggle with having a perfect appearance. In that case, you can try to gradually eliminate some steps from your grooming routine, wear a shirt that doesn’t fit perfectly, and practice interacting with others when looking less than perfect.

“Know that no matter what perfectionistic tendencies you are working to give up, the goal is not to get rid of your anxiety, but instead to help you learn that you can tolerate not coming across perfectly,” she says. “Even if this makes you feel anxious.”

Another strategy is to practice mindfulness, Dr. Saltz says. She says evaluating negative self-talk can help you understand if your self-criticism is fair or even accurate—and make room to accept a certain amount of failure in your life.

“Be compassionate with yourself about making mistakes, about failing at things, and challenge those negative self-judgments that you might repeatedly have,” she says.

Now that you know about being a perfectionist and mental health, check out ways to be nicer to yourself.

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