Authored by: Gail Post, PhD, please note: a version of this article was previously published on Medium.

In a recent episode of The Bear, a TV series about life as an aspiring chef, lead character Carmy writes notes to remind himself that there are no exceptions to achieving perfection.

His perfectionism, though, slowly tears him apart and drives others away.

The fictional scenario plays out all too often in real life, as I often see with my psychotherapy clients. While it might seem obvious that we all need balance in life, sometimes perfection seems like the only way forward. How do we recognize when striving for perfection morphs into perfectionism — and what can we do about it?

Perfection vs. perfectionism

Perfection differs from perfectionism, even though these concepts are often used interchangeably. Perfectionism describes the traits, thoughts, feelings and behaviors that occur when self-worth hinges on accomplishments.

Perfectionism is defined by the Merriam-Webster dictionary as “a disposition to regard anything short of perfection as unacceptable, especially the setting of unrealistically demanding goals accompanied by a disposition to regard failure to achieve them as unacceptable and a sign of personal worthlessness.” The definition emphasizes the problematic role of unrealistically high standards and an attribution of worthlessness if goals are not achieved.

Quite a difference from the behavioral descriptions used to define perfection, such as: “freedom from fault or defect; flawlessness; an unsurpassable degree of accuracy or excellence.”

Yet, there is ongoing debate about whether perfectionism can be considered healthy or adaptive.

What’s so bad about perfectionism?

Perfectionism contributes to anxiety and a relentless pursuit of often unattainable goals. While most people would be thrilled to achieve something close to perfection, the perfectionist’s satisfaction quickly wanes. Concerns about whether that success can be repeated and whether the achievement was actually good enough fuel an endless cycle of worry and regret.

Anxiety is a natural response to a perceived threat. Its hallmark sensations (e.g., racing heartbeat, sweaty palms, clenched teeth) and thoughts (e.g., worries about failure, self-doubt, a sense of dread) are uncomfortable at best and devastating at worst. Anxiety is “at the core” of perfectionism and has negative consequences, wrote psychologist and perfectionism researcher Thomas Greenspan in Psychology in the Schools. It negatively affects relationships, emotional well-being, and even performance, since fear, hesitation, insecurity, and too much focus on detail hamper success.

In my clinical psychology practice, perfectionistic clients who actually seek help (many don’t) often resist lowering their expectations. Many want help to achieve greater levels of perfection — not to eliminate their perfectionism. They hate feeling anxious, but assume their anxiety will dissipate if they just try a little harder. If they could just achieve their goals. If they could just be more perfect.

Perfectionists struggle to rebound from a perceived failure experience, others’ critiques, or when success rides on a one-time event, such as an audition, concert, or sports competition. Anxiety and shame arise when perfectionists fail to live up to their own or others’ expectations. As I have written previously, failure can feel awful; it makes sense that some turn to perfectionism as the wished-for antidote to this negative experience.

Perfectionists often ruminate and worry about the what/ifs and coulda/shouldas. Intrusive thoughts about failure are their constant companions. They are always looking over their shoulder, wary that any flaw or imperfection will be discovered. They overextend themselves, preparing well beyond what is necessary to minimize any possibility of failure. Terrified of disapproval, they conform to whatever is expected, and suppress their own needs or desires.

Like a self-defeating addiction, perfectionism is seen as the essential ingredient for success, rather than as an insidious fuel for anxiety and self-hatred. Actions taken to alleviate anxiety, such as using an addictive substance, perpetuate a vicious cycle of temporary relief followed by anxiety. Other compensatory mechanisms, such as obsessive-compulsive behaviors (e.g., frequently checking your work for mistakes) both perpetuate and are fueled by perfectionism, wrote Hofstra University researcher Anthony Pinto and colleagues.

Could perfectionism be good for you?

Adaptive or healthy perfectionism, or what psychology researchers Joachim Stoeber and Kathleen Otto describe as perfectionistic strivings, suggest that a little bit of perfectionism can harness motivation. Perfectionism can drive achievement as long as it is unencumbered by excessive concerns about mistakes or others’ judgments. This is true: successful people enlist their motivation and strive for excellence.

However, theories that combine these two distinct qualities — a healthy drive for excellence with perfectionism — muddy the water and confuse the public. The act of striving for perfection is conflated with the negative effects of perfectionism, leading many people to assume that “good perfectionism” is, well… a good thing.

“A body of literature asserts that some perfectionism is healthy, even though a critical review of this literature finds no factual or theoretical basis for such a claim” wrote Greenspon. In his article, he claims that the concept of “healthy perfectionism” is an oxymoron and points out that the “commonly asserted belief in a dichotomy between healthy and dysfunctional perfectionism is based on a misunderstanding of the nature of perfectionism, in part, confusing the concept with striving for excellence.” (p. 197).

(For a deep dive into the research, see this special issue spearheaded by psychology professors and perfectionism researchers Gordon Flett and Paul Hewitt.)

