Perfectionism & OCD: Understanding the Connection & Differences

What Is Perfectionism?

Perfectionists generally focus on the need to perfect and “correct” themselves.¹ They often base their self-worth on achievements, and the only way they can feel confident is to be flawless or seen as such. They tell themselves that if they stop ever achieving, they will lose the admiration of others. There is no middle ground for perfectionists, and second place is not good enough. Children with perfectionism may be highly sensitive compared to other children their age, experience anxiety, depression, and low frustration tolerance.

Adaptive Vs. Maladaptive Perfectionism

Some people can have healthy (adaptive) levels of perfectionism, while for many it can become a problem.

Here are the key distinctions between adaptive and maladaptive perfectionism:

• Adaptive Perfectionism: Adaptive perfectionism is characterized by being goal-oriented and motivated toward success.
• Maladaptive Perfectionism: Maladaptive perfectionism causes the person to fear failure, judge themselves and others, and be unable to accept anything less than perfection from themselves and others.

What Is OCD?

Obsessive compulsive disorder (OCD) is a diagnosable mental health condition characterized by unwanted recurring thoughts or images (obsessions), which create anxious thoughts and/or repetitive behaviors (compulsions). Someone with OCD may organize and keep things arranged in a particular manner, but it’s more of an effort to manage anxiety, and not evidence of perfectionism.

OCD Vs. Perfectionism

In general, perfectionists make no room for mistakes. They can also be excessively preoccupied with past mistakes, previous offenses, and fear of future failures. Those closest to them may feel like they cannot do anything right due to their exacting standards. However, unlike OCD, perfectionism is not a diagnosable condition.

Perfectionism Vs. OCD

Is Perfectionism a Type of OCD?

Perfectionism is not a specific type of OCD, but it is an associated symptom for many with OCD. People with OCD tend to overestimate their responsibility in a situation and struggle to tolerate uncertainty, which can lead to perfectionism. Many people with OCD will be perfectionistic, while not all perfectionists will have OCD. “Just right” OCD is a subtype of OCD that can involve perfectionism. In this type of OCD, people are preoccupied with something being exact or precise.

Perfectionism OCD Symptoms

“Just right” OCD is a subtype that shares many traits with perfectionism. A person with this disorder needs everything to be perfect, orderly, or complete. This can also overlap with symmetry OCD. A person with this type of OCD has obsessive thoughts about perfectionism, followed by compulsive acts like arranging objects, checking, or repeating tasks until they feel perfect.

Some symptoms of OCD that overlap with perfectionism include:

• An obsessive belief that things aren’t right or how they should be
• A need for things to be done in a very specific way
• Repeatedly arranging or lining up objects
• Repeating tasks over and over until they feel perfect
• Checking objects and tasks repeatedly

Is Perfectionism a Personality Disorder?

Most of us have perfectionist tendencies around things that are very important to us, such as planning a big event. Maladaptive perfectionism, however, can be a sign of a personality disorder, typically OCPD. When someone focuses on perfection so much so that they don’t complete the work they have to do or hold up their commitments to the people they love, it could be a sign of a personality disorder.

Perfectionism in OCD Vs. OCPD

In OCD, the need for perfectionism is driven by fear and anxiety. Compulsions are performed to prevent terrible things from happening. OCD has a severe impact on a person’s ability to function, is upsetting, and usually feels irrational. Unlike OCD, with OCPD, the need for perfectionism does not feel irrational or problematic. A person with OCPD truly strives for perfection in their life and doesn’t see it as a problem.

Does Perfectionism Cause Obsessive Compulsive Disorder?

Though there may be a bidirectional relationship between OCD and perfectionism, it is impossible to say that perfectionism causes OCD. The more likely explanation is that the same factors that could lead someone to become a perfectionist could trigger OCD, like significant life stressors or even childhood trauma.

Connections Between Perfectionism & OCD

While many people have certain habits that look like OCD, such as color-coding their clothing, eating the same thing for lunch every day, or refusing to use a public toilet, OCD is much more complicated. OCD causes significant disruption in one’s life and is more than just a collection of habits or “quirky” behaviors.

