Perfectionism And OCD: What Are The Differences and Similarities?

A client came to see me recently and explained that he finds it very hard to decide almost anything. The more important the decision the more he agonizes.

He wants every decision to be “perfect”. He is often petrified of making a mistake. He becomes riddled with self-doubt, has repetitive thoughts, and will frequently procrastinate. This compulsive over reflection and insanely rigid perspective shows up in many aspects of his life, often causing him to experience intense anxiety.

He is frequently too critical of many of the women he has dated and not sure that his current girlfriend is “right” for him.

He strives to be perfect but winds up being ambivalent. He wonders whether he has Obsessive Compulsive Disorder (OCD) or is really plagued by unhealthy perfectionistic tendencies, or a  maladaptive form of excessive perfectionism.

His compulsive actions reflect a lack of self-trust and insecurity. He feels like he has to “make up” for his insecurities by striving toward perfection, never quite reaching it, but always doing more than is necessary. This leaves him feeling anxious and exhausted, unable to move forward.

What is Perfectionism?

Some people consider being called a perfectionist a boost to their ego. They feel it is a sign that they are perceived as someone who has high expectations of himself and does excellent work. And that is sometimes true.

However, being a perfectionist should not be mistaken with being a high achiever because high achievers are not necessarily perfectionists.

Perfectionism often manifests itself in different ways. There are positive aspects and negative ones as well. I’ll discuss those further in this article.

Healthy And Unhealthy Perfectionism

There is significant difference between healthy and unhealthy perfectionism.

Unhealthy (maladaptive) perfectionistic people struggle with impossibly high standards and inflexible goal setting, often causing high levels of anxiety. They don’t have the necessary flexibility to get the job done efficiently, especially under extreme or changing circumstances.

They are highly self-critical as well as fearful of being criticized by others. This can lead to a dysfunctional belief system, procrastination, over analysis and indecision.

Unhealthy or maladaptive perfectionists tend to have low self-esteem.

Mental Health Conditions Associated With Perfectionism

Common mental illnesses associated with perfectionism are:

  • Obsessive-Compulsive Disorder (OCD)
  • Eating Disorders (ED)
  • Anxiety (social anxiety, generalized anxiety disorder, panic disorder, etc.)
  • Depression

These conditions may be present without perfectionism, and perfectionism may be present without mental health conditions; however, they can often co-occur.

What Is The Link Between Anxiety And Perfectionism?

Perfectionism has been identified as a personality trait that is closely linked to anxiety. Individuals who display perfectionistic tendencies may be particularly prone to feelings of worry and fear, leading to an increase in overall levels of anxiety.

Perfectionists often strive for unattainable goals and can become overwhelmed when they are unable to meet their own expectations. This can lead to feelings of inadequacy and worthlessness, which can further heighten levels of anxiety.

Perfectionists may also be more likely to ruminate over their own shortcomings, leading to an increase in anxious thoughts. Perfectionism can also have a negative effect on an individual’s relationships with others—perfectionists may become overly critical of themselves, resulting in an inability to accept compliments and criticism from others.

The combination of these factors can create a cycle whereby the individual feels increasingly overwhelmed by anxiety, which in turn further reinforces their perfectionistic tendencies. If left unaddressed, this cycle can become entrenched and lead to more severe mental health issues such as depression and anxiety disorders.

The good news is that there are a number of strategies that can help people break this cycle and manage their perfectionism-driven anxiety.

These include learning to recognize your own standards rather than those imposed by others, setting realistic goals, engaging in calming activities such as mindfulness and yoga, and seeking professional help when needed. With help and support, it is possible to break the cycle of anxiety and perfectionism and create a more balanced life.

Healthy Perfectionism

Healthy (adaptive) perfectionists have high standards as well but are more flexible, do not have an intense need for everything to be perfect, and can tolerate things being imperfect.

Although they put forth extraordinary efforts to achieve their goals, they do not suffer from such harsh self-criticism.

They are more focused on achieving their objectives, not looking to perfection as their guiding principle. They are likely to be enthusiastic about projects and would therefore enjoy the process as well as the achievement of completion.

They are not tortured by the work but typically optimistic about the actions they are taking and can adjust to the obstacles that they confront.

Healthy or adaptive perfectionists tend to have high self-esteem.

Is Perfectionism Obsessive Compulsive Disorder (OCD)?

No, perfectionism is not a mental health disorder or a mental illness or necessarily a form of  Obsessive Compulsive Disorder (OCD). It is more a personality trait than a mental health condition.

People who have perfectionist tendencies tend to strive for excellence not out of fear, but because they’re motivated by the reward or satisfaction of controlling their lifestyles.

People who have OCD are essentially driven by specific fears. The fear of not doing something perfectly can be so intense that it results in compulsive behaviors, such as repeatedly checking and rechecking that the doors are locked or the stove is turned off. The urge to repeat actions derives from the feeling of dread or anxiety if they do not complete them perfectly.

Obsessive-compulsive personality disorder is characterized by a preoccupation with orderliness, perfectionism, and control. It is an extreme form of perfectionism that can cause significant distress or impairment in day-to-day functioning.

What Is OCD?

According to   Obsessive Compulsive Disorder is an Anxiety Disorder in which a person has uncontrollable, thoughts (obsessions) and/or behaviors (compulsions) that compel him to have repetitive behaviors and sometimes perfectionistic tendencies.

