What Is Clinical Perfectionism?
Perfectionism takes many forms, but clinical perfectionism is marked by two painful forces:
Unrealistically high personal standards
Harsh self-criticism when those standards aren’t met
According to Hewitt and Flett’s model (1991), there are three types:
1. Self-Oriented Perfectionism
You place impossible expectations on yourself and measure your worth entirely by achievement. Even small mistakes feel like moral failures.
Linked to: depression, disordered eating, chronic low self-worth, and stress-related health issues in young adults.
2. Socially-Prescribed Perfectionism
You believe others are judging you harshly, and that love or approval is conditional on success. You’re constantly scanning for disapproval.
Linked to: anxiety, burnout, social withdrawal, and suicidal thoughts in youth (Curran & Hill, 2019).
3. Other-Oriented Perfectionism
You expect others to be perfect and become highly critical when they fall short. This can strain relationships and mask deeper insecurities.
Linked to: interpersonal conflict, lack of trust, and hostility (Hewitt & Flett, 1991).
Perfectionism’s main core processes include: intense fear of making mistakes, fears of being a failure, strong attachment to high-standards, rules for both ourselves and those around us.
With perfectionism the person’s sense of self is based on accomplishments.
A person struggling with problematic perfectionism may not be able to perform a task unless they know they can do it perfectly; they may view the end product as the most important part of any undertaking, and as a result, spend lots of time scrutinizing and reviewing all the various details, perhaps to the point of never completing the task as it is never “right.”
“I can’t relax until everything’s done—perfectly.”
Jonah is a 22-year-old university student. He’s known as the “responsible one.” He turns in assignments early, proofreads emails three times before hitting send, and never shows up to class without a color-coded notebook and meticulously formatted slides.
From the outside, Jonah seems like an ideal student. But on the inside, he’s unraveling.
He spends four hours rewriting a two-paragraph response. He avoids applying for internships because his résumé “isn’t impressive enough.” He doesn’t start creative projects he cares about because he’s afraid they won’t be perfect. He has trouble falling asleep at night, replaying every “mistake” he made that day.
Jonah’s not just driven. He’s stuck in a loop that perfectionism often creates: an endless cycle of striving, self-doubt, fear of judgment, and avoidance.
And he’s far from alone.
Let’s consider Summi’s situation. Summi “puts a lot of pressure on (herself) to get things right” this includes multiple areas of her life, her school work, her friendships, as well as taking care of the things she owns.
Summi spends hours on her homework, going over it again and again to make sure that she got everything right. When giving advice to her friend, she replays it in her mind to make sure she gave the best advice possible, and will often revisit the topic with the friend to revise her advice, even after the situation is resolved.
When shopping for a laptop, Summi asks herself “how efficient is it,” “will I be able to keep it for years,” and “it needs to be a good investment of my money.” It feels very important to her that she make the “best choice” and often making choices makes her feel anxious and she spends hours researching laptop options.
What Problematic Perfectionism Looks Like—Beyond Work or School
Perfectionism shows up in many everyday places. Let’s meet a few more examples:
Lena, 34, Parent and Partner
Lena spends hours planning Pinterest-worthy birthday parties, making homemade lunches, and researching the “perfect” parenting techniques. She rarely asks for help because it feels like failure. She often feels resentful, but then guilty about her resentment.
At night, she lies awake wondering if she’s emotionally damaging her kids.
“I always feel like I’m not doing enough—like I’m falling short as a mom.”
Carlos, 28, Fitness Enthusiast
Carlos started going to the gym to feel healthy and confident. But now he’s tracking every calorie, avoiding social events with food, and criticizing himself if he misses a workout.
He follows fitness influencers who seem to have flawless bodies. Even though people compliment his physique, he constantly compares himself to others online.
“I feel like I have to maintain an image
Perfectionism Is on the Rise – And It’s Hurting Our Mental Health
Perfectionism might sound like a “humblebrag”—the classic job interview answer to “what’s your biggest weakness?” But for millions of people, it’s a serious mental health risk.
A major meta-analysis by Curran & Hill (2019) analyzed data from over 40,000 college students in the U.S., U.K., and Canada between 1989 and 2016. Their conclusion? Problematic perfectionism has increased significantly across generations—especially the kind rooted in fear of judgment and social rejection.
Other studies confirm the toll:
- 68% of students report perfectionistic tendencies that interfere with school, sleep, or well-being (Rice et al., 2016).
- High perfectionism is linked to higher rates of anxiety, depression, eating disorders, and suicidal ideation (Flett & Hewitt, 2002).
- According to the American Psychological Association (2023), perfectionism is now viewed as a “transdiagnostic risk factor”—a contributor to a wide range of mental health disorders.
What Is Problematic Perfectionism, Really?
Unlike healthy striving—which is flexible, values-driven, and motivating—problematic perfectionism is rigid, fear-driven, and exhausting. It’s less about doing your best and more about avoiding the shame of falling short.
