Perfectionism Therapy: When High Standards Become Exhausting
Is perfectionism driving your success or draining you? Learn the signs, the research and how therapy for perfectionism can help.
You reread the email four times before sending it. You finish the presentation and focus only on the one slide that was slightly off. Praise slides past you, while criticism lodges for days.
High standards can be a real strength. But when the standard is "flawless" and the cost is exhaustion, procrastination or a harsh inner critic, it may be perfectionism rather than ambition. This article explains the difference, what research tells us, and how therapy for perfectionism can help.
Striving versus perfectionism
Wanting to do good work is healthy. Perfectionism is different. Psychologists generally describe it as very high standards combined with harsh self-criticism when those standards are not met, and a sense that your worth depends on meeting them.
A simple test: when you make a mistake, do you think "that could have been better, what can I learn?" or "what is wrong with me?" The first is striving. The second is closer to perfectionism.
Three kinds of perfectionism
Researchers Paul Hewitt and Gordon Flett describe three forms, widely used in research:
- Self-oriented: demanding perfection of yourself.
- Socially prescribed: feeling that other people demand perfection from you.
- Other-oriented: demanding perfection of others.
Most people recognise one of these more than the others. Many high achievers live with the second: a constant sense of being measured, and of the bar always moving.
What the research says
A study by Thomas Curran and Andrew Hill, published in the journal Psychological Bulletin in 2019, combined 164 samples covering more than 41,000 university students in the United States, Canada and the United Kingdom between 1989 and 2016. All three forms of perfectionism rose over that period, and the biggest rise was in socially prescribed perfectionism.
The study looked at students, so it cannot tell us about every workplace or every person. But it supports what many people feel: the pressure to appear flawless is not only personal. It is also cultural.
Signs of perfectionism
- Procrastinating because you cannot start unless it will be perfect.
- Overworking, redoing tasks and struggling to delegate.
- An inner critic that is far tougher than you would ever be on a friend.
- Difficulty enjoying your achievements.
- Avoiding things you may not do well.
- Tension, poor sleep or a feeling of always being "on".
These experiences are common, and they are not a diagnosis. If they are affecting your wellbeing, a professional can help you make sense of them. Perfectionism often sits alongside worry, so you may also recognise yourself in our article on high-functioning anxiety, or in the exhaustion described in our guide to executive burnout.
How perfectionism counselling can help
Therapists work with perfectionism in different ways. With perfectionism counselling in an integrative setting, you might:
- Understand where the standards came from. Many people learned early that approval depended on performance.
- Get to know the inner critic. Notice it, understand what it is trying to protect you from, and learn to respond differently.
- Practise self-compassion. Treat your own mistakes with the steadiness you would offer someone you care about.
- Notice the body. Perfectionism often comes with physical tension, and settling the body can make it easier to loosen the mind. This is where mind-body psychotherapy can help.
- Try "good enough". Run small, safe experiments, and see what happens when something is done at 90 per cent.
Progress is often gradual. There is no need to lose your high standards. The aim is to hold them without being run by them.
A small experiment to try
Pick one low-stakes task this week, such as an internal email or a routine report. Decide in advance what "good enough" looks like, do it, and send it without a final check. Afterwards, notice what you felt in your body and what actually happened. Many people are surprised by how little changes for anyone else.
Counselling with Akanista
Our integrative counselling helps people understand long-standing patterns such as perfectionism and the inner critic, working with thoughts, emotions and the body together. Sessions are online and confidential, and you can begin with a free introductory conversation.
Learn more about counselling →
Frequently asked questions
Is perfectionism a mental illness?
No. Perfectionism is a personality trait and a pattern of thinking, not a diagnosis. It can be linked with other difficulties, such as anxiety, so it is worth seeking professional advice if it affects your wellbeing.
What causes perfectionism?
There is rarely one cause. Early experiences, family and cultural expectations, pressure at work and temperament can all play a part.
Can therapy cure perfectionism?
Therapy does not remove high standards. It can help you relate to them differently, soften self-criticism and reduce the cost of constant striving.
How is perfectionism different from high-functioning anxiety?
They often overlap. Perfectionism centres on standards and self-criticism, while anxiety centres on worry and tension. Our article on high-functioning anxiety explores the second.
Sources: Curran & Hill (2019), Perfectionism is increasing over time