The obsessive and unwanted thoughts are often driven by fears and the compulsive actions are typically an attempt to quell those fears. For example, a fear of germs or contamination would be followed by the ritualistic behavior of repeated hand washing.

Unhealthy perfectionism in its most extreme form can be associated with OCD. It is a characteristic that OCD sufferers tend to have.

Treatments For OCD

There are several treatments available for OCD, depending on the severity of symptoms. Generally speaking, psychotherapy (cognitive behavioral therapy or exposure and response prevention) is often recommended as a first line treatment for people with OCD.

This type of therapy helps individuals become aware of their obsessive thoughts and teaches them how to manage compulsions in order to reduce symptoms.

In some cases, medication may be prescribed in addition to psychotherapy. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed medications for OCD, as they can help reduce the severity of obsessions and compulsions.

“One of the most effective ways of coping with obsessive-compulsive symptoms – including perfectionism – is called exposure and response prevention. To use response prevention, a person would deliberately stop him or herself from performing rituals or other activities that he or she would normally do to work toward perfection.” –

One of the new ways of treating OCD is neurofeedback therapy. It works by providing feedback to a person about their brain activity and can help them learn to regulate the amount of anxiety they feel when faced with challenging situations.

Neurofeedback has been found to be effective in reducing the symptoms of OCD, particularly those related to perfectionism.

“Neurofeedback for OCD is a safe and effective treatment aimed at reducing the intensity and frequency of a patient’s OCD-related symptoms. While there is no cure for OCD, neurofeedback therapy can help patients achieve improved control of their thought and behavioral patterns so they can have a higher quality of life. ” –

No matter what treatment you choose, the important part is to be aware of your own needs and know that there are many ways to effectively manage OCD. With the help of a healthcare professional, you can explore which treatment options will work best for you.

Are You A Perfectionist?

Perfectionism (the unhealthy kind) is often thought to be a maladaptive way of dealing with one’s own feelings of discomfort, insecurity and fears. It is not easy or comfortable but stressful and often disappointing.

Below are some characteristics of a maladaptive perfectionist. If you have some or more of these characteristics you probably have struggled to get past their limitations. You might have been undermining your own success in your professional life as well as your social life and may want to finally change those dysfunctional patterns and get control of your life.

You can be helped.

The Symptoms Of Unhealthy Perfectionism

Very critical: Unhealthy perfectionists tend to be much more critical of themselves and of others than average. Instead of taking pride in their achievements they are likely to find flaws in almost everything they (or someone else) does, despite its merits. They favor unproductive criticism.

No middle ground: Maladaptive perfectionists set high goals, often too high to achieve, thereby setting themselves up for failure. Even if he is on track, because he is so unrelentingly critical he may think it a failure.

He is an all or nothing type of thinker, thereby always falling short of satisfaction.

Fear of failure: If you think about the process of meeting objectives on the way to a goal,  you realize why perfectionists are afraid of failing. Since they are likely to be unsatisfied with their progress, they frequently see themselves as falling short, therefore they tend to be unhappy, somber or depressed much of the time.

Procrastination: They tend to procrastinate because they tend to worry so much about how something will turn out that they end up in a sort of paralysis, unable to move ahead as they get consumed by always second guessing decisions.

Defensiveness: Because maladaptive perfectionists are so critical, they are not likely to take any criticism well. They tend to become defensive and angry with anyone offering them opinions.

Low self-esteem: Maladaptive perfectionists are often depressed or at least unhappy human beings most of the time. They see themselves as “not perfect” and anything less than perfect is unworthy.

Inflexible: Flexibility or adaptability is a sign of good mental health and goes a long way in fostering creativity. Unhealthy perfectionists are often inflexible and unable to ease up and relax.

Overcoming Unhealthy Perfectionism

Perfectionism is not hereditary. It is typically a learned dysfunctional pattern that takes hold.

It is not in your genes so you can learn to change it by recognizing your traits and working to improve them. If you want to become a more adaptive perfectionist and less rigid read on.

Enjoy The Process: Stay in the NOW! Don’t over concern yourself with the product of your work but how well the process is going. Enjoying the process is key to success in almost any endeavor.

Do Better Goal Setting: Set goals that are simple, achievable and have clear objectives included. When you complete an objective (a step in the goal process) congratulate yourself and mean it!

Face The fear: Whenever you feel anxious about what you are doing ask yourself why. Recognize that everyone gets anxious about achieving success and that it should not cause you to become paralyzed.

Review And Celebrate Your Successes: Reflect on what you have achieved and be proud of it! Almost everyone can point to something they have worked for and achieved so don’t sell yourself short.

Welcome Constructive Criticism: Learn to take criticism, especially from people you respect, and use it to improve. Defensiveness is your enemy, learn to be open minded.

Learn To Adapt: If something is not working then try something else. Don’t let yourself get stuck in self-recriminations. Adaptability or flexibility enhances creativity and keeps your mind resilient.

Is Perfectionism Good Or Bad?

Clearly that depends on the type you have. If it’s adaptive it’s good. If it’s maladaptive, it’s bad.

Other Articles Of Interest:

The Top 10 Barriers To Self Growth

How To Overcome Being Overwhelmed

How Can Creative Thinking Be Improved

About the Author

Dr. Stan Hyman is a licensed psychotherapist and life coach in private practice in Miami, Florida. He works with people wanting to perform more creatively and at higher levels in both their professional and personal lives. This includes individuals, couples and business partners.