What is maladaptive perfectionism, and when is it a problem?

Striving for excellence, paying close attention to detail, and aiming to do your very best in your pursuits can be a good thing. It makes you set big goals, pushes you to always do better, and might even help you achieve your most ambitious dreams. What could be bad about that? 

In many cases, nothing! But if you’re constantly striving for perfection in everything that you do—and can’t accept anything less—you might wonder: What if your perfectionism is actually hurting you more than you believe it helps you? 

We’re here for that question—and any others that you might have. Like: Is there such a thing as healthy perfectionism? When does it veer into unhealthy territory, also known as maladaptive perfectionism, and what would that look like? What causes this harmful form of perfectionism? How can it impact your life and mental health? And what can you do if maladaptive perfectionism has you feeling burned out, drained, and distressed, instead of accomplished and capable? 

It can be exhausting and demoralizing to deal with this kind of unrelenting perfectionism, but stay with us, because if you think you need help, you can absolutely get the relief you need. 

When does perfectionism become maladaptive?  

Performing at the healthy level of discipline and attention to detail required to pursue excellence often helps you achieve goals in school, athletics, at work, and in your personal pursuits. These kinds of tendencies and behaviors are sometimes referred to as adaptive perfectionism, and as we’ve said, it can be a positive trait. 

When your need for perfectionism becomes your driving force, however, and the fear of being imperfect brings you intense psychological distress that seeps into every area of your life—that’s when it can veer into unhealthy territory, says Monique Williamson, LMFT, a licensed therapist with NOCD. This kind of perfectionism is referred to as maladaptive perfectionism. 

If you’re a perfectionist, it’s normal to have a fear of failure. It sort of goes with the metal territory. “But if you have maladaptive perfectionism, you’re more focused on not doing things wrong, whereas with perfectionism there’s a drive to make what you do as good as possible, and to accomplish things,” says Williamson.   

In healthy perfectionism, you might be ambitious and hardworking, but are able to be proud and happy about the fruits of your labor, and acknowledge when you do things well, as opposed to maladaptive perfectionism that makes you chase unrealistic expectations, and focus on areas in where you feel like you’ve fallen flat, instead of celebrating the times when you’ve excelled. 

This difference means that with maladaptive perfectionism, you’re ruled more by fear than positive motivation. 

There’s also an unrealistic—or even impossible—element to the goals that you set for yourself if you have this condition. You might expect that you’ll accomplish way too much in a very small timeframe—to be better than everybody else, or learn everything there is to know about a certain subject, so you can only score 100% on your tests, or get nothing else but praise from your boss.  

This can create a perfect storm of self-criticism and extreme distress, when you’re unable to live up to your too-high expectations, that leads to low self-esteem, shame, and negative self-talk. It can be paralyzing and cause debilitating behaviors like procrastination and indecisiveness. You might deal with constant self-imposed pressure that feels exhausting. You might even participate in self-punishment to “make up” for whatever you did that wasn’t done to your high standards.  

What’s worse: If you struggle with maladaptive perfectionism, you might not be able to enjoy the things that you worked so hard to accomplish, because you’re so focused on what you might have done wrong. 

What causes maladaptive perfectionism? 

There are several things that can make you develop maladaptive perfectionist tendencies—usually in adolescence or as an adult—including your upbringing, culture, and general mental health. 

One of the biggest factors that can shape the way that you view accomplishments and failures is the environment you were raised in. For example, if you had huge expectations placed on you your whole life, then you’re likely to place a higher value on your achievements. The same holds true if you were expected to perform and excel as a child. Similarly, if you were praised for your perfectionism and accomplishments in your younger years, you might always find yourself striving for that same pedestal of perfection in the years to come. 

Additionally, if you were raised in an environment where imperfections were not tolerated or forgiven, you may have internalized those values. 

All of these factors could make you more likely to exhibit perfectionist behaviors that might become maladaptive.  

Mental health can also be a huge contributor to maladaptive perfectionism tendencies. Low self-esteem, for example, may cause you to crave value through your accomplishments. Unsurprisingly, maladaptive perfectionism is often associated with mental health conditions like anxiety and depression. There’s even a link between perfectionism and eating disorders. 

Is there a link between maladaptive perfectionism and OCD? 

Obsessive-compulsive disorder (OCD) is a mental health condition that is often portrayed as one that involves perfection and control, so it might make you wonder if your symptoms and OCD could be linked. 

