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Do you have extremely high demands and expectations of yourself or a strong fear of failure? Here we examine perfectionism and when to seek help.

What is perfectionism?

Perfectionism is a set of thoughts and behaviours, a type of obsessive-compulsive disorder (OCD), where people try to live up to very high standards and expectations in a way that can lead to problems for themselves and others. It is not a diagnosis, but a set of beliefs about life that have developed over time. There may also be genetic factors that contribute to the problem.

Perfectionism can cause a strong fear of failure or not living up to unrealistic standards and societal norms. You may be very self-critical and driven by feelings of shame for not performing well enough. They may also become frustrated and have difficulties in relationships and work. It is possible to get help if you suffer from perfectionism to improve your quality of life.

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Causes of perfectionism

There are several factors that contribute to the development of perfectionist thinking and behaviour, including both genetic and environmental factors. Upbringing and values also play a role. If you have not been accepted for who you are by your parents and have developed a performance-based self-esteem, you may try to compensate by performing to feel good about yourself. Critical and demanding parents also contribute to copying the behaviour. This can lead to self-criticism or criticism of others. They may lack a basic sense of empathy and compassion for themselves.

Societal expectations can also play a role, with social media leading us to compare ourselves more with others than in the past. Beauty ideals are another factor, where people believe they have to look a certain way to be liked and accepted. So there are several reasons why people can develop perfectionism.

Perfectionism diagnosis

Perfectionism is not a psychiatric diagnosis but it can be part of other mental health problems. This does not mean that you do not have a disorder but it is treatable.

Perfectionism in childhood

People who have perfectionist demands on themselves and others may have learned this during childhood. Parents’ thoughts and actions towards their children affect how the child thinks and feels about themselves. This in turn affects how the child then acts towards other people. If the parents are critical and performance-oriented, the child may develop behaviours from internalising the parents’ beliefs. This can stop them from accepting themselves as they are and develop a performance-based self-esteem with lower self-worth.

If you have parents who behave badly in other ways, with controlling and blaming behaviours, you may get a sense of being wrong. Children may begin to compensate for this by trying to perform in order to be accepted and loved. This type of learning often means that people don’t focus on what they want in life but try to get the approval of their parents or others. They can also become very achievement-oriented and angry with themselves and others if things don’t turn out exactly as planned and become inflexible. Such behaviour can create problems in everyday life.

Need for control perfectionism

The need for control is often high in people who are perfectionists. They want to be able to predict things and are inflexible in the face of change such as when things don’t turn out the way they want. If you are very perfectionist, you may have difficulty trusting others and delegating tasks, which leads to stress because you have to do everything yourself. If things are not perfect, you may also become frustrated and angry. This can affect relationships and make it difficult to work with others.

Self-esteem and perfectionism

If you suffer from perfectionism, you may have developed low self-esteem and feel ashamed of yourself. This can mean you believe you are worthless but instead of challenging this belief, you start to compensate by performing and making unreasonable demands on yourself and others. If you succeed at something, you may get a temporary relief, but it doesn’t help in the long run and the feeling and thought returns. You find it difficult to accept yourself as you are. It is possible to get help.


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OCD perfectionism

OCD is a psychiatric diagnosis described by obsessive thoughts and compulsive actions. This can cause great suffering for the person affected as they may have unwanted thoughts that cause anxiety. To reduce anxiety, people engage in various behaviours or rituals that can take time and energy. If you don’t do the compulsion, you may have catastrophic thoughts and strong fears. Examples of OCD include turning lights on and off, checking the stove or washing your hands for fear of germs. OCD is similar to perfectionism because people often want to do the compulsion in a certain specific and exact way to get emotional relief. OCD can be treated, but it may require some effort.

Eating disorder perfectionism

If you have developed an eating disorder, you may have high expectations of yourself, a strong need for control, and be a high achiever. The eating disorder then becomes a way to control feelings of shame and fear of not being good enough. People may believe if they have a perfect body, they will be accepted and liked. This belief can lead to behaviors that are very harmful to your health. Food and exercise can be used to try to control the body, believing that one’s value will improve. They often have low self-esteem at their core. If you have an eating disorder, it is important to seek help and treatment.

