When perfectionism becomes a problem

Numerous studies have shown links between eating disorders and perfectionism, and helping sufferers learn to cope with and manage their perfectionistic personality traits may be useful in helping to maintain recovery.

A recent article in the Boston Globe describes perfectionism as

"...a phobia of mistake-making," said Jeff Szymanski, executive director of the Obsessive Compulsive Foundation, which is based in Boston. "It is the feeling that 'If I make a mistake, it will be catastrophic.' "

Striving for perfection is fine, said Smith College psychology professor Randy Frost, a leading researcher on perfectionism. The issue is how you interpret your own inevitable mistakes and failings. Do they make you feel bad about yourself in a global sense? Does a missed shot in tennis make you slam your racket to the ground? Do you think anything less than 100 percent might as well be zero?

So how do you treat perfectionism? CBT is typically the gold standard, helping people recognize and change their ideas that everything must be perfect, the black and white thinking ("If I'm not perfect, I'm a failure"), among other things. The Globe article summarizes a basic perfectionism treatment program as follows:

  • Get to know your perfectionism: become more aware of your perfectionistic patterns of thinking and behavior, and their effects on your life and those around you. What are your triggers?
  • Challenge your thinking and question your beliefs: Is it really so important for every book on your shelf to be placed even with the one next to it? What would happen if they were uneven? Do you know anyone with uneven books? What are the costs and benefits of spending time making everything "just so"?
  • Change your behavior by exposing yourself to what you fear: Practice making mistakes, though not if they will lead to terrible consequences. Send a letter to a friend with typos in it. Burn dessert a bit at a party.

My first thought? Deliberately making a mistake? Are you joking? Obviously, I have issues.

I've always been a perfectionist, practicing my handwriting (in the days before you typed everything) in a little journal, organizing my bookshelves, and let's not even discuss school and grades and test scores. Most studies have found this is true for many sufferers of eating disorders, that perfectionism exists before the ED and persists long after recovery.*

That being said, perfectionism isn't all bad. Though it is distressing to me at times, it has also helped me in some areas. I got a writing gig once because mine was the only pitch letter without any typos. And good grades and test scores have been useful as well. The point is to try and figure out what types of perfectionistic thoughts and behaviors are causing you serious distress, and which provide a more positive role in your life. Two key attributes of perfectionism have been linked to higher levels of distress:

One, he said, is "concealment," the need to hide mistakes and imperfections. The other is "contingent self-worth," the feeling that "in order to be a worthwhile person, I have to perform in such and such a manner, I have to behave perfectly."

Have you been able to tame the more distressing aspects of perfectionism? How? Any suggestions?

(h/t Mind Hacks)

*This result was recently challenged by a paper stating that, in recovered women, perfectionism scores were no higher than in healthy controls. I'm not surprised that recovery helps reduce levels of perfectionism, and maybe a part of recovery is learning to manage your perfectionism.


Jessi said...

good food for thought (pun intended)... Brilliant post :)

Anonymous said...

One, he said, is "concealment," the need to hide mistakes and imperfections. The other is "contingent self-worth," the feeling that "in order to be a worthwhile person, I have to perform in such and such a manner, I have to behave perfectly."

I read that and spontaneous eye-leakage occurred. Just yesterday in therapy I was getting so pissed at my therapist because when I said I'm not good at anything she kept repeating it and challenging me. And no! I'm not GOOD at anything! Because Good = perfect!!!! blah

Kim said...

Well, yes, my perfectionism definitely predated my anorexia. I used to punish myself when I did things I thought were "wrong" as a kid (we're talking 6 years old). When I accidentally hit someone with the ball while playing handball, I gave myself a timeout. I think my parents were totally baffled. One time, my dad offered me money to get a "B" instead of an "A." So, yeah. I think it's interesting that the perfectionism persists after recovery. Doesn't surprise me. I think it's a pretty big personality trait. I'm trying to look at the positives. My life is pretty organized, thanks to my perfectionism. As long as I don't cross the line of becoming highly obsessive and compulsive, I am a dream friend/wife/employee/etc. (if I do say so myself). I'm good at remembering things. I'm dependable and reliable. Sure, it would be great if I could go easier on myself when I make mistakes, but that's probably not in my code. At the very least, I can not starve over mistakes :)

Anonymous said...

Perhaps this is a bit off-topic, but a couple of years ago one of my children had a terrifically good "gifted education" teacher.

My younger child had tested into the gifted program, and, as per county and state regs, we were required to have a face-to-face meeting with the teacher as our children qualified for "special needs." This teacher did a group parent meeting, and then one-on-one meetings if requested.

I showed up dutifully as did most other parents. She gave us each a legal pad to take notes on, though some of us (me included) had brought our own. She started talking.

At first it was about our bright kids getting more field trips and hands-on, self-directed projects. Then she started talking about the nature of giftedness in people. She said that "gifted" kids usually come from "gifted" parents. We all keep taking notes. She goes on and on. Then she delivers what seemed like a minor bombshell in the room. SOME gifted kid don't make great grades all the time, some do. Some come from bright and illustrous parents. Some don't. In fact SOME gifted kids come from parent who are bright themselves, but are horrible lifelong procrastinators.

