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The Dangerous Downsides of Perfectionism

Many of us believe perfectionism is a positive. But researchers are finding that it is nothing short of dangerous, leading to a long list of health problems – and that it’s on the rise.

BBC Future

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In one of my earliest memories, I’m drawing. I don’t remember what the picture is supposed to be, but I remember the mistake. My marker slips, an unintentional line appears and my lip trembles. The picture has long since disappeared. But that feeling of deep frustration, even shame, stays with me.

More often than I’d like to admit, something seemingly inconsequential will cause the same feeling to rear its head again. Something as small as accidentally squashing the panettone I was bringing my boyfriend’s family for Christmas can tumble around in my mind for several days, accompanied by occasional voices like “How stupid!” and “You should have known better”. Falling short of a bigger goal, even when I know achieving it would be near-impossible, can temporarily flatten me. When an agent told me that she knew I was going to write a book someday but that the particular idea I’d pitched her didn’t suit the market, I felt deflated in a gut-punching way that went beyond disappointment. The negative drowned out the positive. “You’re never going to write a book,” my internal voice said. “You’re not good enough.” That voice didn’t care that this directly contradicted what the agent actually said.

That’s the thing about perfectionism. It takes no prisoners.

If I’ve struggled with perfectionism, I’m far from alone. The tendency starts young – and it’s becoming more common. Thomas Curran and Andrew Hill’s meta-analysis of rates of perfectionism from 1989 to 2016, the first study to compare perfectionism across generations, found significant increases among more recent undergraduates in the US, UK and Canada. In other words, the average college student last year was much more likely to have perfectionistic tendencies than a student in the 1990s or early 2000s.

“As many as two in five kids and adolescents are perfectionists,” says Katie Rasmussen, who researches child development and perfectionism at West Virginia University. “We’re starting to talk about how it’s heading toward an epidemic and public health issue.”

The rise in perfectionism doesn’t mean each generation is becoming more accomplished. It means we’re getting sicker, sadder and even undermining our own potential.

‘My life has been nothing but a failure,’ perfectionist Claude Monet once said. He often destroyed paintings in a temper – including 15 meant to open an exhibition. Credit: Getty Images.

Perfectionism, after all, is an ultimately self-defeating way to move through the world. It is built on an excruciating irony: making, and admitting, mistakes is a necessary part of growing and learning and being human. It also makes you better at your career and relationships and life in general. By avoiding mistakes at any cost, a perfectionist can make it harder to reach their own lofty goals.

But the drawback of perfectionism isn’t just that it holds you back from being your most successful, productive self. Perfectionistic tendencies have been linked to a laundry list of clinical issues: depression and anxiety (even in children), self-harm, social anxiety disorder and agoraphobia, obsessive-compulsive disorder, binge eating, anorexia, bulimia, and other eating disorders, post-traumatic stress disorder, chronic fatigue syndrome, insomnia, hoarding, dyspepsia, chronic headaches, and, most damning of all, even early mortality and suicide.

“It’s something that cuts across everything, in terms of psychological problems,” says Sarah Egan, a senior research fellow at the Curtin University in Perth who specialises in perfectionism, eating disorders and anxiety. "There aren’t that many other things that do that.

"There are studies that suggest that the higher the perfectionism is, the more psychological disorders you’re going to suffer.”

***

Culturally, we often see perfectionism as a positive. Even saying you have perfectionistic tendencies can come off as a coy compliment to yourself; it’s practically a stock answer to the “What’s your worst trait?” question in job interviews. (Past employers, now you know! I wasn’t just being cute).

This is where perfectionism gets complicated – and controversial. Some researchers say there is adaptive, or ‘healthy’ perfectionism (characterised by having high standards, motivation and discipline) versus a maladaptive, or ‘unhealthy’ version (when your best never seems good enough and not meeting goals frustrates you). In one study of more than 1,000 Chinese students, researchers found that gifted students were more perfectionistic in the adaptive ways. (Maladaptive perfectionists, on the other hand, were more likely to be non-gifted). And while research shows that maladaptive attributes like beating yourself up for mistakes or feeling like you can’t live up to parental expectations make you more vulnerable to depression, some other studies have shown that ‘adaptive’ aspects like striving for achievement have no effect at all or may even protect you.