Perfectionism and ADHD

Many people with ADHD suffer from perfectionism. Since the disability often involves difficulties with concentration and impulsiveness, there may be a history of making a lot of mistakes. Difficulties with schoolwork or work tasks, for example, can lead to frustration and self-criticism. You may also say things impulsively in relationships that you don’t really mean and this can lead to conflicts, which also increases self-criticism. Many people with ADHD feel ashamed of their behaviour and may try to compensate by overachieving and trying to be perfect. If you have difficulty managing your ADHD, seek help from a licensed psychologist or occupational therapist to help you manage your thoughts, feelings and behaviours that have become problematic.

Autism perfection

In autism spectrum conditions, that used to be called Asperger’s, a high-functioning autism, perfectionism can be part of the problem. People can be very detail-oriented and search for a perfect expression of a certain behaviour. You might see details that others don’t, have difficulty with change, and need things done in specific ways.

How perfectionism can affect your everyday life

If you have perfectionist symptoms or personality traits, it can affect your daily life in several ways. You may be afraid of making mistakes and overworking or avoiding things resulting in tasks taking a long time to complete, such as when studying or working. This can lead to stress and anxiety. If you are very demanding and self-critical, you may also become frustrated or angry if things don’t go as planned. You may have difficulties in relationships and cooperation with others. Read more about the symptoms of perfectionism here.

Symptoms of perfectionism

There are several symptoms that can indicate that a person is suffering from perfectionism. Some characteristics are:

  1. High standards: Perfectionists often set unrealistically high standards for themselves and others.
  2. Self-criticism: They tend to be hard on themselves and react strongly to small mistakes.
  3. Fear of failure: There is a strong fear of failure or not living up to expectations. This fear can be so pronounced that it prevents one from trying new things or taking on challenging tasks.
  4. Excessive attention to detail: Perfectionists can pay a lot of attention to details and have difficulty seeing the big picture.
  5. Procrastination: Sometimes perfectionism can lead to avoidance of tasks because of a fear of starting or completing a task if it cannot be done perfectly.
  6. Difficulty delegating: Perfectionists may have difficulty delegating work to others because they tend to believe that no one else can achieve the standards they have set.
  7. Lack of satisfaction: Despite achieving success, perfectionists often do not feel satisfied and they tend to focus on what is lacking or what can be improved.

If you recognise these symptoms, it may be a good idea to seek therapy to help change these thought patterns and attitudes. This can reduce your stress, make you feel happier and make it easier to relate to other people. If you often feel frustrated, therapy can help you manage your emotions better and increase your self-compassion.

Perfectionism treatment

Psychological treatment is available if you suffer from perfectionist traits or thought patterns. Cognitive behavioural therapy (CBT) is a form of treatment that focuses on thoughts, feelings and behaviours that are helpful in bringing about change. There are also newer forms of CBT such as Acceptance and Commitment therapy (ACT) and Compassion-focused therapy (CFT) that can be effective. ACT focuses on values, acceptance and change, and learning to live by the values important to you. You can also create a distance to thoughts through mindfulness to reduce negative thoughts about yourself and your performance. CFT works more with compassion to reduce self-criticism and feelings of shame. It can be a very good method to reduce perfectionist thinking, focusing instead on shared human experiences. It is possible to feel better and change the way you live.

Perfectionism CBT

CBT is an evidence-based treatment method for working with thoughts, feelings and behaviours. The treatment can be adapted to the individual’s needs and the number of sessions varies according to the severity of the problem. It could be range anywere between 4-20 sessions. A treatment includes various tools to achieve change and these can be:

  • Analysis of behaviours, thoughts and feelings to see how they affect everyday functioning.
  • Techniques to address cognitive biases such as black and white thinking or catastrophising.
  • Behavioural change where you practice managing your emotions in different situations.

Seeking help can change your life

Perfectionism is not something you need to deal with on your own. Talking to a professional therapist or psychologist can help you understand your problem better through CBT treatment. You are not alone and it is okay to ask for help. Lavendla has qualified therapists and psychologists available to help you feel better.

Your next step

If you or someone you know is struggling with perfectionist thoughts and beliefs, it’s a good idea to talk to a professional therapist or psychologist. Lavendla’s therapists and psychologists qualified and your conversations are always strictly confidential. Don’t be afraid to take that first step.

