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OCD and Perfectionism

Perfectionism Oftens Means Being Better Than Perfect

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Updated September 01, 2010

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Perfectionism has long been thought to play a role in the development and maintenance of OCD and other forms of mental illness. Let’s explore the relationship between OCD and perfectionism.

What is Perfectionism?

Research on perfectionism has indicated that there are two main types:

Adaptive/Healthy Perfectionism: This type of perfectionism is characterized by high standards of yourself as well as others, persistence in the face of adversity, and conscientiousness. Healthy perfectionism usually goes along with goal-directed behavior and good organizational skills.

Maladaptive/Unhealthy Perfectionism: This type of perfectionism is characterized by excessive preoccupation with past mistakes, fears about making new mistakes, doubts about whether you are doing something correctly and being heavily invested in the high expectations of others, such as parents or employers. An excessive preoccupation with control is also a hallmark feature of maladaptive/unhealthy perfectionism.

In general, while adaptive/healthy perfectionism tends to be associated with good psychological well-being and high achievement both at school and at work, maladaptive/unhealthy perfectionism has been associated with distress, low-self esteem and symptoms of mental illness.

OCD Perfectionism

The unhealthy form of perfectionism has been strongly linked to OCD. Perfectionism appears to be particularly strong if you have a strong need for things to be done “just right” or require certainty. For example, unhealthy perfectionism tends to be very high if you feel that your compulsions have to be done exactly the right way. In these cases, it is not uncommon to believe that if the compulsion is carried out perfectly, a feared outcome, such as death of a loved one, will not take place.

Likewise, unhealthy perfectionism tends to be high if your OCD symptoms revolve around checking. Specifically, if you do not feel you have perfect certainty that you have locked the door or turned off the stove, you might return to check these items over and over again. Tied to this is the excessive fear of making a catastrophic mistake, such as leaving the door open all day or burning down the house by leaving the stove on. Ironically, checking over and over again reinforces the idea that you are not perfect or possibly even "losing your mind." This can make you feel even worse and less self-confident which, of course, sets you up to do more checking.

Finally, unhealthy OCD perfectionism may help to perpetuate obsessions. For instance, like many people with OCD you might believe that you must have complete control over your thoughts. As such, when a bizarre or distressing thought pops intrusively into your mind, you label these thoughts as dangerous because they are out of your control. This causes you to monitor the thought even more closely, which can help to create an obsession.

Tips for Dealing with OCD Perfectionism

Learn Cognitive-Behavioral Techniques: Techniques such as cognitive restructuring and behavioral experiments can be helpful in learning to objectively evaluate the likelihood and/or consequences of making catastrophic or even minor mistakes. Cognitive therapy can also be a useful tool for critically examining the beliefs we hold about ourselves and others.

Practice Giving up Control: As part of cognitive-behavior therapy and/or exposure and response prevention therapy, you may be asked to participate in exercises designed to build your capacity to tolerate a loss of control. This can involve being prevented from checking something or adjusting something until it is "just right." Although this can initially be extremely distressing, over time you will gain more confidence in your ability to tolerate a loss of control.

Adopt a Mindful Stance: Mindfulness emphasizes being less “invested” in our thoughts. Accepting that we have less control than we think over our thoughts can be very helpful in reducing the distress that often accompanies intrusive thoughts. Mindfulness meditation exercises can help to promote a more objective awareness of our day-to-day thoughts and emotions.

Sources:

Bieling, P.J., Israeli, A.L., & Antony, M “Is perfectionism good, bad or both? Examining models of the perfectionism construct" Personality and Individual Differences 2004 36: 1373-1385.

Chik, H.M., Whittal, M.L., O'Neil, M.L."Perfectionism and treatment outcome in obsessive-compulsive disorder" Cognitive Therapy Research 2008 32: 676-688

Frost, R.O., & Steketee, G. "Perfectionism in obsessive-compulsive disorder" Behavior Research Therapy 2010 35: 291-296

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