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Perfectionism is a personality trait characterized by a desire for flawlessness and the setting of high performance standards, accompanied by critical self-evaluation and concerns regarding others’ evaluations. While the pursuit of excellence can be beneficial, excessive perfectionism can lead to significant psychological distress and impairment in functioning.

Epidemiological studies have estimated the prevalence of perfectionism in the general population to be between 2% and 20%, with higher rates among certain groups such as individuals with eating disorders and those in high-achieving occupations. Perfectionism has been associated with comorbidities such as depression, anxiety, eating disorders, and substance abuse.

Symptoms for Perfectionism

Some of the symptoms of perfectionism include setting unrealistic goals, being overly critical of oneself and others, procrastination, and difficulty making decisions. Perfectionists may also struggle with anxiety, low self-esteem, and depression. They may be perfectionists in some areas of their life but not in others, and the severity of their perfectionism can vary. In general, perfectionism can be a double-edged sword, as it can drive a person to achieve great things but can also cause significant stress and emotional distress.

Here are some of the main symptoms of perfectionism:

  • Setting extremely high and unrealistic standards for oneself and others.
  • Being overly critical of oneself and others.
  • Procrastination or difficulty making decisions.
  • Persistent feelings of anxiety, inadequacy, and low self-esteem.
  • Depression, or feeling like a failure when unable to meet one’s own high standards.
  • A tendency to be perfectionists in some areas of life but not in others.
  • A tendency to engage in black-and-white thinking and to see things as either perfect or flawed.
  • A tendency to be overly focused on details and to pay excessive attention to minor details.

It’s important to note that not everyone who exhibits these symptoms has perfectionism. These symptoms may be present in people with other mental health conditions as well. If you are concerned about your own perfectionism or that of someone you know, it’s best to talk to a mental health professional for a proper diagnosis and treatment plan.

Cause and Risk Factors for Perfectionism

The cause of perfectionism is not well understood and is likely to be multi-factorial. Cognitive and behavioural theories have posited that perfectionists have overly high standards and expectations for themselves and others, which lead to negative thoughts and behaviours when these standards are not met. Neurobiological studies have suggested that perfectionism may be related to altered activity and functioning in brain regions involved in emotion regulation and decision making.

Risk factors for the development of perfectionism include genetic predisposition, early life experiences, and societal and cultural influences. Perfectionistic parents or caregivers, critical feedback, and the promotion of achievement and performance as key values in one’s environment have all been implicated in the development of perfectionistic tendencies.

Outlook for Perfectionism

Prognosis for individuals with perfectionism depends on the severity and chronicity of their symptoms, as well as their willingness to seek treatment. Cognitive-behavioural therapy (CBT) has been found to be effective in reducing perfectionistic tendencies and associated distress. In severe cases, medication may be necessary to address comorbid conditions such as depression or anxiety.

Therapy for Perfectionism

Treatment for perfectionism typically involves psychotherapy, with the goal of reducing perfectionistic tendencies and associated distress. Various types of therapy have been found to be effective in treating perfectionism.

Emotion-focused therapy (EFT) is a type of psychotherapy that focuses on helping people identify and understand their emotions and how they affect their thoughts and behaviors. This type of therapy can be helpful for people with perfectionism because it can help them learn to accept their imperfections and recognize that it’s okay to make mistakes. In EFT, people with perfectionism may be encouraged to identify and express their feelings, such as shame or anxiety, and to work through these emotions in a healthy and constructive way.

  • One of the key components of EFT for perfectionism is working through shame. Perfectionists often experience intense feelings of shame when they are unable to meet their own high standards or when they make mistakes. This shame can be deeply ingrained and can be difficult to overcome. In EFT, a therapist can help a person with perfectionism understand the roots of their shame and develop strategies for coping with it. This may involve building self-compassion, learning to accept imperfections, and developing a more balanced and realistic perspective on one’s own performance.

Cognitive-behavioural therapy (CBT) is a type of psychotherapy that focuses on the relationship between thoughts, emotions, and behaviors. In the treatment of perfectionism, CBT aims to identify and modify perfectionistic thought patterns and behaviors that contribute to distress. This may involve setting more realistic and flexible standards for oneself, challenging negative thoughts and beliefs, and learning to tolerate uncertainty and imperfection.

Dialectical behaviour therapy (DBT) is a form of CBT that emphasizes acceptance and change. In the treatment of perfectionism, DBT aims to help individuals balance their pursuit of perfection with acceptance of their limitations and imperfections. This may involve learning mindfulness skills to increase awareness and acceptance of one’s thoughts and emotions, as well as developing healthy coping strategies for dealing with perfectionistic urges.

Acceptance and commitment therapy (ACT) is a type of psychotherapy that focuses on increasing psychological flexibility and accepting one’s thoughts and feelings. In the treatment of perfectionism, ACT aims to help individuals let go of their rigid and unrealistic standards for themselves and others, and instead focus on their values and goals. This may involve learning to distinguish between unhelpful perfectionistic thoughts and more helpful and realistic ones, and committing to actions that align with one’s values.

Choosing the right type of therapy for a person struggling with perfectionism will depend on their individual needs and preferences. A mental health professional, such as a therapist or psychiatrist, can help determine the best course of treatment.

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