Perfectionism Therapy in London & Online

What is Perfectionism?

Perfectionism is a term used to describe a person’s persistent patterns of behaviour, emotions, and thoughts. It’s a psychological trait, like being extraverted, neurotic, or open to new experiences, that affects how we behave and feel.

But what exactly is perfectionism? Simply put, it’s a drive to achieve flawlessness and strive for excellence in all areas of life, sometimes to an extreme and harmful degree. It’s important to understand that while striving for excellence is admirable, perfectionism can take it to a whole new level, causing anxiety, stress, and even depression.

What are the Main Signs of Perfectionism?

There are three main forms of this psychological trait [1]:

Self-oriented Perfectionism

This is the most well-known form and is essentially an extreme form of conscientiousness.

You believe that what you do must always be perfect and it’s better not to do anything at all than not to do it perfectly. Other signs include:

• Extreme self-criticism (e.g., feeling overwhelmed by one small mistake and beating yourself up for it)
• You don’t apply the same perfectionistic standards to other people (e.g., others can make mistakes while you cannot)

• Disregarding other important activities (e.g., leisure) in pursuit of perfectionistic standards (e.g. working long hours in order to get something done “the way it should be done”, at the expense of cultivating important relationships)

• Worry and anxiety about incomplete tasks (for example, believing that something terrible will happen if you don’t complete the task to perfection)
• Procrastination out of fear of “not being enough”
• Procrastinating tasks due to fear of not meeting perfectionistic standards. (e.g., you struggle to begin work because you’re afraid of not being good enough and not being able to achieve perfection)
• Impostor syndrome that makes you like you’re a fraud and lack talent.
• No time for important social activities

Socially-prescribed Perfectionism

A socially-prescribed perfectionist believes that others expect him to be impeccable.

This can be expressed in the realm of productivity, but also in less formal settings such as social gatherings. Other signs include:

• Being very self-conscious in social situations (e.g., constantly being aware of your appearance and how others view you in social situations).
• Feeling overly sensitive to criticism and taking it personally, even when it is not intended as an offense.
• Always trying to do what others expect of you
• Lacking assertiveness (e.g., you find it difficult to say “no” even when you have too much on your plate already).
• Overthinking and overinterpreting others’ behavior
• Anxiety and worry related to others’ perceptions of you
• Avoidance of social situations
• Overthinking others’ behaviour with negative interpretations (e.g. “Why is he looking at me that way?” or “This cashier obviously hates me. What did I do?”)
• Anxiety over others’ opinions (e.g., you find it difficult to fall asleep due to thoughts of past social “mistakes”).
• Avoidance of social situations due to fear of criticism or anxious thoughts about others’ perceptions of you.

Socially-prescribed perfectionism can be seen as an extreme form of agreeableness, a personality trait characterised by a strong desire to get along with others and a sensitivity to their thoughts and actions.

Other-oriented Perfectionism

 This form of perfectionism is about being too demanding towards others. Sings include:

• Being highly critical of others (e.g., harshly criticising a partner for small mistakes like spilling a cup of tea).
• Expecting others to be perfect while not holding oneself to the same standards (double standards).
• Being arrogant, condescending, and demeaning towards others when they fail to meet unrealistic expectations. 
• Reduced quality of relationships (others may find it uncomfortable to be around you).
• Being suspicious of others’ motives and intentions towards you. 
• A Belief that if you’re not demanding and arrogant, others will take advantage of you. 
• Irritability when dealing with people who don’t meet your expectations (e.g., avoiding situations where you may encounter someone you dislike)

How is Perfectionism Maintained?

What Causes Perfectionism?

Have you ever wondered what’s behind the drive for perfection? Well, there are many factors that can contribute to perfectionism. But the thing is, different types of perfectionism can have different causes. For example, some forms of perfectionism can be linked to personality traits such as conscientiousness and self-orientation, while others can be linked to traits such as agreeableness and social pressure. Let’s dive a little deeper into these causes and see what might foster perfectionism.

Heritage

Some people are just more prone to perfectionism due to their genetics, passed down from their parents. But it’s not just the genes alone. The environment also plays a role in shaping whether this genetic predisposition manifests. For example, if you have a genetic tendency towards self-oriented perfectionism but were raised by parents with reasonable expectations and who didn’t overly criticise you as a child, it’s less likely that you’ll become overly perfectionistic.

Environment

This group of factors involves everything from your upbringing, early life surroundings, friends and significant life events. Even if you don’t have a genetic predisposition towards perfectionism, a strict parenting style and excessive criticism can still lead to an increase in your perfectionist tendencies. Some important non-genetic factors include:

• Parenting style: Strict parents who constantly criticize their child can lead to an increase in perfectionist tendencies, In the case of lenient or absent parents, a lack of structure and guidance can lead to the individual setting impossibly high standards for themselves as they attempt to compensate for the lack of external expectations.
• Culture: In Eastern Asian countries with strict social codes, the pressure to conform can lead to socially-prescribed perfectionism.
• Social circle: Being bullied in school can contribute to perfectionist tendencies as a child tries to avoid criticism.
• Later life experiences: Having an overly critical boss or colleagues can cause perfectionist tendencies to develop in adulthood.

When should I get Therapy for Perfectionism?