Footballer Cristiano Ronaldo says he strives for excellence, not perfection: ‘I am not a perfectionist, but I like to feel that things are done well.’ Credit: Getty Images.

But that isn’t always the case. Simply having high personal standards has been linked to suicide ideation, for example. And even if there sometimes may be upsides to perfectionist thinking, they are minor – and, researchers argue, misunderstood.

In a 2016 meta-analysis of 43 studies on perfectionism and burnout, for example, Hill and Curran found that athletes, employees and students experienced either a tiny or no benefit from aspects like having very high personal standards, compared to people who didn’t have them. People who expressed more ‘maladaptive’ perfectionism, on the other hand, experienced significantly more burnout.

“There has been some suggestion that, in some cases, perfectionism might be healthy and desirable. Based upon the 60-odd studies that we’ve done, we think that’s a misunderstanding,” says York St John University’s Hill. “Working hard, being committed, diligent, and so on – these are all desirable features. But for a perfectionist, those are really a symptom, or a side product, of what perfectionism is. Perfectionism isn’t about high standards. It’s about unrealistic standards.

“Perfectionism isn’t a behaviour. It’s a way of thinking about yourself.”

From the outside, it can be difficult to tell who is motivated and conscientious and who is a perfectionist. Credit: Getty Images.

In fact, many researchers say that factors often dubbed ‘healthy’ perfectionism, like striving for excellence, aren’t actually perfectionism at all. They’re just conscientiousness – which explains why people with those tendencies often have different outcomes in studies. Perfectionism, they argue, isn’t defined by working hard or setting high goals. It’s that critical inner voice.

Take the student who works hard and gets a poor mark. If she tells herself: “I’m disappointed, but it’s okay; I’m still a good person overall,” that’s healthy. If the message is: “I’m a failure. I’m not good enough,” that’s perfectionism.

That inner voice criticises different things for different people – work, relationships, tidiness, fitness. My own tendencies may differ greatly from somebody else’s. It can take someone who knows me well to pick up on them. (When I messaged my partner I was writing this story, he immediately sent back a long line of laughing emojis).

As a result, perfectionists and non-perfectionists “might look the same for a short period of time from a distance. But when you get up close and observe them over time, conscientious people have more adaptive ways of coping with things when things go wrong,” Hill says. “Perfectionists feel every bump in the road. They’re quite stress-sensitive.”

Perfectionists can make smooth sailing into a storm, a brief ill wind into a category-five hurricane. At the very least, they perceive it that way. And, because the ironies never end, the behaviours perfectionists adapt ultimately, actually, do make them more likely to fail.

Tennis star Serena Williams is a self-described perfectionist who destroys racquets and casts blame when things go wrong – outbursts which have cost her the game. Credit: Alamy.

In one lab experiment, for example, Hill gave both perfectionists and non-perfectionists specific goals. What he didn’t tell them was that the test was rigged: none of them would succeed. Interestingly, both groups kept putting in the same amount of effort. But one group felt much unhappier about the whole thing – and gave up earlier. Guess which.

Faced with failure, “perfectionists tend to respond more harshly in terms of emotions. They experience more guilt, more shame,” says Hill. They also experience more anger.

“They give up more easily. They have quite avoidant coping tendencies when things can't be perfect.”

That, of course, hinders them from the very success that they want to achieve. In his 60-plus studies focusing on athletes, for example, Hill has found that the single biggest predictor of success in sports is simply practice. But if practice isn’t going well, perfectionists might stop.

It makes me think of my own childhood peppered with avoiding (or starting and quitting) almost every sport there was. If I wasn’t adept at something almost from the get-go, I didn’t want to continue – especially if there was an audience watching. In fact, multiple studies have found a correlation between perfectionism and performance anxiety even in children as young as 10.

Perfectionism and performance anxiety often are intertwined in adolescents and children, research has found. Credit: Getty Images.

The trouble is that, for perfectionists, performance is intertwined with their sense of self. When they don’t succeed, they don’t just feel disappointment about how they did. They feel shame about who they are. Ironically, perfectionism then becomes a defence tactic to keep shame at bay: if you’re perfect, you never fail, and if you never fail, there’s no shame.

As a result, the pursuit of perfection becomes a vicious cycle – and, because it’s impossible to be perfect, a fruitless one.