Half the room stops cold and looks up. I am one of these.

She chuckles. She askes us if we'd ever heard about the relationship between giftedness and procrastination. No one has. Then she goes on to describe a person who is a perfectionist with a pronounced anxiety-bent. She cites studies. How they tend to do well on tests, but how this subset often will put off and put off the work until they can tell themselves that if they don't do a stellar job it's okay because they started late, had these and those impedements, etc. . . Reasons, as it were, that they did not have to be utterly perfect.

She talked about perfectionism as a tyranny that often afflicts the gifted, and how habitual procrastination is actually a typically unrecognized sign of perfectionism, and how it's a way to self-treat co-existing anxiety. She handed out studies and education journal articles about it.

I have that sort of procrastination, and so does my older (formerly) AN daughter. This was a revelation that suddenly made perfect sense of much of our lives and habits. The teacher also confided that she was just like this, and knew the pitfalls well.

After the session, as I'd planned already, I cornered the teacher to tell her that my younger daughter was living in a household where MM refeeding for AN was ongoing with all it's glory and effects on others.

Gifted teacher was then at a loss for words momentarily. She told me that she'd been severely AN in HS and college and her mother had gotten frustrated with treatment centers and fetched her home saying they'd had this problem in the family before, fed her three big meals a day every day, and wouldn't allow her to move back out until her AN behaviors were gone for a whole year. (Her mom was a Greek immigrant and spoke little English.) That was 20 years ago and the teacher was surprised that there was real research out there that would
back up her mom every which way.


sarah-j said...

I so identify with loads of the but article but not the whole thing. I'm a perfectionist about certain things but in other areas, I can be really chaotic and scatty.

I used to have really bad OCD, so I used to have to 'think right' and do loads of random things 'perfectly' and really beat myself up if I didn't. However, in relation to schoolwork, I really wish I could be a bit more perfectionistic. (I think) I can really procrastinate in relation to that and certain other things. Sometimes it really upsets me that I'm not good enough at being a perfectionist! (Has anyone else experienced this?)

However, I have totally experienced what were identified in the article as the most problematic aspects of perfectionism- they were very much a part of my unconscious thinking for years and they are much less so now. I think the reason for that is that my therapists constant refrain to me that 'you're being too hard on yourself, you're being too hard on yourself' eventually went into my head and I just kind of relaxed a bit. Taking my anxiety and stress levels down a bit just somehow helped with everything but I don't fully understand how the process worked. I wish I did so that I could tell people and they could use it.

sarah-j said...

ps, the comment above mine wasn't there when I was writing. That person's comment is kind of relevant to my worry about not being perfectionistic enough. Thanks Anon!

anynon said...

I would not have considered my daughter a 'perfectionist' or particularly anxious at younger ages. It started up in middle school rather quickly. While ill, she became incredibly neat and organized (unlike her former self or most kids her age). As she got over AN, she went back to more slobby habits. Have you ever heard of this? She is perfectionistic in certain regards--her art work, her writing, etc. But her rooms is usually a mess. And, as she recovered from AN, I'd say she had some personal hygiene issues too. Not typical of her in the past. Just basic 'taking care of herself' stuff.

Carrie Arnold said...

Anon (the first one),

Thank you for your insights! I do know of the relationship between procrastinating and perfectionism. And I think sometimes procrastination is a way to let yourself off the hook a bit, because you can blame your mistakes on external factors.


AN definitely makes you perfectionistic, whether you were before or not. And I think you bring up a good point: not ALL people with AN are perfectionists before the illness. It would go to figure that if you weren't perfectionistic before the illness, you probably won't be after recovery.

There are definitely areas in my life where I'm not overly perfectionistic. I can't remember the last time I washed my car (thankfully, it's brown!). I fundamentally oppose ironing. Very few people are perfectionistic about *everything.*

Carrie Arnold said...


Um, yes, I've felt bad about myself because I wasn't "good enough" to be a perfectionist and perhaps I should work a little bit harder at that one...

Kind of silly when you think about it.


I'm with you in learning to understand the vast gulf between "good" and "perfect." I think I might blog on this later today because it's a bit complicated and reminds me of some (please don't run away!) calculus I did in high school/college.

No calculator will be required, though. :)

Lisa said...

It's so important to be aware of your perfectionism, like you said. When I was younger and realized that not everyone thought the same way I did, it blew my mind.

I struggle with the knowledge that, in the past, my perfectionism/fear of failure DID help me. My doc tells me to keep asking myself, now, if it is in fact still helping.

A:) said...

Good article Carrie -- I have really nothing to add, except that I am also a perfectionist and my recovery has helped me understand it. I find when I am struggling with perfectionism/test scores/grades or a project it helps me to label what I am feeling as "my perfectionism" -- this way, I understand that what I am feeling is partially irrational.

Wouldn't it be wonderful to give up all of our perfectionism, ED tendencies, depression and anxiety just for an hour and be "normal?"


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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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