You should ask for help as soon as you notice some of the following signs:

If you experience any of the following signs, it may be time to consider seeking therapy for perfectionism:

• Struggling to complete tasks due to constant self-criticism and the need to do better. 

For example, spending an excessive amount of time checking and rechecking a report or essay, leading to working after-hours and sacrificing personal time. 

• Excessive criticism of others, even for small mistakes, that affects your personal and professional relationships. 

For instance, constantly mentioning a minor mistake your friend made, which makes them feel uncomfortable. 

• Being overly concerned about others’ opinions and changing your behaviour to please them. 

For example, choosing a restaurant based on others’ preferences and disregarding your own wants.

These three signs broadly correspond to the three types of perfectionism mentioned. Their consequences are widely different though.

For instance, self-oriented perfectionism can lead to burnout, as you tend to focus too much on work and neglect other important areas of life like relationships and leisure time. 

If you feel anxious about social situations and overly worried about others’ perceptions of you, it could be a sign of socially-prescribed perfectionism, which is often linked to Social Anxiety or avoidant personality disorder.

On the other hand, if others are avoiding you because of your tendency to be overly critical or expect too much from them, you may be experiencing other-oriented perfectionism.

In general, if perfectionism is causing you to feel anxious, irritable, frustrated, and angry, and it’s impacting your work, relationships, and leisure time, it’s a good idea to seek help from a mental health professional.

Does Perfectionism Therapy Work?

Yes! Perfectionism can be treated in numerous ways and some of them, like CBT or Acceptance and Commitment Therapy (ACT), have been tested in numerous scientific studies and their efficiency is unambiguously proven [2].

What’s the Best Therapy Approach for Perfectionism?

The two most popular therapy approaches to work with perfectionism are:

• Psychodynamic approaches. Which mainly focus on providing counselling to people who have other-oriented perfectionism tied to deeper issues with narcissism. 
• Cognitive Behavioural Therapy (CBT) approaches. Which have seen a lot of clinical trials in the contexts of self-oriented and socially-prescribed perfectionism. These are just the most popular approaches. 

Aside from these two, perfectionism can be treated with a variety of other therapies, including person-centred therapy and integrative therapy. 

CBT Therapy for Perfectionism

CBT for perfectionism has the most empirical evidence [3]. It was shown that after 10 CBT sessions, 75% of participants who struggled with perfectionism started to feel better. CBT for perfectionism works in the following way:

• Identifying negative automatic thoughts (e.g. “I must do this task perfectly.”)
• Identifying irrational maladaptive beliefs (e.g. “I must be perfect. If I am not perfect, I am worth nothing.” or “I must always do everything perfectly. If I don’t do it perfectly each time, it’s better not to do it at all.”)
• Building more adaptive and rational beliefs and replacing the old ones (e.g. “It would be great to do everything perfectly, but this is not always possible, and that’s the way the world works.” or “Just because something I do isn’t 100% perfect, doesn’t necessarily mean I am a bad person.” or yet, “No one is perfect and no one can be perfect. It’s okay not to be a perfect person.”)

What are the Benefits of Therapy for Perfectionism?

Working with one of our therapists on your perfectionism, can bring several benefits, including:

• Less self-criticism
• Increased productivity and work efficiency
• Less anxiety about work and unfinished tasks
• More confidence in social situations, less sensitivity towards what others think about you (especially if you’re suffering from socially-prescribed perfectionism)
• Reduced social anxiety 
• Becoming less critical towards others (in case you have issues with other-oriented perfectionism)
• Improved confidence and self-esteem
• Greater enjoyment from your relationships
• Higher quality of life

How Long Does Perfectionism Treatment Last?

About 10 sessions of CBT for perfectionism can significantly improve signs and symptoms of perfectionism. A third-wave CBT psychotherapeutic approach, Acceptance and Commitment Therapy (ACT), was also shown to effect a significant improvement after 10 weekly sessions [2]. 

Some people have very severe perfectionism which is related to other psychological issues such as depression or personality disorders. Therapy is efficient in these cases too, but it will likely take more time for improvements to become visible.

Does Online Therapy Work for Perfectionism?

Yes, it does work – recently a study has been published which tested the effects of online CBT for perfectionism. The intervention significantly improved the overall psychological functioning of participants and reduced overall levels of perfectionism [4]. So, you’re likely to benefit from therapy whether you’re looking to have your sessions in-person or online.

Tips to get you started Managing Perfectionism

There are certain things you can do on your own to start tackling your perfectionism, even before starting therapy:

• Get a second opinion – even though you may not think that the job is done, other people may think differently. Exposing yourself to another’s honest and trusted opinion can help you slowly dismantle your perfectionistic, all-or-nothing beliefs.
• Take some time to unwind and relax – (self-oriented) perfectionists often work too much, which in turn affects performance; taking some time off will relieve the pressure and help you recommence working with more energy and drive.
• Ask other people what they think about your standards. Chances are you might realise yours are higher than the average.
• Understand that perfectionism can be changed – don’t describe yourself exclusively in terms of performance and what others think about you.
• Compare the standards you’re applying to yourself and those you apply to others. If you notice a drastic difference, this might be a telling sign of perfectionism. Try to refocus your mind on the greater importance of completing the task and meeting basic requirements, rather than attempting to finish it perfectly.