Perfectionism: when high standards become the problem

High standards are not a problem. Most of the people I see with perfectionism are good at what they do, and their standards are part of the reason. The difficulty starts when standards stop being something you aim for and become the measure of whether you are acceptable. At that point, falling short doesn't feel like a missed target. It feels like evidence that you aren't good enough.

In CBT, this is called clinical perfectionism: judging your worth largely by whether you meet demanding standards, and continuing to pursue them despite the cost to your health, your relationships or your enjoyment of life.

How perfectionism shows up

Perfectionism is often less visible than people expect. It can look like:

• Rewriting an email several times, or checking work long after it is good enough
• Procrastinating on tasks where you can't guarantee a good result, then working through the night to finish them
• Finding it hard to delegate, because others won't do it properly
• Dismissing achievements almost immediately ("anyone could have done that", "it should have been better")
• Dwelling for days on a small mistake or a piece of mild criticism
• Avoiding new things you might not be good at straight away
• A persistent, harsh internal commentary that rarely lets up

It isn't limited to work. The same pattern can attach itself to appearance, fitness, parenting, a home, or how you come across to other people.

Why perfectionism keeps itself going

Perfectionism is self-reinforcing. A few patterns tend to keep it in place:

The goalposts move. When you do meet a standard, it gets quietly redefined as not that demanding after all, and the bar rises. Success brings relief rather than satisfaction, and the relief is short.

Success is put down to effort, and failure to you. If things go well, it was because you worked so hard, which seems to prove the hard work is necessary. If things go badly, it reflects on who you are.

All-or-nothing judgement. Something is either right or a failure, with little in between. A presentation that went well apart from one moment gets filed under "went badly".

Checking and avoidance. Over-preparing and re-checking prevent you from discovering that slightly less would have been fine. Avoidance and procrastination protect you from being judged on anything less than your best, at the cost of pressure later.

Perfectionism, self-esteem and social anxiety

Perfectionism rarely travels alone. Underneath it there is often a fragile sense of self-worth: a belief that you are only acceptable if you perform well. In that sense, perfectionism often works as a rule for living that protects against low self-esteem. As long as you meet the standard, the underlying belief stays out of sight. When you don't, it comes straight back.

It also overlaps closely with social anxiety. Perfectionistic standards about how you should come across, such as always being articulate, never appearing anxious, or never saying something foolish, make social situations feel like tests you can easily fail.

Left unaddressed, perfectionism is one of the most common routes into burnout, particularly in demanding professional roles.

How CBT for perfectionism works

There is a specific, well-researched CBT approach to perfectionism. The aim is not to lower your standards across the board or to make you care less about your work. It is to loosen the link between your standards and your sense of worth, and to make your standards flexible enough to be useful rather than punishing.

In practice, treatment usually involves:

• Mapping the cycle. Identifying the standards, how you judge yourself against them, and the behaviours that keep the cycle going.
• Broadening how you value yourself. Looking at how much of your self-worth rests on achievement, and deliberately investing in other parts of your life.
• Behavioural experiments. Testing predictions directly. What actually happens if you send the email after one read-through, or submit work at 90% rather than after a fifth revision? People are often surprised by the answer.
• Reducing checking, over-preparation and procrastination, step by step.
• Working on self-criticism. Learning to respond to setbacks in a way that is honest about what went wrong without turning it into a verdict on yourself.

In my practice

Perfectionism is one of the areas I see most often, frequently in people who have done very well by most external measures and who have quietly paid a high price for it. A common fear at the start is that without perfectionism they will stop achieving. In my experience, the opposite is more usual. People who stop being governed by their standards tend to work more efficiently, procrastinate less and recover from setbacks faster, because each one no longer carries so much weight.

If perfectionism sits alongside anxiety, you may also find my page on anxiety therapy useful.

Guy Klein

BABCP-accredited CBT therapist and EMDR Europe accredited practitioner, in clinical practice since 2015. Guy works with adults online and in Queen's Park, North West London, with a particular focus on OCD, anxiety and trauma. More about Guy