Here are a few of the connections between OCD and perfectionism:

A Need for Certainty

A need for certainty means that a person will not engage with something or do an activity unless there is absolute clarity regarding the outcomes. There is no room for chance or risk in this person’s life.

Perfectionism Can Increase Checking Behaviors

Since perfectionists cannot tolerate making a mistake, they may check and recheck items frequently. This checking behavior could include their work, their door locks, or their stove.

Perfectionism Can Make Obsessions Worse

Obsessions tend to be irrational and rigid, and they allow perfectionism to grow. Perfectionism can lead a person to increase the frequency or intensity of their obsessions, which in turn increases the need to perform compulsions, heightening the OCD cycle.

How Do I Stop Obsessive Perfectionism?

For those who are dealing with OCD and perfectionistic tendencies, there are many ways to cope. Initially, ways to deal with OCD perfectionism include practicing recognition and acceptance. Then, they can challenge the unhelpful or harmful thoughts and tendencies. This is often the most difficult step because it can feel unnatural to question the way we think and feel about expectations and high standards. If you believe you have OCD, seeking professional treatment should be the first step.

The following tips can be helpful in coping with OCD perfectionism:

• Decrease overachievement: When people neglect their health to pursue perfection in work, school, and other areas of life, overachievement becomes a threat to physical and emotional well-being. Try to recognize the value of effort vs. outcome, and reward success along the way.
• Practice mindfulness: Mindfulness involves focusing on the present moment without imposing outside judgments. When we focus on the present moment rather than some potential future, we can reduce anxiety.
• Practice letting go: Through exposure to situations that are less than perfect, a person can learn to tolerate the distress associated with imperfection and the thoughts that accompany these situations.
• Learn to evaluate and challenge your critical thinking: People who struggle with perfectionism tend to listen to the negative thoughts in their heads more than the average person. These thoughts need to be identified and challenged.
• Define what “perfect” actually means and whether it’s possible for you to actually achieve: Think about what it would take for something to actually be perfect. Is this realistic, or even possible? What would it take for someone to achieve this? If it’s literally impossible, you may start to see the need to change your thinking.
• Test your perfectionistic predictions: Do some experiments, and intentionally do some things less perfectly than you usually would. Intentionally leave some room for errors and see if the things you dread the most actually happen.  
• Practice self-care: Neglecting one’s physical and emotional needs will increase stress and inhibit their ability to be successful.
• Learn to accept criticism: The art of distinguishing between criticism and personal attack is a crucial skill in personal growth.
• Take up a hobby that you’re not instantly good at: Try a hobby that you are new at intentionally to learn about how you can give grace to yourself regarding not being perfect on the first try.
• Join a support group: Support groups are great at helping you to feel more seen and heard within a safe and healing community. Online OCD resources can be a great place to find a support group.
• Talk to a therapist: Therapy is a great way to learn more about yourself and learn ways to cope and manage symptoms in healthy ways.

Treatment for OCD

If you are dealing with perfectionism OCD, it is important to locate a trained mental health professional. Therapists will generally utilize ERP to treat OCD and perfectionism OCD.⁵ However, there are also cases when your therapist will refer you to a psychiatrist or a psychiatric nurse practitioner for medication evaluation. Typically, if medication is prescribed, a selective serotonin reuptake inhibitor (SSRI) will be suggested.

Examples of ERP Exposures for Perfectionism OCD

An ERP therapist will use gradual exposure to a feared object or situation to help a person with OCD tolerate it without practicing their compulsions. Some possible exposures include leaving things imperfect or incomplete, tolerating asymmetry or messiness, or doing tasks only once without checking them. This can help a person tolerate the distress of things not being perfect and start to break the OCD cycle.

Finding Help for OCD

Online therapist directories and OCD-specific treatment programs like NOCD make it easy to research information like insurance coverage, populations treated, and types of treatment offered. Look for a therapist who has experience in treating OCD and utilizes exposure & response prevention (ERP). You can also consult your insurance carrier by calling the customer service number on your card. If you are having difficulty locating a mental health professional, your primary care physician (PCP) may be able to provide a list of therapists and psychiatrists in your area.