People with obsessive compulsive disorder often tend to be perfectionists. They want everything to be perfect, and they are afraid of making errors. This can lead to excessive preoccupation with control, as they try to avoid any situation where they might make a mistake. They may also become obsessed with past mistakes, dwelling on them and beating themselves up over them. This can make it very difficult for them to move on and live in the present.
One study conducted in 2010 found that perfectionism is associated with a high prevalence of OCD symptoms.  People who experience OCD with high levels of perfectionism are more likely to feel depressed and anxious. Perfectionism also contributes to an elevated risk of suicide.
Studies have also shown that perfectionism can influence the development and maintenance of OCD. People who exhibit high levels of perfectionism also tend to clean up their environment. It may be a result of their OCD or an independent factor. People who display high levels of perfectionism also tend to be more likely to suffer from OCD. .
What is OCD perfectionism?
OCD perfectionism is a subtype of OCD that is characterized by an excessive need for things to be perfect. People with this form of obsessive compulsive personality disorder often have extremely high standards for themselves and others, and they may spend a lot of time obsessing over details or engaging in compulsive behaviours until the result seems perfect.
People with OCD perfectionistic tendencies may feel a great deal of pressure to be perfect. This can cause them to overwork themselves and develop unhealthy eating habits. Ultimately, these behaviours can damage their health and their relationships.
Adaptive vs Maladaptive perfectionism
There are several differences between adaptive and maladaptive perfectionism. Whilst adaptive perfectionism can be useful and beneficial to a person, maladaptive perfectionism can do more harm than good. It’s characterized by unrealistic expectations for one’s self and an overriding need for control. .
On the other hand, adaptive perfectionists engage in coping strategies that are beneficial for their well-being. These strategies include achieving goals and accepting failures. The adaptive perfectionist will strive to meet goals but will not obsess over the outcome to the point where it becomes debilitating and interferes with the person’s life.
This condition may also affect a person’s career. Those with OCD may spend time focusing on minor details to the exclusion of everything else. As a result they may spend more time working on a project compared to someone without OCD (sometimes outside of work hours). They may also spend more time revising their work, rechecking it for mistakes and procrastinate because of their fear of failing.
This can lead to redoing work to the extent that projects cannot be completed in a timely manner. For example, a perfectionist might spend hours editing a report, only to miss the deadline because they were not able to step back and see the big picture.
As a result an individual may become increasingly irritable and anxious, and their stress levels can increase. While a certain degree of attention to detail is important, it is important to remember that minor details should not take precedence over the timely completion of tasks.
Moral perfectionism and excessive guilt
People with OCD often feel morally imperfect and feel a heightened sense of guilt and regret over things they’ve done in the past. This can lead to them obsessively ruminating about the past and different scenarios in their head. To learn more about how to significantly reduce feelings of guilt, please read this helpful article: How to recover from moral scrupulosity OCD
The relationship between OCD, trauma and perfectionism
Perfectionism is often driven by a need to know that we are doing things right, and that we won’t make any mistakes. This need can be particularly strong in people who have experienced trauma or who have been through tough times; when the world feels like a scary place, it can be comforting to think that if we just do everything perfectly, we will be safe.
Unfortunately, this can lead to a lot of anxiety and stress, as well as feeling like we are never good enough. It can also hold us back from taking risks and trying new things, as we are afraid of making errors.
If you find yourself struggling with perfectionism, it may be helpful to remind yourself that nobody is perfect and that making mistakes is part of life. Remember that even if things don’t turn out perfectly, you will still be okay.
A history of childhood bullying or abuse can lead to feelings of worthlessness and low self esteem. People with OCD may set unrealistic expectations for themselves and underrate their own performance. One study found that self-compassion may protect perfectionists from depression .
Self criticism has been been shown to be associated with various mental disorders and poorer outcomes for self critical patients in therapy. .
Furthermore self criticism has been shown to be the main factor that resulted in a decline of an individual’s mental health, whist having high standards was less of a factor.
In other words having high standards is adaptive perfectionism (useful to an individual) whilst self criticism is unhealthy perfectionism.
Therefore CBT that focuses on changing self critical beliefs such as “I’m worthless” or “I am unworthy of success and happiness” may be more useful than attempting to lower an individuals personal standards.
CBT for OCD perfectionism
CBT may help perfectionists develop a belief system that is less rigid. For example rather than seeing yourself as a competent or incompetent person you can recognise that their area grey areas in terms of performance and be kinder to yourself on days when you don’t perform as well as expected.
ERP for OCD perfectionism
If your anxiety is related to your own perfectionism, you may want to try to change your behaviour. For example, you may want to reduce the amount of time you spend checking documents. Instead of spending 2 hours checking, spend only 30 minutes. By working with an ERP therapist individuals can slowly desensitise themselves from the fear of imperfection. This will gradually result in a reduction in anxiety.
Although OCD perfectionism is not a formal symptom of the disorder, it is a common trait among those with OCD.
People with severe OCD and perfectionism tend to hold themselves to standards that are extremely high. They may become obsessed with being perfect in everything they do, which can lead to anxiety and depression. Sometimes, perfectionism can lead to eating disorders and self-harm. It can also lead to behaviours such as excessive exercise and unhealthy habits. These behaviours can also affect work, education, and personal relationships.
Many people with this disorder equate their performance in their life with their self esteem and worth as a human being. Fortunately, there are treatments including CBT to change distorted beliefs or exposure and response prevention, which gradually reduces a persons anxiety over time when they choose to not engage in the coping compulsion.
If you are suffering from OCD, you should consult with a mental health professional.
: Perfectionism and Intolerance of Uncertainty are Predictors of OCD Symptoms in Children and Early Adolescents: A Prospective, Cohort, One-Year, Follow-Up Study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8650182/
: Is perfectionism good, bad, or both? Examining models of the perfectionism construct. https://www.sciencedirect.com/science/article/abs/pii/S0191886903002356?via%3Dihub
: Self-compassion moderates the perfectionism and depression link in both adolescence and adulthood. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0192022
: Self-criticism and psychotherapy outcome: A systematic review and meta-analysis. https://www.sciencedirect.com/science/article/abs/pii/S0272735819303204