Obsessive Compulsive Disorder (OCD) and Perfectionism

Perfectionism OCD, also referred to as "just right" OCD, is a subtype of obsessive-compulsive disorder that involves obsessive thoughts and compulsive behaviors about making things "perfect."

This form of OCD is often characterized by needing things to be done perfectly or correctly. It can lead to intense obsessions and checking behaviors. People also experience feelings of anxiety about what will happen if things are not perfect.

What Is Perfectionism?

Before we talk about perfectionism and OCD, it's important to define perfectionism. Some perfectionism can be helpful, making you more conscientious and goal-directed. Excessive perfectionism, on the other hand, can leave you stuck in a pattern of unrealistic expectations that has a negative impact on your well-being and ability to function.

So how can you know what is good (and not only good but ideal) and what is not? Research on perfectionism has indicated that there are two main types of perfectionism: adaptive/health perfectionism and maladaptive/unhealthy perfectionism.

Adaptive/Healthy Perfectionism

Adaptive/healthy perfectionism tends to be associated with good psychological well-being and high achievement both at school and at work. This type of perfectionism is characterized by:

• Conscientiousness
• Goal-directed behavior
• Good organizational skills
• High standards for yourself as well as others
• Persistence in the face of adversity

Maladaptive/Unhealthy Perfectionism

Maladaptive/unhealthy perfectionism, on the other hand, has been associated with distress, low-self esteem, and symptoms of mental illness. This type of perfectionism is characterized by:

• Being heavily invested in the high expectations of others, such as parents or employers
• Doubts about whether you are doing something correctly
• Excessive preoccupation with control
• Excessive preoccupation with past mistakes
• Fears about making new mistakes

OCD and Perfectionism

The unhealthy form of perfectionism has been strongly linked to obsessive-compulsive disorder (OCD). Perfectionism appears to be particularly strong if you have a strong need for things to be done “just right” or require certainty.

Tied to a Need for Certainty

For example, unhealthy perfectionism tends to be very high if you feel that your compulsions have to be done in exactly the right way. In these cases, it is not uncommon to believe that if the compulsion is carried out perfectly, a feared outcome, such as the death of a loved one, will be avoided.

May Increase Checking Behaviors

Unhealthy perfectionism tends to be high if your OCD symptoms revolve around checking. Specifically, if you do not feel you have perfect certainty that you have locked the door or turned off the stove, you might return to check these items repeatedly.

Tied to this is the excessive fear of making a catastrophic mistake. You might worry about things such as leaving the door open all day or burning down the house by leaving the stove on.

Can Intensify Obsessions

Unhealthy OCD perfectionism may help to perpetuate obsessions. For instance, like many people with OCD, you might believe that you must have complete control over your thoughts.

When a bizarre or distressing thought pops intrusively into your mind, you label these thoughts as dangerous because they are out of your control. This causes you to monitor the thought even more closely, which can help to create an obsession.

Coping With OCD Perfectionism

What can you do to cope with OCD perfectionism? The first step is to recognize OCD in yourself as well as your perfectionistic tendencies. There are a few things that can work particularly well in coping.

Adopt a Mindful Stance

Mindfulness emphasizes being less "invested" in our thoughts. Accepting that we have less control than we think over our thoughts can be very helpful in reducing the distress that often accompanies intrusive thoughts. Mindfulness meditation exercises can help to promote a more objective awareness of our day-to-day thoughts and emotions.

Cognitive Behavioral Techniques

Techniques often used in cognitive behavioral therapy (CBT) can also be helpful. Techniques such as cognitive restructuring and behavioral experiments can be helpful in learning to objectively evaluate the likelihood and/or consequences of making catastrophic or even minor mistakes.

Practice Giving Up Control

As part of cognitive behavioral therapy and/or exposure and response prevention therapy, you may be asked to participate in exercises designed to build distress tolerance. This is your capacity to tolerate a loss of control.

Examples include things that involve being prevented from checking something or adjusting something until it is "just right." Although this can initially be extremely distressing, over time, you will gain more confidence in your ability to tolerate a loss of control.

Living With OCD Perfectionism

There are a number of things that you can do to address both symptoms of OCD as well as perfectionism. Some ideas:

• Try self-help strategies. Many of the self-help behaviors that help people cope with OCD may also help with perfectionism.
• Work on changing unhealthy perfectionism. Specifically, addressing perfectionism related to the condition is likely to help with many aspects of the disorder.
• Work on overachieving behaviors. Techniques that help overachievers address perfectionism may also make a difference with OCD.

Perhaps the most important point of noting the role of perfectionism with OCD, however, is to recognize how OCD is different for everyone. Whatever personality traits a person has can come to play in the disorder.

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Summary

If you need help with symptoms of OCD, perfectionism, or both, talk to your doctor or a mental health professional. A therapist can help you navigate your journey through life with OCD. Studies suggest that between 32% and 70% of people with the condition can achieve remission, and others can find significant relief from their symptoms.