Why Perfectionism and Anxiety Disorders Go Hand-in-Hand

Last year, researchers at the University of Montreal asked a group of 48 people a series of questions about how often and how intensely they experienced emotions such as anger, guilt, boredom, irritability, and anxiety. After taking the survey, they were “exposed to situations designed to provoke particular feelings (including relaxation, stress, frustration, and boredom).” The results showed that those participants who had a history of body-focused repetitive behaviors like nail biting and hair twirling were significantly more likely to experience the urge to engage in those behaviors when placed in distressing situations.

While on the surface this may come as no surprise, the researchers drew another, more interesting conclusion from the results. “We believe that individuals with these repetitive behaviors may be perfectionistic, meaning they are unable to relax and to perform a task at a ‘normal’ pace,” said Dr. Kieron O’Connor, lead author of the study. “They are therefore prone to frustration, impatience, and dissatisfaction when they do not reach their goals.”

Being described as a perfectionist typically isn’t regarded as cause for alarm. After all, isn’t perfectionism a good thing? Maybe not. A growing body of evidence suggests that perfectionism can be an extraordinarily damaging, cause overwhelming emotional suffering, and act as both a cause and symptom of anxiety disorders. It is also implicated in everything from seemingly benign self-destructive behaviors like nail biting to overt acts of self-mutilation and even suicide.

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The Turmoil of the Perfectionist


“Other than those people who have suffered greatly because of their perfectionism or the perfectionism of a loved one, the average person has very little understanding of how destructive perfectionism can be,” says Dr. Gordon Flett, a psychologist at York University. While perfectionists may appear to have it together on the surface, underneath the thin veneer of perfection lies deep turmoil that may both drive and result from the pursuit of perfection. Psychologist Thomas S. Greenspon explains, “Perfectionistic people typically believe that they can never be good enough, that mistakes are signs of personal flaws, and that the only route to acceptability as a person is to be perfect.”

Often, this turmoil can be difficult for others to see or even for the perfectionist to acknowledge, as those who suffer often work diligently to maintain a cohesive image of accomplishment and well-being. As a result, perfectionists who are struggling with psychological distress may be less likely to receive the help they need, causing ever-deeper levels of emotional pain that can sometimes end in acts of self-destruction; research has linked perfectionism to nonsuicidal self-injury, and a 2007 study on suicides in Alaska found that 56% of those who took their own lives were described as perfectionists by family and friends.

The Complicated Relationship Between Perfectionism and Anxiety


The specific nature of a perfectionist’s distress can come in many forms, but the common thread that appears to run through perfectionist experiences is anxiety. As Melissa Dahl of New York Magazineelegantly writes, “Perfectionism is more than pushing yourself to do your best to achieve a goal; it’s a reflection of an inner self mired in anxiety.” This anxiety may take the form of any number of disorders, including Generalized Anxiety Disorder, Panic Disorder, and Obsessive Compulsive Disorder, and may arise from either specific triggering events or unknown sources.

The exact relationship between perfectionism and anxiety is complicated; the pursuit of perfection becomes a maladaptive way of coping with the distress of anxiety and perfectionism itself further fuels the anxiety by creating high standards that the anxiety may prevent you from achieving. “Many people with anxiety have difficulty gauging when tasks are completed to their satisfaction,” says clinical psychologist Kathariya Mokrue.

They often say, ‘It’s hard for me to know when I need to stop’ despite their having invested tremendous time and energy. Then what eventually happens next is fatigue and exhaustion, or a loved one pleads for them to stop. Their ‘internal thermometer’ for when to stop is essentially not calibrated properly. Risks associated with being wrong or imperfect are often blown out of proportion, leading to maladaptive anxiety. This anxiety, in turn, serves as a signal to work frantically, and it is only when this signal is drowned out by physical or mental exhaustion that people stop.

Often, procrastination, risk-aversion, frustration, exhaustion, and lack of focus interfere with the ability to complete tasks to your high standards. Ultimately, however, even the successful completion of tasks is not enough to quell the anxiety, which quickly finds a new target. For perfectionists, self-judgment is ever-present and anxiety is constantly looming as you anticipate the ways you can fall short.

A Genesis Story


Although the roots of some people’s psychological distress remain nebulous, Merely Me, a mental health writer, can trace the exact lineage of both her perfectionism and anxiety. Raised in a poor household by a mom who suffered from schizophrenia, she “grew up thinking that in order to change my life situation some day, that I would not only have to excel in school but that I had to be perfect.” Deeply insecure about her family’s poverty and her mother’s mental illness, she tried desperately to achieve scholastically to compensate for her perceived shortcomings. Simultaneously, a part of her believed that if she were perfect her mom would be cured.

Finish this sentence: If I am not perfect then …? As a child I would finish that sentence with: My mother will never be happy or sane. I will never get out of poverty. I will be unloved. As an adult my thinking is similar to when I was a child. I feel that if I am not perfect that my household will fall apart, my son with autism will regress, and everyone will be disappointed in me. Every perfectionist has their own variation of this theme.

Merely Me starkly describes how perfectionism evolves as a maladaptive coping mechanism to deal with overwhelming and consuming anxiety. Perhaps the most interesting thing about her description is her articulation of perfectionism causing a kind of magical thinking regarding the well-being of others, giving her an illusion of control that was simultaneously damaging for its falsehood and comforting for the sense of control it gave her in a situation where she had none. This, for many, is the locus of perfectionism.

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Admitting Imperfection


One of the most difficult things for perfectionists is often admitting that they have a problem. As such, seeking help for your distress may require overcoming tremendous internal obstacles. If perfectionism and anxiety are impairing your ability to function, decreasing your quality of life, or cause you to consider self-harm, seeking treatment is the most important and brave choice you can make. Admitting that you need help isn’t a sign of weakness, but one of courage, strength, and love for both yourself and those dearest to you.

Through comprehensive mental health treatment, you can achieve diagnostic clarity to fully understand the nature of your distress and gain a deeper understanding of the complex relationship between your perfectionism and anxiety disorder. At Bridges, we tailor treatment plans consisting of individual, group, and holistic therapies to address the needs of each individual, ensuring that your therapeutic process speaks to you. Using a whole-person approach, we will guide you toward increased distress tolerance and help you replace maladaptive coping mechanisms with healthy life skills. For clients with anxiety disorders and perfectionist personalities, therapeutic modalities such as art therapy, drumming, and meditation are often instrumental in opening up the possibilities for exploring and expressing yourself in an environment in which there is no right or wrong or potential for perfection.

Perfectionism and anxiety disorders are treatable conditions and with the right tools, you can move toward a happier, healthier, and more hopeful life.

Bridges to Recovery offers comprehensive treatment for people struggling with anxiety disorders and perfectionist personality traits, as well as any other mental health disorders and co-existing impulse control disorders. Contact us for more information about our innovative program and how we can help you or your loved one on the path to healing.