CBT for Perfectionism: Break Free from Impossible Standards

In this article I explain how perfectionism works, why it is so easy to miss, and how CBT for perfectionism can help you feel calmer, more balanced and more able to say “that’s good enough”.

Perfectionism is often described as refusing to accept any standard short of perfection, even when it comes at a cost. Many of us recognise it in ourselves. It isn’t a diagnosis in the way depression or anxiety are, but it is a very common thread running through anxiety, low mood, burnout and chronic self-criticism, and it responds well to a cognitive behavioural therapy (CBT) approach.

What is perfectionism?

Perfectionism is more than liking things done well. It is a pattern in which your self-worth becomes tied to meeting extremely high standards, usually in one particular area of life. For example:

• “I must exceed every target at work.”
• “I mustn’t let anyone down.”
• “I have to look competent and never make mistakes.”

When how you feel about yourself as a person depends on how well you perform, every task carries a threat. Walking into work each day, it is no surprise that you feel anxious: What if I miss this deadline? What if they think I’m not good at my job?

How perfectionism leads to anxiety and low mood

Standards set at an unrealistic level will, sooner or later, be missed, and if your self-worth rides on meeting them, a miss feels like personal failure. That is how perfectionism so often feeds both anxiety (worrying about falling short) and low mood (feeling “not good enough” when you do).

The problem is rarely a lack of effort. It is that the rules you are living by are impossible to keep.

Why perfectionism is hard to spot: the moving goalposts

One of the trickiest things about perfectionism is that the goalposts keep moving. If you meet your standard, it is easy to decide it wasn’t high enough, and raise the bar again. If you don’t meet your standard, you feel you’ve failed.

It is also common for people with perfectionism not to see themselves as perfectionists at all. In my work, I have heard versions of: “I can’t be a perfectionist, because I never get things perfect.” That thought is itself a hallmark of the pattern.

How thinking biases make perfectionism worse

Our minds don’t always interpret events accurately. In CBT we call these thinking errors or cognitive biases. If you are worried that a colleague thinks you’re not very good at your job, you are likely to read their kind offer of help as proof they think you’re incompetent.

High standards combined with biased interpretations leave you fighting a losing battle: the evidence is filtered to confirm the fear.

Where does your self-worth come from?

What people base their self-worth on varies from person to person. It might be work performance, academic results, relationships and friendships, or appearance, shape and weight. Most of us care about several of these.

The difficulty arises when we put all our eggs in one basket and rest most of our self-worth on a single area. Then there is no balance, and when that one area wobbles, our whole sense of self wobbles with it.

A helpful image is a ship. A basic fishing boat has one compartment below deck; one hole and it sinks. A cruise liner has many compartments, so if one is breached it can be sealed off and the ship stays afloat. If your self-worth is spread across many areas, such as work, friendships, family, hobbies, health and values, a setback in one area doesn’t sink you.

Avoidance and procrastination: the perfectionism trap

When perfectionists fear they won’t meet their standards, a common response is to put the task off for as long as possible. Avoidance brings short-term relief, but it keeps the anxiety alive and makes the task feel even bigger.

In CBT we often do the opposite of what the anxiety is telling us: we start the task, begin with the hardest part, and notice that it is far more manageable than we feared.

How CBT for perfectionism works

CBT is a practical, evidence-based talking therapy that looks at how our thoughts, feelings, behaviours and physical reactions interact. CBT for perfectionism can help you to:

• Spot the rules and standards you are living by, and where they came from
• Test out those standards through behavioural experiments, such as deliberately doing something “good enough” and seeing what actually happens
• Challenge unhelpful thinking patterns and cognitive biases
• Reduce avoidance, procrastination and over-checking
• Broaden the sources of your self-worth so that it is more balanced and resilient
• Build self-compassion and a kinder inner voice

To discuss CBT for perfectionism, get in touch here.