***

Perfectionism is also dangerous. Record numbers of young people are experiencing mental illness, according to the World Health Organisation. Depression, anxiety and suicide ideation are more common in the US, Canada and the UK now than a decade ago. Research shows that perfectionistic tendencies predict issues like depression, anxiety and stress – even when researchers controlled for traits like neuroticism. Worsening matters, being self-critical might lead to depressive symptoms but those symptoms then can make self-criticism worse, closing a distressing loop.

Mental health problems aren’t just caused by perfectionism; some of these problems can lead to perfectionism, too. One recent study, for example, found that over a one-year period, college students who had social anxiety were more likely to become perfectionists – but not vice versa.

It’s also been shown that one of the most robust protections against anxiety and depression is self-compassion – the very thing that perfectionists lack. And self-criticism, which perfectionists are so good at, predicts depression.

When it comes to the most dramatic example, suicide, numerous studies also have found that perfectionism is a lethal contributor all on its own. One found that perfectionism made depressed patients more likely to think about suicide even above and beyond feelings of hopelessness. A recent meta-analysis, the most complete on the suicide-perfectionism link to date, found that nearly every perfectionistic tendency – including being concerned over mistakes, feeling like you are never good enough, having critical parents, or simply having high personal standards – was correlated with thinking about suicide more frequently. (The two exceptions: being organised or demanding of others).

Some of those criteria, particularly pressure from parents and perfectionistic concerns, also were correlated with more suicide attempts.

“Black-and-white thinking can lead perfectionists to interpret failures as catastrophes that, in extreme circumstances, are seen as warranting death,” the researchers wrote. “Our findings also join a wider literature suggesting that when people experience their social world as pressure-filled, judgmental, and hypercritical, they think about and/or engage in various potential means of escape (eg, alcohol misuse and binge eating), including suicide.”

Perhaps because a perfectionist's body is often awash with stress, perfectionism is correlated with earlier death. Credit: Getty Images.

And while conscientious people tend to live longer, perfectionists die earlier.

In many ways, poorer health outcomes for perfectionists aren’t that surprising. “Perfectionists are pretty much awash with stress. Even when it’s not stressful, they’ll typically find a way to make it stressful,” says Gordon Flett, who has studied perfectionism for more than 30 years and whose assessment scale developed with Paul Hewitt is considered a gold standard

Plus, he says, if your perfectionism finds an outlet in, say, workaholism, it’s unlikely you’ll take many breaks to relax – which we now know both our bodies and brains require for healthy functioning.

***

No matter how self-defeating perfectionism may seem, it’s a tendency being shared by more and more people. The meta-analysis by Hill and Curran is the first to comprehensively look at rates of perfectionism over a long period of time. (There are so many ways of measuring perfectionism out there, researchers had to wait until a solid one – in this case, Flett’s and Hewitt’s – had been around long enough and been used across enough studies). In all, the studies added up to a pool of more than 40,000 US, UK and Canadian undergraduate students.

There were increases across the board from 1989 to 2016. But the largest rise was in ‘socially prescribed perfectionism’, characterised by the feeling that others have high demands: 32%. “The reason that’s so problematic is that’s the dimension most strongly correlated with serious mental illness,” says Curran.

The findings align with what’s been reported previously. One 2015 study of gifted suburban adolescents, for example, found “significantly higher scores of perfectionism (especially unhealthy dimensions) than previous studies”. A decade-long look at adolescent Czech math whizzes found the same.

In her clinical practice, where she often works with patients with eating disorders, Egan has seen it too. “I’m constantly shocked by the age ranges. We’re seeing younger and younger presentations of girls: seven years old, eight years old,” she says. “That’s often driven by perfectionism. So, I think, yes: each generation probably is getting more perfectionistic.”

Where is this increase coming from? When you keep in mind the idea that perfectionism stems from marrying your identity with your achievements, the question might become: where isn’t it coming from?

After all, many of us live in societies where the first question when you meet someone is what you do for a living. Where we are so literally valued for the quality and extent of our accomplishments that those achievements often correlate, directly, to our ability to pay rent or put food on the table. Where complete strangers weigh these on-paper values to determine everything from whether we can rent that flat or buy that car or receive that loan. Where we then signal our access to those resources with our appearance – these shoes, that physique – and other people weigh that, in turn, to see if we’re the right person for a job interview or dinner invitation.

