Managing unhealthy perfectionism: 5 thought patterns to watch out for

Perfectionism can be both healthy and unhealthy. Healthy aspects of perfectionism include setting high personal standards, while unhealthy perfectionism include aspects like concerns about mistakes, doubts about own actions, fear of negative evaluation by others, and feelings of discrepancy between expected and actual achievement.¹ Unhealthy perfectionism is linked to a wide range of negative outcomes including depression, poor coping skills,² anxiety,³ burnout,^4,5 and performance anxiety.^6,7

An important contributing factor in the maintenance of unhealthy perfectionism is cognitive biases, or unhelpful thought patterns,⁸ which are often habitual – you can be totally unaware of them.

Below are five main cognitive biases which play a role in the maintenance of unhealthy perfectionism. This article is mostly based on the book Cognitive-Behavioural Treatment of Perfectionism by Sarah Egan and colleagues.⁸ I think the best way to understand these biases is through examples, so I’ve provided fictional scenarios of Paul the Perfectionistic Pianist!

1. “All-or-nothing” thinking

Paul has a performance exam coming up and thinks:
A: If I get 90 + in my performance exam, then I will be happy
B: If I get anything below 90, I’m a total failure

This type of ‘black or white’ thinking (known as dichotomous thinking) is a core component of unhealthy perfectionism and is a key differentiating factor between the positive and negative aspects of perfectionism.^2,9 Judging standards in a rigid, dichotomous way (either you succeed or fail, and there is nothing between) can lead to harsh self-criticisms and generalisations (e.g. “I didn’t get 90 so I am a failure”).

One way to challenge this could be to reframe your thoughts as being on a continuum: rather than a performance being a “success” or a “failure’, imagine a continuum between the two and think about where in this space you would place your performance.

2. Noticing negatives and failures, discounting positives and successes

Paul receives markers’ comments for his performance. The markers enjoyed his performance very much and praised him for many aspects of his performance—they thought it was musical and conveyed the character well. The markers also provided several criticisms. They said that he used too much pedal and there was one section which was not as polished as the rest of the piece.

Paul feels upset. He thinks that he got a terrible feedback and that his performance was a failure. He thinks, “I should’ve practised that section more. And I knew that I was using too much pedal, why didn’t I just use less? I bet the markers always say that they enjoy performances just to be nice”.

This type of selective attention, where one only focuses on the negatives and failures, is a common bias of perfectionists. Positive outcomes are ignored or seen as being not that valuable. The markers said that they enjoyed Paul’s performance, but Paul discounts this by thinking, “I bet the markers always say that just to be nice”.

In fact, when perfectionists succeed, they reset their standards—they believe that it was too easy for them and that therefore it should not count as a success. The following example illustrates this:

Paul wins first prize at a local competition. His friends congratulate him but Paul thinks, “I only won because many people didn’t turn up. Besides it’s just a small local competition, it doesn’t mean anything”.

Because of this, perfectionists reset a higher goal when they achieve one, creating a vicious spiral in which they can never feel like they have succeeded.

3. Double standards

Paul has a small memory slip in a performance. He thinks to himself afterwards, “I played so badly, it was an absolutely disastrous performance. I’m a total failure, everyone must think that I’m a terrible musician…”

Six months later, Paul’s friend has a memory slip in their performance. Paul goes up to the friend who is very upset and says, “Oh it wasn’t so bad…you recovered pretty well, half the people probably didn’t even notice!”

A good way to identify double standards is to ask some questions to yourself. For example:

• Do you have one set of rules and standards for yourself, and a different one for other people? Are you more ‘lenient’ with other people and ‘stricter’ with yourself?
• Imagine a friend was in your exact situation. Would you think and/or say the same thing? What would say to them?

4. Overgeneralising

Perfectionists tend to generalise by believing that one mistake makes them a failure in general. For example, look back at the previous example about the memory slip—does one memory slip in a performance really make you “a total failure” and a “terrible musician”?

It is also important to think and reflect about what it means to be a “failure as a person”. For many musicians, their identity and self-esteem as a musician is closely tied to their identity and self-esteem as a person, meaning that criticisms or setbacks in their musical life can deeply affect their self-esteem in general.¹⁰ It is important to remember that you are more than just a musician—you are a person!

5. Shoulds and musts

Perfectionists may constantly put themselves under pressure and stress through countless ‘should’ and ‘must’ statements in their self-talk. Here are some examples of thoughts which a musician might have:

• “I must practise four hours a day”
• “I should always be productive and never waste time”
• “I must always give excellent performances”
• “I should have practised more for the performance”

Below are some questions you can ask yourself to challenge these ‘should’ and ‘must’ thoughts:

• How many times a day do you say ‘should’ or ‘must’ to yourself?
• How do ‘should’ and ‘must’ statements make you feel?
• Could you replace ‘should’ and ‘must’ with “I would like to…” or “I would prefer to…”?

Take home message

To summarise, the main cognitive biases associated with the maintenance of unhealthy perfectionism include:

• “All-or-nothing” or “black and white” thinking
• Noticing the negatives and discounting the positives
• Setting double standards
• Overgeneralising
• Should’s and must’s

These cognitive biases are often habitual and automatic, so simply identifying them and becoming aware of your thought patterns is an important first step.

Once you identify them, you can challenge them. One way to challenge your own thoughts is to ask yourself questions. For example:

These types of challenging questions can help you review your thoughts in a more critical and objective manner, and slowly weaken the power of these cognitive biases.