With the right support and tools, you can significantly improve your quality of life. If you are ready to take that first step, we are here to support you. Book an online session today and start your journey towards a better future.


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12 common questions about perfectionism

What is perfectionism?

Perfectionism is a set of thoughts and behaviours where people try to live up to very high standards and expectations in a way that can lead to problems for themselves and others.

Is perfectionism a diagnosis?

Perfectionism is not a psychiatric diagnosis but it can occur in various psychiatric conditions. It is a way of relating to life but can also be a personality trait.

Is perfectionism hereditary?

It is not clear whether perfectionism is hereditary, but genes and environment may be linked to the problem.

What are the symptoms of perfectionism?

You may develop a strong fear of failure or not living up to unrealistic standards and societal norms. You may also be very self-critical and driven by feelings of shame, fear and anger at not performing well enough.

How is perfectionism treated?

Cognitive behavioural therapy (CBT) is a form of treatment that focuses on thoughts, feelings, and behaviours that can be helpful. There are also newer forms of CBT such as Acceptance and Commitment therapy (ACT) and Compassion-focused therapy (CFT) that can help bring about change.

Can perfectionism cause other mental health problems?

Perfectionism can be present in several psychiatric conditions such as OCD, eating disorders, ADHD and autism. If you think you have any of these other conditions, it is important to seek help for them too.

Can children be perfectionists?

Yes, perfectionism can affect children and teenagers as it is often a pattern that also develops in childhood.

How does growing up affect perfectionism?

If you had parents who were themselves very perfectionist, and perhaps critical or shaming, you may develop perfectionism as a compensatory behaviour. You might develop a performance-based self-esteem where you identify with what you do and have basic self-acceptance. This can be helped in treatment.

Does perfectionism affect the ability to work?

Yes, it can affect your ability to function by making you very stressed and difficult to cooperate with others. If you are very stressed, you can also use CBT for stress.

How does perfectionism differ from just wanting to be good at something?

Getting good at something in a certain profession, for example, is a normal drive to contribute in various ways. The difference with perfectionism is that you have a basic acceptance and empathy for yourself where you also see that you are human. You don’t make unrealistic demands on yourself or try to achieve something to be accepted, which leads to less stress and more positive feelings.

What to do if you feel stressed if things are not perfect?

Perfectionism can lead to suffering when you become stressed, frustrated, and scared if things don’t turn out as you intended or in a specific way. It is possible to get help. Book an initial consultation with one of our psychologists and therapists.

Where can I go if I need help?

Lavendla makes it easy to book an initial session with one of our therapists or psychologists to discuss your problems and start planning a treatment. We help you make the difficult easier.

What does treatment for perfectionism involve?

Seeking help is a big step towards better health, deciding to work on your well-being is a positive thing. Here is an overview of the steps typically involved in CBT treatment.

Step 1: An initial assessment session

The first meeting with your psychologist or therapist is a mapping session where you review your history and the origins of perfectionism. You may be asked questions about your life situation, feelings, thoughts and behaviours. You may also be asked to fill in assessment forms.

Step 2: Goal setting

This is where you and your therapist set concrete goals for the therapy, both short- and long-term. It can define which areas of your life are most affected by your problem and how you would like to change them.

Step 3: Treatment with different techniques and tools

This is the actual treatment phase, which involves exercises aimed at giving you the tools to overcome and work through the problem you are suffering from. Depending on the method used, the content may differ: ACT concentrates more on values and acceptance, while CFT focuses more on compassion.

Step 4: Monitoring and evaluation

The treatment is monitored regularly to see how well the therapy is working. If necessary, the treatment plan can be adjusted or renewed.

Step 5: Ending and looking ahead

As the therapy comes to an end, it is time to reflect on the progress made. You will also receive a maintenance plan for how to use the tools and strategies you have learned in the future. It is also important to monitor the results over time.

If you or someone close to you is seeking professional help, do not hesitate to book a session with one of our licensed psychologists or therapists.

In an acute mental health crisis, call 111 or visit 111.nhs.uk immediately.


Written by Dominic Wardall

Dominic is a Cape Town-based copywriter and editor with extensive background and studies in psychology. Dominic is a central part of the articles written on Lavendla.