Self-help for Perfectionism

What is perfectionism?

As you go through life, you will set standards for yourself. Some might seem easy to achieve (“I need to get dressed every day”), others might be fairly ordinary (“I should make sure my children get to school on time”), and others might be challenging (“I want to play sport at a professional level”).

Challenging or demanding standards can be useful. Working hard to achieve them can give you a sense of structure, motivation, and direction in life. This can be called ‘helpful’ perfectionism, and it can lead to great success. Learning to play an instrument well, for example, takes time, patience, dedication, and commitment. High standards and the pursuit of excellence can certainly help accomplished musicians reach this level of musical ability.

High standards become a problem when they are unrealistic, and when trying to achieve them makes things worse for you or other people. Thinking that your self-worth depends upon achieving these standards – despite the problems they create – could mean you are struggling with ‘unhelpful perfectionism’ or ‘problematic striving’. In situations like these, perfectionism can cause a great deal of distress and hold you back in life.

Perfectionism exists on a spectrum. Helpful perfectionism can help you achieve excellence in your life, whereas unhelpful perfectionism can be a burden that damages your well-being.

Signs of unhelpful perfectionism or problematic striving include:

What is it like to struggle with perfectionism?

Perfectionism can become a problem in almost any area of your life, such as your work, academic studies, relationships, appearance, eating habits, cleanliness, and health and fitness. Ben struggled with perfectionism and his story illustrates what it can feel like to be affected in this way.

Ben’s belief that he needed to be the best at work

I’ve always worked hard and made sacrifices to succeed. My parents were both very hard-working and they pushed me to do the best I could at school. Sure, I missed out on fun things like hanging out with friends, but my grades were the priority. As a result, I graduated from university at the top of my class and managed to get my dream job. I was happy there at first, but then I started to get really strong headaches.

Work quickly became stressful for me. I wanted to impress my boss and my team, so I would work late and sacrifice my weekends to be ahead on my projects. I’d spend hours re-reading and editing my work, but it never seemed good enough. Team meetings were even more stressful. I wanted everyone to see me as clever and competent, so I’d prepare by rehearsing the questions they might ask and how I’d respond. Afterwards, I’d criticize myself over what I could have done better, and try to sound smarter next time. Spending so much time checking and preparing for work eventually led me to fall behind. My manager also noticed that there were tasks that I postponed or avoided doing – I think I was just anxious about getting them wrong. I was terrified that I’d fail if I stopped working so hard.

Striving cost me so dearly, and it started to take over my life. I slept less, ate worse, and didn’t have time to see my friends anymore. My headaches also kept getting worse, and since my doctor couldn’t find a reason for them, I was referred to see a therapist.

Do I have perfectionism?

Perfectionism can sometimes be difficult to notice. Answering the screening questions below can give you an idea of whether it is worth arranging a professional assessment.

Do you set standards for yourself that are demanding and difficult to achieve?	Yes	No
Are you constantly pushing yourself to achieve targets, goals, or aspirations?	Yes	No
Do you feel anxious about not meeting your standards?	Yes	No
When you reach a goal or target, do you ‘raise the bar’ for yourself?	Yes	No
Are you more concerned about what you haven’t achieved than what you have achieved?	Yes	No
Do other people think your standards are too high?	Yes	No
Do you criticize yourself or feel like a failure when you don’t meet your standards?	Yes	No
Do you spend a lot of time checking whether you have met your standards (e.g., closely monitoring your performance, re-reading work, or comparing yourself to others)?	Yes	No
Do you ever avoid tasks because you might fail or do a less than perfect job?	Yes	No
Do you postpone tasks because of how long or demanding they will be to complete?	Yes	No
Does meeting your standards leave you feeling exhausted or overwhelmed?	Yes	No
Do you prioritize achieving your goals over rest, relaxation, spending time with others, or having fun?	Yes	No
Do you value yourself based upon your successes and achievements?	Yes	No

If you answered ‘yes’ to many of these questions you may be struggling with perfectionism. You might find it helpful to speak to your family doctor or a mental health professional.

What keeps perfectionism going?