Curran and Hill have a similar hunch. “Failure is so severe in a market-based society,” points out Curran, adding that that has been intensified as governments have chipped away at social safety nets. Competition even has been embedded in schools: take standardised testing and high-pressure university entrances. As a result, Curran says, it’s no wonder that parents are putting more pressure on themselves – and on their children – to achieve more and more.

Rather than perfectionism leading to academic success, researchers have found high-achieving adolescents are more likely to become perfectionists. Credit: Getty Images.

“If the focus is on achievement, then kids become very averse to mistakes,” Curran says. “If children come to internalise that – the idea that we only can define ourselves in strict, narrow terms of achievement – then you see perfectionistic tendencies start to come in.” One longitudinal study, for example, found that a focus on academic achievement predicts a later increase in perfectionism.

Similarly, the gold-star method of parenting and schooling may have had an effect. If you get praised whenever you do something well and not praised when you don’t, you can learn that you’re only really worth something when you’ve had others’ approval.

If other strategies, like making children feel guilty for making a mistake, come in, it can get even more problematic. Research has found that these types of parental tactics make children more likely to be perfectionists – and, later, to develop depression.

Fear of failure is getting magnified in other ways, too. Take social media: make a mistake today and your fear that it might be broadcast, even globally, is hardly irrational. At the same time, all of those glossy feeds reinforce unrealistic standards.

As well as reinforcing unrealistic standards, social media gives us more reason to fear making mistakes. Credit: Getty Images.

Some perfectionism is inheritable. But it also arises because of environment (after all, if it were just genetic, it seems unlikely it would be increasing so much). So how can parents counteract it? Model good behaviour by watching their own perfectionistic tendencies, researchers say. And exhibit unconditional love and affection.

“It’s saying things like ‘You really tried hard at that. I’m proud of the effort you put in.’ It’s about creating an environment where imperfection isn’t just accepted but is celebrated – because it means we’re human,” says Rasmussen, who co-authored an analysis on how family systems can breed perfectionism. “Or communicating to the child that love and care aren’t conditional on performance.

“It’s the idea that you don’t have to be perfect to be lovable or to be loved.”

***

Perfectionism can be a particular challenge to treat. You can train someone to be more self-compassionate in a therapeutic setting. But if they go back to the office, say, with the same demanding boss and same deep-seated behaviours, a lot of that can go out the door.

Then, of course, there is that widespread (if erroneous) belief that being a perfectionist makes us better workers (or parents, or athletes, or whatever the task is at hand).

“The difficult part of it, and what makes it different than depression or anxiety, is that the person often values it,” says Egan. “If we have anxiety or depression, we don’t value those symptoms. We want to get rid of them. When we see a person with perfectionism, they can often be ambivalent towards change. People say it brings them benefits.”

She’s helped her patients by helping them prove to themselves that’s not the case. If someone says, for example, they need to do three extra hours of work at home each night to be good at their job, they might experiment with not doing that for a week. Usually the patient not only finds that it makes no difference – but that the extra rest might even improve their performance.

I’ve experimented with some of that letting go myself. It’s gone hand-in-hand with becoming aware when I’m taking on too much and exhausting myself in my attempt to do ‘enough’ (an amount, I’ve realised, that for me doesn’t actually exist).

The bigger piece, though, is replacing that critical ticker-tape with kinder messages – toward both myself and others. I’ve started (with varying success) consciously stopping myself from overreacting to other people’s mistakes. More difficult, but also important, has been stopping myself from overreacting to my own. Ironically, that includes trying not to criticise myself when I fall short of that goal in itself.

It’s a work in progress. But what I’ve noticed is that, each time I’m able to replace criticising and perfecting with compassion, I feel not only less stressed, but freer. Apparently, that’s not unusual.

“It can be liberating, allowing imperfection to happen and accepting it and celebrating it,” Rasmussen says. “Because it’s exhausting, maintaining all of that.”

Amanda Ruggeri is the special projects editor and a senior journalist at BBC.com. You can follow her on Twitter at @amanda_ruggeri.

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This post originally appeared on BBC Future and was published February 20, 2018. This article is republished here with permission.

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