0CD Perfectionism

What’s so wrong with striving to do your very best? Without high expectations, what would motivate you to accomplish your goals and aspirations?

There is nothing wrong with working hard and and setting certain standards for yourself. However, if you live with anxiety because you are terrified you may make a mistake or a wrong decision, you may be suffering from OCD perfectionism.

OCD perfectionism should not be confused with obsessive-compulsive personality disorder, or OCPD. The latter is not an anxiety disorder; it is a personality trait which initiates behaviors that demand rigidity and inflexibility. Conversely, OCD perfectionism is a symptom of an anxiety disorder, and may include a constellation of behaviors and symptoms.

The individual with this diagnosis is often in extreme distress due to their unrealistic expectations, which leads to procrastination, indecisiveness, self-reproach, anxiety and depression. OCD perfectionism has far-reaching effects, and contributes to skin-picking (dermatillamania), eating disorders, social anxiety disorder, dirt contamination, phobias, and body dysmorphic disorder, just to name a few.

When an individual suffers from OCD perfectionism, nearly every action is viewed from the perspective that there is a right way and a wrong way: there is no gray area. This simplistic view can cause a person to procrastinate endlessly for fear of making a wrong decision. Relationships, jobs, or anything that requires some small degree of risk-taking can therefore be crippling.

It can afflict an individual with regard to their own need to be perfect; and it may also affect their need for others to comply with their perfectionistic standards. They can be so controlling and demanding that their relationships buckle under the stress, and the resultant rifts are sometimes irreparable. Imagine living with someone who insists you do everything in a particular way or he or she becomes angry and critical. The OCD perfectionist often does not have the insight to recognize just how controlling their behavior can be — and how precarious their careers, academic life and relationships are becoming as a result.

The treatment for OCD perfectionism is to teach the individual how to tolerate the discomfort of relinquishing the need to be perfect. For example, I have encouraged clients to leave home with their socks mismatched, without makeup, and dressed in clothing that is not coordinated well. I may suggest that they limit their time at any particular store while shopping, especially if they have had a pattern of spending excessive amounts of time struggling with choices about their purchases.

OCD perfectionism is pervasive, and usually worsens over time unless it is treated. The prognosis, like most anxiety disorders, is excellent with the proper treatment.