However, Williamson says that perfectionism and control aren’t actually symptoms of OCD themselves. Instead, OCD is defined by the presence of obsessions and compulsions. Obsessions are intrusive thoughts, feelings, images, and urges that go against your usual values and ways of thinking—and because of that, they bring a great deal of distress. When you have OCD, these disturbing obsessions cause you to engage in repetitive and ritualistic actions, called compulsions, that are meant to make you feel better, or prevent something bad from happening. 

Even though it isn’t an inherent part of OCD, she adds that perfectionism can show up in patients with OCD, in a number of ways. For example, you may feel the need to act on your compulsions perfectly because, if you don’t, the consequence is dealing with the extreme anxiety and distress that your obsessive thoughts bring. Or, on the other hand, your obsessive thinking might involve the belief that if things aren’t perfect, something bad will happen or you’ll feel “off.”

That’s what drives a particular subtype of OCD called perfectionism or “just right” OCD. If you have perfectionism OCD, you could have obsessions with symmetry, organization, or evenness, and you might feel the compulsive urge to correct any imperfections to feel better. You may even have rituals that you think need to be carried out perfectly in order to stop something bad from happening—for example, turning the light switch on and off an exact number of times to keep something awful from happening if it’s somehow not perfect.   

The need for perfection in people with OCD is driven specifically by obsessions and related compulsions, rather than a personal drive to achieve or complete something flawlessly. However, there are some notable overlaps and similarities. For example, Williamson notes that both people with OCD and people with maladaptive perfectionist tendencies often find themselves ruminating on things that may be going wrong, rather than what has been done well, and how they can fix those perceived errors—albeit for different reasons. “There’s also an all-or-nothing kind of thinking that is also common with this type of perfectionism. What you do is either perfect or totally flawed,” she adds. 

In both OCD and maladaptive perfectionism, the mentality is often that imperfection in any form can’t be tolerated. Falling short can bring intense anxiety and distress in both cases. 

What to do if your perfectionism is causing significant distress 

It’s simple: Find the right form of help. Therapy can be extremely effective—so you don’t have to live the rest of your life under constant pressure from your unrealistic expectations. Yes, you can still strive for the best, but in a healthier way.

If maladaptive perfectionism is taking over your life, messing with your self-esteem, and burning you out, cognitive behavioral therapy (CBT) can be an invaluable resource. One of the key benefits of working with a mental health professional is that they can help you learn how to move away from your unrealistic—or even impossible—expectations that you set for yourself. 

“When you set unrealistic standards, you’ll always fail,” Williamson says. “Most perfectionists have already done way above average. So it’s about learning that things don’t always have to be 100% for them to be good.” 

Your therapist might help you learn how to use different frameworks to set goals for yourself that are actually achievable, rather than improbable or even impossible, so you eventually reach a healthier frame of mind when it comes to your accomplishments. 

Additionally, when working with patients who struggle with maladaptive perfectionism, Williamson says she likes to shift the focus to what they can do well, not what they did wrong. Your therapists might help you become comfortable with mentally lowering your impossible standards so that you can be proud of the good you’ve done, even if it isn’t what you might deem perfect.  

Finally, if you think you may be struggling with OCD, the most effective treatment is a specialized type of therapy called exposure and response prevention (ERP). While traditional talk therapy can be a useful tool for maladaptive perfectionism in general, it can actually make OCD even worse. ERP was developed specifically to treat OCD, and is clinically proven to be highly effective in the majority of people. 

ERP works by having you confront the thoughts and fears that cause distress, and learning new ways of responding, rather than engaging in compulsions. Eventually, your brain learns that you can handle things being imperfect, and that you don’t need to rely on compulsions to feel better.

It works in specific therapy exercises that trigger your discomfort related to perfection. For example, Williamson has had clients color outside of the lines in a coloring book or use a “wrong” color, make typos on a public forum or an email, or call somebody by the wrong name—in other words, all things that are purposefully imperfect. When you learn that you can handle imperfection and that you don’t have to fix these things, you become better able to live life on your own terms, rather than chasing an impossible standard of perfection.

This type of therapy can be transformative. You may no longer feel distress when your intrusive thoughts and urges strike—meaning that you’ll be able to notice them enter your mind, and just let them pass by. And as a result, your need to engage in compulsions will go away. 

If in-person sessions aren’t convenient for you, you can always go virtual. Still not sure about telehealth? We hear you. But research actually shows that ERP can be more effective when done virtually, delivering results in less time than traditional outpatient ERP therapy, often in as little as 12 weeks.

At the end of the day, there’s a subtle but significant difference between striving for a job well done and aiming for absolute perfection. When you find the right help, you can start to live a life in which you can learn to acknowledge your accomplishments and hard work without constantly forcing yourself to chase unreachable goals.