When is good enough really good enough?
For some perfectionists, that can be tough to determine and likely depends on what’s at stake.
Striving for excellence often can be quite positive, especially when it helps you have a full and fulfilling life. While there’s nothing inherently wrong with striving for perfection, sometimes this quest for perfection becomes so extreme that it causes significant distress or impairment.
This “pathological perfectionism” can affect adults along with high school and college students. Both men and women can be affected, with women more being more susceptible to body image perfectionism.
What is pathological or extreme perfectionism?
Pathological perfectionism is characterized as extreme and inflexible. It involves the person basing their self-worth entirely on constantly striving for and achieving unrelenting perfectionistic standards.
Perfectionism might particularly focus on appearance, social behavior, or work performance. Or it might be pervasive across all areas of life, often at the expense of relationships, work and health.
When people suffer from pathological perfectionism, their thoughts are often distorted in particular ways. For example, they may see things only as “black or white.” As a result, they may tell themselves: “I either reached the goal or I’m a total failure as a person.”
They’ll often create rigid rules and focus on what they have not achieved vs. what they have.
What are symptoms of pathological perfectionism?
Behaviorally, when people have pathological perfectionism, they tend to over-prepare, work excessively and fail to prioritize.
When perfectionist people temporarily meet their goal, they might devalue it as “too easy” and then set the bar higher. If they don’t meet their goal, rather than re-assessing it and creating a sub-goal as a stepping stone to the larger goal, they usually continue to strive for the unrealistic goal and berate themselves for not reaching it.
Because they often receive little satisfaction and much distress related to goal-directed behavior, they might procrastinate or avoid goal-directed activities and berate themselves for this.
Pathological perfectionism is associated with anxiety, depression and anger and can focus on your own performance, the performance of others, or both.
How is this different from constructive perfectionism?
Having high standards and working hard toward goals are fine attributes that can help people achieve productive and satisfying lives. But there’s a difference between “constructive” and “pathological” perfectionism. With constructive perfectionism, you’re less likely to judge your total worth based on outcome.
In addition, constructive perfectionism is flexible. Standards depend on the importance/stakes of the project and on seeing the big picture, and people can allocate their time and energy accordingly.
People who exhibit constructive perfectionism also adjust their standards realistically when doing so would be beneficial
What does research show?
A recent study of 42,000 American, Canadian, and British college students found that perfectionism has been increasing significantly during the past 30 years. And today’s college students report higher levels of perfectionism than college students did during the 1990s or early 2000s.
Researchers measured three types of perfectionism:
- self-oriented, or a desire to be perfect
- socially prescribed, or a desire to live up to others’ expectations
- other-oriented, or holding others to unrealistic standards
From 1989 to 2016, researchers found that the self-oriented perfectionism scores rose by 10 percent; socially prescribed scores increased by 33 percent, and other-oriented perfectionism rose by 16 percent.What causes perfectionism?
Little is known about the causes of perfectionism. However, there are theories that perfectionism is caused by a combination of learning from other people and culture (ours is a culture that rewards striving and high standards) as well as biological predispositions.
How is this condition treated?
The treatment for pathological perfectionism is psychotherapy and possibly medication.
In particular, cognitive behavioral therapy enables you to recognize patterns of responses.
With therapy, you’ll learn to recognize:
- your perfectionistic beliefs and rigid rules
- the related distress and excessive behavioral strategies
- triggers for these reactions
- the short and long-term consequences for themselves and others
You’ll be encouraged to experiment with specific new ways of behaving and more balanced ways of thinking. If you experience severe depression or anxiety, you also might benefit from psychiatric medication.
When should you see your doctor for this condition?
You should seek cognitive behavioral therapy for perfectionism if it persistently results in significant distress or impaired social, academic or professional functioning.
Lawrence Needleman is a psychologist who specializes in treating adults with anxiety disorders at The Ohio State University Wexner Medical Center.