Research studies have shown that cognitive behavioral therapy (CBT) is one of the most effective treatments for perfectionism ^{[1, 2]}. CBT therapists work a bit like firefighters: while the fire is burning they’re not so interested in what caused it, but are more focused on what is keeping it going, and what they can do to put it out. If they can work out what keeps a problem going, they can treat the problem by interrupting the cycles that maintain it.

In 2002, three leading mental health professionals – Roz Shafran, Zafra Cooper, and Chris Fairburn – published an influential model of perfectionism, which was updated in 2010 ^{[3, 4]}. The model describes some of the ‘parts’ that keep perfectionism going. These include:

Treatments for perfectionism

Psychological treatments for perfectionism

Individual, or one-to-one, cognitive behavioral therapy (CBT) designed for perfectionism is the psychological treatment that has the strongest research support for treating perfectionism ^{[1, 2, 5]}. There is some evidence that it can also help address problems that sometimes accompany it, such as disordered eating, anxiety, and depression ^[6].

CBT is a popular form of talking therapy. Unlike some other therapies, it is often quite structured. After talking things through so that they can understand your problem, you can expect your therapist to set goals with you so that you both know what you are working towards. You should seek out a therapist who has specialist training and experience in treating perfectionism. At the start of most sessions, you will set an agenda together so that you can agree on what that session will concentrate on. Some of the ‘ingredients’ of effective CBT for perfectionism include ^[7]:

• Developing a shared understanding of what is keeping your perfectionism going, usually drawn out as a diagram or ‘formulation’.
• Learning about things that contribute to perfectionism, such as ‘myths’ that can drive it. (e.g., “The harder people work, the better they do in life”)
• Finding new ways of feeling good about yourself aside from striving and achievement.
• Testing the accuracy or helpfulness of your perfectionistic beliefs using behavioral experiments.
• Reducing the behaviors that keep perfectionism going, such as excessive checking and procrastination.
• Changing unhelpful thoughts and beliefs linked to your perfectionism, such as all-or-nothing ways of thinking. (e.g., ‘’I’m either successful or a failure.”)
• Criticizing yourself less, and learning how to treat yourself more fairly.
• Developing new skills to help you in your day-to-day life, such as problem-solving and time management.
• Creating a plan that helps you maintain your progress and avoid setbacks in the future.

Medical treatments for perfectionism

Medical treatments usually aren’t used to treat perfectionism, but are sometimes used to address problems that accompanying it, such as depression.

References

1. Lloyd, S., Schmidt, U., Khondoker, M., & Tchanturia, K. (2015). Can psychological interventions reduce perfectionism? A systematic review and meta-analysis. Behavioural and Cognitive Psychotherapy, 43, 705-731.
2. Suh, H., Sohn, H., Kim, T., & Lee, D. G. (2019). A review and meta-analysis of perfectionism interventions: Comparing face-to-face with online modalities. Journal of Counseling Psychology, 66, 473.
3. Shafran, R., Cooper, Z., & Fairburn, C. (2002). Clinical perfectionism: A cognitive behavioural analysis. Behaviour Research and Therapy, 40, 773-791.
4. Shafran, R., Egan, S. J., & Wade, T. (2010). Overcoming perfectionism: A self-help guide using cognitive-behavioural techniques. Constable and Robinson.
5. Galloway, R., Watson, H., Greene, D., Shafran, R., & Egan, S. J. (2022). The efficacy of randomised controlled trials of cognitive behaviour therapy for perfectionism: A systematic review and meta-analysis. Cognitive Behaviour Therapy, 51, 170-184.
6. Robinson, K., & Wade, T. D. (2021). Perfectionism interventions targeting disordered eating: A systematic review and meta‐analysis. International Journal of Eating Disorders, 54, 473-487.
7. Egan, S. J., Wade, T. D., Shafran, R., & Antony, M. M. (2014). Cognitive behavioral treatment of perfectionism. Guilford Press.

About this article

This article was written by Dr Matthew Pugh and Dr Matthew Whalley, both clinical psychologists. It was last reviewed on 2022/05/09.