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Do you have very high demands and expectations of yourself? Do you have a strong fear of failure? If you want to learn more about perfectionism and how to get help, this article is for you.

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 an intense 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. Getting help if you suffer from perfectionism to improve your quality of life is possible.

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Causes of perfectionism

Several factors contribute to the development of perfectionist thinking and behaviour, including 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 also play a role in the development of perfectionism. For example, social media may have made us compare ourselves more with others than in the past. Beauty ideals also have an impact, where people may believe that 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 you do not have a disorder, which is treatable.

Perfectionism in childhood

People with 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 where they internalize the parents’ beliefs. This may mean that they do not accept 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. They 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

People who are perfectionists often feel a need for control. They want to predict things and are inflexible in the face of changes, such as when things don’t turn out how they want. If you are a perfectionist, you may have difficulty trusting others and delegating tasks, leading to stress because you must 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. This can mean that you actually believe that 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 temporary relief, but it doesn’t help in the long run and the feeling and thought return. You find it difficult to accept yourself as you are and to assume that you are ok no matter what happens. It is possible to get help with this in treatment.


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OCD perfectionism

OCD is a psychiatric diagnosis where you have obsessive thoughts and compulsive actions. This can cause great suffering for the person affected and they may have thoughts that are unwanted and 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 a little more effort.

Eating disorder perfectionism

If you have developed an eating disorder, you often have high expectations of yourself, a strong need for control and can be a high achiever. The eating disorder then becomes a way to control their feelings of shame and fear of not being good enough. People may believe they will be accepted and liked if they just have a perfect body. This belief can go very far, and you can develop behaviours that harm your health. Food and exercise can be used to control the body, believing your 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. ADHD often involves difficulties with concentration and impulsiveness; you may have a history of making many mistakes. Difficulties with schoolwork or work tasks, for example, can lead to frustration and become very self-critical. You may also say things impulsively in relationships that you don’t mean, leading to conflicts, which can increase self-criticism. Many people with ADHD feel ashamed of their behaviour and may try to compensate for it by overachieving and trying to be perfect. If you have difficulty managing your ADHD, you can seek help from a psychologist or occupational therapist to help you manage your thoughts, feelings and behaviours in everyday life that become problematic.

Autism perfection

In autism spectrum conditions, and what used to be called Asperger’s, which is more high-functioning autism, perfectionism can be part of the problem. People are often detail-oriented and search for a perfect sense of a certain behaviour. You can see details that others don’t notice and have difficulty with change, with things having to be done in specific ways.

How perfectionism can affect your everyday life

If you have perfectionist symptoms or personality traits, it can affect your everyday life in several ways. You may be afraid of making mistakes and overworking or avoiding things, so tasks take a very 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: Many people strongly fear failure or not meeting expectations. This fear can be so pronounced that it prevents them from trying new things or taking on challenging tasks.
  4. Excessive attention to detail: Perfectionists can pay much attention to details and have difficulty seeing the big picture.
  5. Procrastination: Perfectionism can sometimes lead to task avoidance because people fear starting or completing a task if it cannot be done perfectly.
  6. Difficulty delegating: Perfectionists may have difficulty delegating work to others because they believe no one else can achieve their set standards.
  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 recognize these symptoms, seeking therapy to help change these thought patterns and attitudes may be a good idea. Therapy can reduce stress, make you feel happier, and make it easier to relate to others. If you often feel frustrated, therapy can also 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 can help bring 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 that are 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 can be anything from 4-20 sessions. A treatment includes various tools to achieve change and these can be, for example:

  • Analysis of behaviours, thoughts and feelings to see how they affect everyday functioning.
  • Techniques to address cognitive biases such as catastrophizing.
  • Behavioural change is 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 and offer CBT treatment to deal with it. You are not alone and it is okay to ask for help. Our website has qualified therapists and psychologists who are happy to help you feel better.

Your next step

If you or someone you know struggles with perfectionist thoughts and beliefs, it’s a good idea to talk to a professional therapist or psychologist. We assure you that all therapists and psychologists on our platform are qualified and that your conversation is always confidential. Don’t be afraid to take the first step.

You can significantly improve your quality of life with the right support and tools. We are here to help you if you are ready to take the next step. Book your first session today and start your journey towards a better future.


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12 FAQs 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, which 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 fear failure or not meeting unrealistic standards and societal norms. They may also be self-critical and be driven by feelings of shame, fear and anger at not performing well enough.

How is perfectionism treated?

Cognitive Behavioural Therapy (CBT) focuses on helpful thoughts, feelings, and behaviours. Newer forms of CBT, such as Acceptance and Commitment Therapy (ACT) and Compassion-Focused therapy (CFT), can also 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 perfectionists, perhaps critical or shaming, you might develop perfectionism as a compensatory behaviour. You can 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 attend CBT for stress.

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

For example, getting good at something in a certain profession is a normal drive to contribute in various ways. The difference with perfectionism is that you have a basic acceptance and empathy for yourself and 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 a lot of suffering, and you can become stressed, frustrated, and scared if things don’t turn out as you intended or in a certain way. It is possible to get help. Book an initial consultation with one of our psychologists or therapists.

Where can I go if I need help?

You can book an initial session with a therapist or psychologist to describe your problems and start planning a treatment through our website. We will help you make the difficult things easier.

What does treatment for perfectionism involve?

Seeking help is a big step towards better health, and deciding to work on your well-being is positive. 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, during which you review your history and the origins of perfectionism. You may be asked questions about your life situation, feelings, thoughts, and behaviours, and 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 treatment phase, which involves exercises to give you the tools to overcome and work through the problem you are suffering from. The content may differ depending on the method used: ACT works more with values and acceptance, while CFT is more compassionate.

Step 4: Monitoring and evaluation

The treatment is monitored regularly to determine its effectiveness. If necessary, the treatment plan can be adjusted or renewed.

Step 5: Ending and looking ahead

As the therapy ends, it is time to reflect on the progress made. You will also receive a maintenance plan for using 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.

If you have thoughts of self-harm or suicidal thoughts, contact 0800 456 789 or the nearest emergency psychiatric clinic.


Written by Samantha Pieterse

Sr. Samantha Pieterse is a registered psychiatric nurse who is deeply committed to mental health and well-being. Samantha brings a unique and valuable perspective to her role as an editor for Lavendla South Africa. She has worked in Government and Private mental healthcare institutions in Gauteng and her expertise ensures that the articles on our website are accurate and accessible. Samantha is dedicated to enhancing mental health awareness and education in South Africa.