When precision matters

Sometimes, though, excellence, precision, accuracy, and yes, even perfection matter.

There are times when we must strive for perfection and get it right. Most of us want our airline pilot, surgeon, and car mechanic to be focused and precise. We expect accuracy from the folks who work at nuclear power plants or secure widgets on our car’s brakes or stamp expiration dates on food labels.

Precision, conscientiousness, and accuracy are just part of the job description — all in a day’s work. But is perfectionism necessary?

Excellencism is a term proposed by University of Ottawa perfectionism researcher Patrick Gaudreau to distinguish between the pursuit of excellence and the excessive, self-defeating actions and emotions associated with perfectionism. He emphasized that excellence is possible without the harsh, self-imposed standards that contribute to anxiety and feelings of worthlessness.

Gaudreau summarized research that links perfectionism to anxiety, depression, burn-out, procrastination, and suicidal thoughts, and described the extreme expectations inherent in perfectionism, including a “tendency to aim and strive toward idealized, flawless, and excessively high standards in a relentless manner” (p. 200).

Gaudreau recommends the use of different terminology to distinguish between the negative impact of perfectionism and the positive effects associated with excellencism. “On the road toward excellence, excellencists will reach excellence and savor the satisfaction of their fully accomplished task… perfectionists will reach excellence, pursue their quest toward perfection, and may never reach their destination” (p. 201).

How to excel, strive for excellence and aim for success… without the scourge of perfectionism

The lure of perfectionistic thinking is ever-present when precision, accuracy, or a final performance are necessary components of a job or accomplishment. Demanding, competitive tasks require sacrifice and take their toll. Our sports heroes, actors, dancers, musicians, and high-end chefs are expected to give 100%, or critics swiftly blast them with harsh reviews.

For Carmy in The Bear, striving for perfection becomes an obsession. His goal of achieving excellence overrides any sense of moderation and self-acceptance.

Not everyone who strives for excellence is perfectionistic, though. Some risk factors for perfectionism include the following:

• Cultural influences (school, peers, competitive activities) that stress excellence at all costs, where failure and imperfection are not acceptable, and where harsh criticism and shaming are tactically applied to motivate improved performance.
• Family dynamics where expectations run high regarding accomplishments; when parents, siblings, or other family members are highly accomplished role models; where there are overt or unspoken messages that a child’s success will bolster a parent’s self-esteem or personal needs.
• An innate tendency toward anxiety, worry, and self-criticism, priming an individual to form high expectations and base self-worth on accomplishments. Those whose self-esteem is based on validation from others and believe they must conform to external standards are most likely to exhibit perfectionistic traits. Some research, for example, as reported by psychiatry researcher Carmen Iranzo-Tatay and colleagues, also suggests that there may be a genetic component that influences the development of perfectionism.
• A response to past traumatic experiences, where achieving perfection conveys a feeling of safety, comfort, and control. This may seem to help an individual manage emotions related to traumatic past events, but results in the pressure to always achieve, be the best, remain vigilant, excel at all costs — and does not address the actual effects of the trauma.

What needs to change

Based on the research (and what I have seen as a clinical psychologist), it seems clear that externally driven perfectionistic concerns are harmful. Yet, challenging perfectionism, changing expectations, and cultivating the self-compassion and humility to accept anything short of perfection is difficult.

Change requires greater self-acceptance and an embrace of different values — those associated with effort, integrity, compassion, endurance, drive, and resilience, rather than a relentless pursuit of success. Disengaging from an identity founded in perfectionism and accepting a “good enough” approach to life may seem counterintuitive at best, and terrifying at worst.

Families can work to prevent perfectionism by creating an environment that encourages excellence, but without harsh demands, pressure to achieve, and where acceptance, love, or approval are not contingent on outcome. A focus on effort, endurance, and progress is essential; an expectation of perfection will fuel anxiety and ultimately lead to self-doubt, avoidance, hesitation, and procrastination, all of which ironically hamper success.

Once perfectionism becomes entrenched, it can be difficult to eradicate. Psychotherapy with a licensed mental health professional is often beneficial. This might include cognitive-behavioral therapy (where harsh thinking is challenged), mindfulness practices (focusing on the present moment rather than worries about the past or future), or a more intensive psychotherapeutic approach to address trauma-based reactions or the depression or anxiety associated with perfectionism.

In a world where achievements and successful celebrities, performers, athletes, and the wealthy 1% are revered, it can be difficult to set realistic goals. However, striving for perfection and excellencism are possible without the burden of unrealistic expectations or the torment of harsh perfectionism.

Here are some helpful popular articles about perfectionism:

• The many faces of perfectionism
• The search for imperfection: Strategies for coping with the need to be perfect
• 8 signs you’re a perfectionist (and why it’s toxic to your mental health)
• The alarming new research on perfectionism
• The difference between perfectionism and healthy striving
• Perfectionists: Lowering your standards can improve your mental health