Understanding Perfectionism: Psychology, Trauma and Healing

Perfectionism is often misunderstood as simply the drive to do things well. In therapy, perfectionism shows up more as a survival strategy. It is rooted in early experiences, shaped by relationships, and reinforced by cultural messages about worth and success.

While some people describe themselves as “high achievers,” perfectionism is not the same as healthy ambition. Ambition can be flexible, adaptive, and connected to intrinsic motivation. Perfectionism is rigid, fuelled by fear, and often accompanied by self-criticism. The cost is high: exhaustion, shame, anxiety, and disconnection from oneself.

What is Perfectionism?

Psychologists Paul Hewitt and Gordon Flett (1991) describe three main forms of perfectionism:

• Self-oriented perfectionism: holding oneself to impossibly high standards

• Socially prescribed perfectionism: fearing that others demand perfection from us

• Other-oriented perfectionism: expecting perfection from others

Each of these patterns can bring distress. For many people, more than one is present at the same time, creating a cycle of striving, shame, and isolation.

Where Does Perfectionism Come From?

Donald Winnicott (1960) introduced the concept of the “good enough parent”. He emphasised that children do not need flawless parenting, but a consistent, attuned caregiver who helps them feel safe enough to grow. When care is inconsistent, critical, or conditional, children often learn that being perfect is the surest way to secure love and avoid rejection.

Bessel van der Kolk (2014) highlights how trauma influences this pattern. When the body is in a state of heightened vigilance, perfectionism can serve as protection. The unconscious logic becomes: If I never make a mistake, I will be safe. If I achieve enough, I will not be abandoned. Seen in this way, perfectionism is less about ambition and more about survival.

Perfectionism is also reinforced by cultural narratives that equate worth with productivity, success, and appearance. In a society that prizes performance, it can feel as if there is no room for vulnerability or error.

The Cost of Perfectionism

On the outside, perfectionism can look like success. At work, it may be praised, and in relationships it may appear as attentiveness. But beneath the surface, it often carries anxiety, burnout, and a relentless fear of failure.

The perfectionist voice is rarely satisfied. No matter how much is achieved, the inner critic insists it is not enough. This can lead to procrastination, avoidance, and difficulty celebrating successes. Perfectionism can also create distance in relationships, as fear of judgment or rejection makes it hard to show up authentically.

Moving Beyond Perfectionism

Kristin Neff’s (2003) work on self-compassion offers an important antidote. She describes three key practices:

• Self-kindness: offering warmth to ourselves instead of harsh criticism

• Common humanity: recognising that imperfection is part of being human

• Mindfulness: noticing our suffering without over-identifying with it

Self-compassion does not mean lowering standards or ignoring mistakes. Instead, it allows us to respond to imperfection with care. This creates a more sustainable and supportive path for growth and learning.

Healing Perfectionism in Therapy

In therapy, the work with perfectionism is about curiosity rather than judgment. Together, therapist and client trace how perfectionism developed and how it is carried in the present. This involves noticing the thoughts, the emotional weight, and also the body’s signals - the tightening, the vigilance, the drive.

Over time, therapy creates a relational space where imperfection is allowed. This can be profoundly reparative. Clients often find themselves grieving the early conditions that made perfectionism necessary, while slowly discovering that love and acceptance can exist without constant striving.

Healing perfectionism can come through loosening the grip of fear so that choices and achievements come from authenticity rather than pressure. This shift allows for creativity, connection, and a deeper sense of self-worth.

Perfectionism may have once been necessary, but it does not need to define a whole life. With compassion and support, it becomes possible to step out of its grip and move toward a way of being that is guided less by fear and more by care and authenticity.

References

Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60(3), 456–470.

Neff, K. D. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85–101.

Van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking.

Winnicott, D. W. (1960). The theory of the parent-infant relationship. International Journal of Psychoanalysis, 41, 585–595.