Perfectionism: A Lurking Epidemic

girl looking in mirror

As a child, colouring in was probably one of my favourite activities, but I can still vividly recall the day in kindergarten where the crayon in my hand slipped slightly, making a mark outside of the solid black line on my drawing. My lower lip started trembling. Tears started filling my eyes. I was devastated. This was just one of many moments in my life where the smallest mistake would fill me with grave devastation and a sense of failure. Welcome to the life of a perfectionist. 

Contrary to popular belief, those who suffer from perfectionism do not find it pleasurable or beneficial, in fact, pursuing extreme and unrealistic standards, or having these imposed on oneself by others, is a tormenting way of living. Even when perfectionists achieve success objectively, such as getting distinctions, graduating, getting promoted, or publishing their first book, they are unable to enjoy their successes and will consider them abject failures. For example, instead of celebrating their graduation, they will focus on how hard they had to work to get there, or if they get promoted, they will focus on how much harder they will now have to work to get to the “next level”. Despite the fact that perfection does not exist, perfectionists live their lives as if perfection is attainable and believe that attaining perfection, or moving closer to perfection, will somehow make their lives complete. Perfectionism, in this regard, is a means of gaining external approval and validation to repair a fractured, shameful sense of self. 

Perfectionists ruminate chronically about their imperfections, constantly over-evaluating their performances, stooping over what could have been or should have been, and experiencing considerable anxiety when they cannot keep up to these unrealistic standards. When they inevitably fail, it just compounds their already tormenting feelings of shame, guilt, and perceived inadequacy and worthlessness. 

Perfectionism: A double-edged sword

When used strategically and intentionally, perfectionism may produce some tangible benefits, such as higher levels of accomplishment. As humans, we are born with an internal drive to improve ourselves, strive for bigger ideals, and seek out opportunities for growth. This internal drive for betterment is inherit in each of us and when used strategically can lead to some of our best accomplishments. It is an internal “pull” towards reaching our goals. However, when this need for betterment of ourselves becomes a “push” towards our goals instead of a “pull”, that’s where things get dark. This “push” towards a goal is fuelled by an internal fear of failure, a fear of not being good enough. This “push” is perfectionism.  

Unfortunately the “pros” of perfectionism do not outweigh its “cons”. At its core, perfectionism is a personality vulnerability factor that is associated with significant negative consequences, including depression, anxiety, eating disorders, body dysmorphia, obsessive compulsive disorder, social anxiety disorder, agoraphobia, addiction, loneliness, early mortality, and suicide. As stated by Sarah Egan, a senior research fellow at the Curtin University in Perth who specialises in perfectionism, eating disorders and anxiety, “It [Perfectionism] is something that cuts across everything, in terms of psychological problems. There aren’t that many other things that do that.”

Perfectionism is not just a way of behaving in the world, but a way of being in the world. It’s not about setting high standards, it’s about setting unattainable standards. It’s not about the fear of failure, but about feeling like a failure.

Within my practice, patients will very often present with clinical symptoms like depression, anxiety, burnout, panic attacks, disordered eating or exercise patterns, addictive behaviours, or interpersonal difficulties, only to find their perfectionism rooted at the core. Given its extensive impact, it is not surprising then that perfectionism is a complex phenomenon and concerns both internal and external factors.

Perfectionism: Understanding it’s complex nature

Because of its complex nature, Hewitt and Flett (1991) considered perfectionism as multidimensional in nature, comprising three dimensions: 

  1. Self-orientated perfectionism: this is when perfectionism is directed toward the self, i.e., when people attach irrational beliefs to being perfect, hold unrealistic expectations of themselves, and are punitive in their self-evaluations.
  2. Socially prescribed perfectionism: this is when perfectionism is perceived to come from others, i.e., people believe their social context is excessively demanding, that others judge them harshly, and that they must be perfect in order to get approval.
  3. Other-orientated perfectionism: this is when perfectionistic expectations are directed toward others, i.e., people impose their own unrealistic standards on the people around them and evaluate others critically. 

Of these three dimensions, self-orientated perfectionism is considered the most complex, as it appears to have a positive motivational component where people strive for achievement of their personal goals. However, this dimension turns toxic when people start to attach their sense of self-worth to their achievements and develop an inability to derive long-lasting satisfaction from their achievements. 