What It Looks Like in Everyday Life (Not Just at Work or School)
We often picture perfectionists as overachieving professionals or high-performing students. But problematic perfectionism shows up in everyday areas, too:
Work & Career
- Rewriting emails ten times before sending
- Avoiding leadership roles for fear of criticism
- Micromanaging every detail and burning out
- Feeling unable to delegate without anxiety
Academics
- Procrastinating due to fear of starting “wrong”
- Obsessing over grades and feedback
- Comparing yourself constantly to peers
Home Life
- Refusing to have guests unless your space is spotless
- Being rigid about routines, parenting, or planning
- Feeling like you’re “failing” at being a partner or parent
Social Media & Body Image
- Spending hours editing posts or selfies
- Comparing yourself to idealized images
- Feeling ashamed of your appearance or “not being enough”
Relationships
- Hiding vulnerability out of fear of being “too much”
- Constant people-pleasing and fear of disapproval
- Feeling unworthy of love unless you’re perfect
Why Problematic Perfectionism Is So Hard to Let Go Of
Perfectionism often works—at first.
You get good grades. Praise. Promotions. Likes. Approval. But over time, the cost outweighs the benefits:
- You stop taking risks.
- You lose touch with what matters to you.
- You feel anxious even when you succeed—because it still doesn’t feel like enough.
And because your self-worth is tied to performance, even small mistakes can feel devastating.
The Psychological Processes Behind Problematic Perfectionism
According to Zurita Ona and others, problematic perfectionism is maintained by a few core psychological processes:
- Fusion with Critical Thoughts
You treat perfectionistic thoughts like facts:
“If I make a mistake, people will see I’m incompetent.”
“I must get everything right or I’ll fail.”
You don’t just have these thoughts—you believe them and act on them.
- Experiential Avoidance
You avoid feelings of failure, shame, or imperfection at all costs. This might look like:
- Procrastinating to avoid starting a task you could “mess up”
- Overworking to prevent mistakes
- Withdrawing from social events because you don’t feel “together” enough
- Rigid Rules and Standards
You live by harsh, internalized “shoulds”:
“I should always look put-together.”
“I should never disappoint anyone.”
These rules aren’t flexible—they’re absolute, and violating them feels like a catastrophe.
- Self-as-Content
You define your identity by performance:
“If I mess this up, it means I am a failure.”
All of this creates what Zurita Ona calls “the perfectionist system”—a trap where your behavior is dictated by a need to control inner discomfort rather than live from values.
When Perfect Becomes Painful: How Problematic Perfectionism Fuels Anxiety (and What to Do About It)
“If I don’t get this exactly right, I’ve failed.”
Monica is a 32-year-old grad student working on her dissertation. Her topic is timely and impactful, her advisor supportive, and her research well underway. Yet she can’t seem to submit anything. She revises the same paragraph ten times. She spends hours second-guessing sentence structure. When she finally turns in a draft, she’s exhausted—and convinced it’s not good enough.
But this isn’t just about school. Monica spends over an hour getting dressed each morning, fearful of looking sloppy. She avoids hosting friends because she doesn’t think her apartment is clean enough. She scrolls Instagram comparing herself to others’ curated lives and feels behind in every way.
Monica isn’t lazy, unmotivated, or dramatic. She’s struggling with problematic perfectionism—a pattern of rigid, relentless self-demands that feels impossible to satisfy.
And she’s not alone.
You Are Not Your Achievements
If you’re nodding along to any of this, know that you’re not broken—you’re human. In a world that constantly tells you to do more, be more, and show only your best side, it’s brave to slow down and ask: Who am I if I’m not perfect?
You deserve to live a life guided by meaning, not fear. A life where mistakes are part of the process, not a reflection of your worth.
The effectiveness of Acceptance and Commitment Therapy (ACT) for Perfectionism
Acceptance and Commitment Therapy (ACT) is a third-wave behavioral therapy that focuses on increasing psychological flexibility—the ability to act in alignment with values, even in the presence of difficult thoughts and feelings. This is particularly well-suited to perfectionism, which is fueled by rigid thinking, experiential avoidance, and fusion with self-critical beliefs.
A growing number of clinical trials, case series, and systematic reviews have investigated ACT’s efficacy for perfectionism, especially the maladaptive, anxiety-linked form seen in high-achieving individuals, students, and people with comorbid conditions like depression and anxiety.
References
- Curran, T., & Hill, A. P. (2019). Perfectionism is increasing over time: A meta-analysis of 27 cohorts. Psychological Bulletin, 145(4), 410–429.
- Flett, G. L., & Hewitt, P. L. (2002). Perfectionism: Theory, Research, and Treatment.
- Harari, M. B., Swider, B. W., Steed, L. B., & Breidenthal, A. P. (2018). Is perfect good? A meta-analysis of perfectionism in the workplace. Journal of Organizational Behavior.
- Ong, W. M., et al. (2019). The effectiveness of Acceptance and Commitment Therapy (ACT) for clinical perfectionism: A systematic review. Behaviour Research and Therapy.
- Rice, K. G., et al. (2016). Perfectionism in college students: A growing concern. Journal of Counseling Psychology.
- American Psychological Association. (2023). Trends in perfectionism and mental health. APA Monitor.
