The Cautionary Tale of One Pathological Perfectionist
Why pathological perfectionism is similar to addiction and how to recover from it.
“Welcome to America,” the immigration officer said after taking a long time to compare Anna’s (not her real name) face to the photograph in her immigration documents.
So it was the end and the beginning. The end of checking the mailbox in hope of an invitation to the interview at the U.S. embassy. The end of checking the mailbox for the letter granting refugee status. The end of packing her entire life, that of her husband, and their young child into three bags. The end of one perfectly executed plan and the beginning of another.
Anna spoke rudimentary English but her ears refused to process it. This was the first discovery she made at JFK airport when English turned out to be just white noise that came from all directions. Discovery number two: while $3 was a small fortune in her country, it was the price of a bottle of water at JFK. It was also 1% of all money her family of three had.
These two discoveries alone would have made any immigrant seriously doubt their ability to achieve the American Dream. Not Anna. Whenever her plans A,B,C, and D failed, there was always another day for another plan.
Fast forward 15 years. Anna and her family are the epitome of the American Dream: well-paying professional jobs, a house in a middle class suburb, and a child in the top-ranked private school.
Anna’s story could have been a great candidate for an article about refugees whose pursuit of happiness had a big payoff. Except that Anna’s is not the story of success. It is the cautionary tale of extreme perfectionism paving the road to failure.
As Anna set in her therapist’s office half-listening to the gray-haired woman whom she met several months ago, she kept asking herself the same question over and over again: “How did it all go so wrong and how to get it under control?”
She needed to figure out her action plan before her short-term disability due to depression expired in two weeks, and she had to resume her corporate job complete with the pager and 60-hour work week. For the first time in her life, Anna didn’t know where to begin.
One more therapy session down the drain, Anna thought as she drove home. The moment she entered her house, she took off her shoes and put them neatly next to each other. She didn’t eat today but her depression robbed her of hunger. She felt nothing other than profound emptiness.
Still, she went into the kitchen, put on her spotless apron, and proceeded to make soup for her husband and son. As always, she carefully washed the cutting board and the knife when she was done. Before Anna went to her bedroom, she adjusted the tablecloth to make its corners perfectly even.
When Anna got into bed, she pulled the blanket over her head. In the darkness that enveloped her, the scene appeared in her mind’s eye. The airport. The immigration officer. It was neither the end nor the beginning. It was the beginning of the end, the series of perfect plans leading to an impasse.
But Anna was wrong. She didn’t realize that her decision to leave her old country behind had nothing to do with what was happening to her. Wherever she would go, she would always bring with her something she was not aware of, something that would eventually lead to the same result.
Anna’s story is not unique. It is not limited to women or immigrants. It can happen to anyone with extreme perfectionism. It is the story of addiction. Pathological perfectionism is an addiction to the idea of perfection. It is the notion that only reaching a certain ideal can bring happiness.
However, just like with any addiction, the serotonin rush is short-lived. With time, it takes more effort to create the spike of endorphins because the greater past success, the higher the fear of failure. That’s why extreme perfectionism is as self-destructive as addiction.
There are many theories about the cause of pathological perfectionism. None of them are definitive. But most researchers agree that extreme perfectionism is a complicated mixture of nature and nurture and usually comes with comorbidity. The BMC Psychiatry study “The relationships between perfectionism, pathological worry and generalised anxiety disorder” concluded the following:
“Comprehensive reviews have reported dimensions of perfectionism playing a key role in mood disorders, eating disorders and various anxiety disorders. Perfectionism is significantly elevated in social phobia, obsessive-compulsive disorder (OCD), and panic disorder with agoraphobia compared to controls. Dimensions of perfectionism have also been shown to significantly relate to symptomatology in social phobia, OCD, panic disorder with agoraphobia, and post-traumatic stress disorder.”
This is what makes pathological perfectionism so challenging to diagnose and treat. In extreme cases like Anna’s, it involves medication.
Lawrence Needleman, Ph.D. suggests that the road to recovery starts with identifying the driving factors behind the individual’s perfectionistic behaviors.
“Cognitive behavioral therapy enables you to recognize patterns of responses. With therapy, you’ll learn to recognize:
-your perfectionistic beliefs and rigid rules
-the related distress and excessive behavioral strategies
-triggers for these reactions
-the short and long-term consequences for themselves and others.You’ll be encouraged to experiment with specific new ways of behaving and more balanced ways of thinking.”
Once Anna got her depression under control with the aid of medication, her therapist shared the worksheet that was meant to help Anna identify the correlation between situation, thought, feeling, and behavior. With daily use, Anna learned that what she considered her biggest asset was what set her on the road to failure.
She discovered that her “perfect” plans were not so perfect after all. Their every step always required meticulous execution. Nothing less was acceptable to Anna. She treated everything with priority except her health.
When the therapist challenged some of Anna’s rigid beliefs, it became obvious that they played a big role in Anna’s professional burnout. Some of them were influenced by her native culture, upbringing, and competitive nature.
Anna shared that she experienced anxiety in social settings and often felt that she “didn’t fit in.” The therapist helped her identify the list of situations that made her uncomfortable. Anna was surprised that there were many more than she realized.
Anna’s need for control turned out to be driven by insecurity and anxiety. She figured out that her need to feel in control lead to her working long hours and asking for a pager because she needed “to make sure that everything is going smoothly.”
Despite getting great reviews from her manager, Anna thought that her colleagues didn’t perceive her as hardworking. When the therapist asked her to elaborate on this aspect of Anna’s professional relationships, it turned out that Anna was the one who felt her colleagues were not working hard enough based on her standards.
It frustrates Anna that everything she was so proud of — her high standards, the unwavering attention to detail, stick-to-itiveness — could be just some of the symptoms of her extreme perfectionism. She agrees that in order to change the status quo, she needs to become more flexible by getting better at identifying and eliminating “black or white” thinking patterns.
Most importantly, Anna understands there is no perfect road to recovery from her pathological perfectionism because she needs to confront some of the habits, rituals, and values which took years to develop.
