By: Sarah Ahmad
Perfectionism is a term we often hear tossed around casually: “I’m such a perfectionist,” or “I want everything to be perfect.” While this may seem harmless – desirable almost, clinical perfectionism can have a significant emotional, mental, and physical impact. Clinical perfectionism is not just striving for excellence, but is an emotional and behavioral pattern that often leads to negative self-judgment, low self-esteem, and burnout.
What is Clinical Perfectionism?
Clinical perfectionism is characterized by excessively high, rigid standards, an overwhelming fear of making mistakes, and the constant need for control. It can be a standard we hold ourselves to, or perceive that others hold us to, or sense that it is socially prescribed. It often manifests in both external behaviors and internal thoughts, including:
- Unrealistic Expectations: Setting iron-clad standards that are nearly impossible to meet, causing constant feelings of inadequacy.
- Fear of Failure: An intense fear of making mistakes or being judged harshly by others, which can lead to avoiding certain tasks or overpreparing.
- Self-Criticism: A harsh inner critic that continually berates the individual for not achieving perfection, often leading to feelings of shame or guilt.
- Procrastination: Ironically, perfectionists may avoid starting projects or tasks because they feel they won’t be able to complete them flawlessly.
In a clinical sense, perfectionism often goes beyond just striving for excellence. It’s rooted in shame, a fear of judgment, and a sense of worth being tied to accomplishments or appearance. Individuals with clinical perfectionism may experience anxiety, depression, and relationship difficulties because of the constant internal pressure they place on themselves.
Perfectionism and Emotional Dysregulation
Dialectical Behaviour Therapy (DBT) is an evidence-based treatment that aims to help individuals manage overwhelming emotions, develop healthier coping mechanisms, and increase overall life satisfaction. DBT skills can help with learning to regulate emotions effectively, and clinical perfectionism is an area it can be helpful with as well.
When emotions like fear, guilt, or shame become overwhelming, individuals with perfectionistic tendencies may strive for perfection as a way to avoid or suppress these uncomfortable feelings. Alternatively, it can also lead to excessive avoidance due to a sense of feeling overwhelmed associated with excessively high standards – this further exacerbates one’s distress. Avoiding negative emotions tends to be ineffective in the long run; instead, it is helpful for individuals to learn to tolerate distress and approach situations with flexibility.
The drive for perfection can be a way of managing feelings of inadequacy or fear, however, it rarely leads to long-term contentment or self-acceptance, and keeps one stuck in a vicious loop.
The DBT Approach to Clinical Perfectionism
DBT offers several skills and strategies that can be helpful in addressing perfectionistic tendencies and building a healthier relationship with ourselves.
1. Radical Acceptance:
The ability to fully accept reality as it is, without denial, judgment or resistance is radical acceptance. In the case of clinical perfectionism, radical acceptance means recognizing that mistakes are part of life, being able to accept our flawed selves as reality, and not letting that fact diminish a person’s worth. It’s about accepting that perfection is unattainable and that imperfection is a natural part of being human. Radical acceptance can help individuals let go of the need to control every outcome, reducing distress and suffering, and allowing for a more balanced approach to life.
2. Mindfulness
Mindfulness is another central element of DBT, and it’s vital when addressing perfectionism. Being mindful means being present in the moment without judgment. People can be prone to ruminating and being consumed by past failures or future worries, which only exacerbates anxiety and self-criticism. Through mindfulness practices, individuals can learn to observe their thoughts and feelings without giving in to them. Additionally, people can also learn about the reasonable mind versus emotion mind, and the value of tapping into wise mind, and choosing their responses and actions informed by both logic and emotion.
3. Cognitive Restructuring/ Checking the facts
Perfectionistic thoughts are often distorted and unrealistic. DBT talks about cognitive restructuring or checking the facts, which involves identifying and challenging these distorted thoughts. For example, someone with perfectionism might believe that “if I’m not perfect, I’m worthless,” or “if my work is not perfect, I’ll be seen as not good enough.” It would be helpful for an individual to examine the evidence for and against this belief, ultimately helping them reframe it into a more balanced, compassionate perspective.
4. Building Self-Compassion
Finally, it is important to cultivate a sense of self-compassion, which is treating oneself with the same loving kindness and understanding that one would offer to a close friend, and to believe in our common humanity. People with perfectionism can be highly self-critical, which exacerbates feelings of shame and inadequacy. Developing self-compassion involves recognizing that it’s okay to make mistakes and that imperfection is a natural part of life and the human condition. Learning to be kind to oneself when things don’t go perfectly is an important part of overcoming clinical perfectionism.
Conclusion
Through DBT, individuals can learn to manage perfectionistic tendencies, develop healthier emotional coping skills, and practice self-acceptance. By learning skills such as radical acceptance, mindfulness, cognitive restructuring, and self-compassion, those struggling with perfectionism can gradually shift away from the harmful pursuit of flawlessness and begin living with authenticity, and emotional resilience.