Although less complex, socially prescribed perfectionism is considered the most debilitating. This is because the perceived expectations people have of what others expect of them are experienced as excessive, uncontrollable, and unfair. Resulting in the frequent experiences of failure and negative emotional states. 

Other-orientated perfectionism, on the other hand, is less widespread and is primarily present in individuals with narcissistic tendencies and those who have a desire for the admiration of others. 

Even though self-prescribed and socially prescribed perfectionism have both been positively associated with psychopathology (e.g., depression and anxiety), socially prescribed perfectionism has shown stronger associations between major psychopathologies, eating disorders, suicide ideation, and early death (Curan & Hill, 2017; Smith et al., 2016, 2017).

Therefore, the need to create awareness on the correlates and consequences of perfectionism has never been more pertinent, because instead of working towards our betterment, perfectionism is making us unhealthier, more neurotic, depressed and anxious, hampering our own potential and that of society–particularly the potential of our younger generations.

Just a few decades ago perfectionism was the exception rather than the rule, however, in today’s technology- and performance driven era, this “push” towards perfection has become the rule rather than the exception. This is corroborated by the prevalence rates of perfectionism over recent years, which has become an alarming trend. This has been evidenced by a meta-analysis cohort study conducted by Curran and Hill (2016), who tracked the increase in perfectionism between 1989 to 2016, using 41,641 college students. What they found was a linear increase in perfectionism, in particular socially prescribed perfectionism. What they also found was a worrying cultural shift

Perfectionism: A cultural value shift

This cultural shift is a change in our cultural values. Just as culture produces individual differences between countries, the culture of different time periods can produce generational differences in personality (Curan & Hill, 2016). Over the years, we have increasingly popularised and prioritised neoliberal views and meritocracy, placing importance on individual achievements and merits at the cost of collective cohesiveness and personal wellbeing. Our cultures have adopted values that are in line with the attainment of the perfectible self, driven by a relentless pursuit of meeting unrealistic standards. Over-valuing performance and undervaluing the self. Creating the belief that one is only worthy through one’s achievements. 

For parents, this shift confers an additional cost, because on top of their own individual pursuits of “parental perfection” also comes the burden of the responsibility for the successes or failures of their children. This was appropriately stated by 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… as many as two in five children and adolescents are perfectionists.”

Just as the prevalence of perfectionism has reached an all-time high, so have the rates of anxiety, depression, body dissatisfaction and eating disorders, especially among the youth. As stated by Curran and Hill (2018):

“there is growing evidence that the increase in psychological ill-health of young people may stem from the excessive standards that they hold for themselves and the harsh self-punishment they routinely engage in. Increasingly, young people hold irrational ideals for themselves, ideals that manifest in unrealistic expectations for academic and professional achievement, how they should look, and what they should own. Young people are seemingly internalizing a pre-eminent contemporary myth that things, including themselves, should be perfect.” 

One of the strongest environmental moderators between perfectionism and the development of an eating disorder is our sociocultural idealization of thinness, which has just been amplified by social media platforms. In our daily lives, we are bombarded with self-improvement messages on all fronts­, from how to get in the best shape of your life and meditate on a daily basis, to how to be more productive and break procrastination, to constantly setting goals, to reading 52 books in year (because every CEO out there reads 52 books in a year and deep down you really want to be a CEO!). As such, our daily routines are filled with unrelenting pursuits of ideal standards. We are indoctrinated with the concept of “to be exceptional you need to do the exceptional”, making any form of “normal” seem undesirable and even harmful to our success. Oh, and heaven forbid you decided to slack down for just a day, social media is right there to remind you of what a lazy git you are and how you are falling behind, wasting your time. Only for these online comparisons to fill you with feelings of guilt, shame, and inadequacy. 

Don’t get me wrong, setting goals and making an effort to pursue those are healthy for your overall wellbeing, but NOT when they are fuelled by a relentless drive for improvement and attainment of unreasonable standards. The sad part is that this drive for productivity, success and perfection is admired with little or no consideration of its consequences on our physical and psychological health.

It is evident that the rise in perfectionism does not mean that our new generations are becoming more accomplished and successful. It means that they are actually getting sicker, sadder and more unfulfilled. As such, need to start by changing our values, our cultural values!

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