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Mental Health Letter / 2007
The perils of perfectionism
Harvard Mental Health Letter | November 2007
The perils of perfectionism
Often evident at the holidays, this personality trait
has a dark side.
November marks the start of both the holiday season and
what could also be called the perfectionist season. Although
holiday celebrations vary, conditions are perfect for one
personality trait to emerge forcefully: The desire for
everything to be perfect — serving the perfect meal, hosting
the perfect family gathering, or showing off the perfect
Perfectionism can be exhausting. In extreme forms, it may
also be hazardous to mental health.
Various studies over the years have linked perfectionism to
obsessive-compulsive disorder, obsessive-compulsive
personality disorder, mood disorders (such as anxiety and
depression), eating disorders (such as anorexia and bulimia),
body dysmorphic disorder, and an interest in cosmetic surgery.
Perfectionism has also been investigated — but subsequently
dismissed — as a cause of insomnia and irritable bowel
A study suggests that perfectionism may at times arise in
reaction to indirect aggression, a largely female type of
social bullying that can leave its victims emotionally
battered and bruised, rather than physically bloodied.
Efforts to pin down perfectionism over the years have been,
well, less than perfect. The debate continues about how best
to define this personality trait and whether it is always a
detriment to mental health or might sometimes be a
Two perfectionism scales are used extensively today. The
Frost Multidimensional Perfectionism Scale assesses six
specific aspects of perfectionism: concern over mistakes,
personal standards, parental criticism, parental expectations,
doubts about actions, and organization. The Hewitt and Flett
Multidimensional Perfectionism Scale, in contrast, measures
three personal and social traits: self-oriented perfectionism
(setting high standards for yourself), socially prescribed
perfectionism (thinking other people are setting high
expectations for you), and other-oriented perfectionism
(having high expectations of other people).
In 1978, Dr. Don Hamachek first suggested that
perfectionism could come in two forms — the “neurotic” one
characterized by excessively high standards and driven by a
fear of failure, and the “normal” version characterized by
more reasonable standards and a feeling of satisfaction. When
it comes to the research, though, scientists have
overwhelmingly focused on the detrimental aspects of
One glaring example: eating disorders. Researchers reviewed
55 papers on eating disorders and perfectionism that were
published between 1990 and 2005. Most studies suggested that
eating disorders (especially anorexia) tend to develop in
people who are perfectionist by nature and that the
perfectionism endures even after recovery.
It remains unclear what causes perfectionism to develop in
the first place. Some evidence suggests that, like perfect
skin and teeth, perfectionism seems to run in families, and so
may have a genetic component. Another view is that
perfectionism is a response to environmental pressures and
needs to be understood in a social context.
Investigating indirect aggression
A study published in 2007 in Aggressive Behavior
supports the idea that perfectionism may develop in a social
context and suggests an unexpected trigger: indirect
aggression. This type of aggression involves socially
manipulative behaviors such as talking behind someone’s back,
giving someone the “silent treatment,” divulging secrets, and
being nice to someone in private but mean in public. Females
tend to engage in indirect aggression more often than males,
with the theory being that this reflects the fact that girls
and women are not encouraged to be overtly aggressive and so
must express such tendencies in covert ways.
To find out whether experiencing indirect aggression might
be linked to long-term perfectionism, researchers at McMaster
University asked two groups of college-age women to fill out
surveys to determine what types of verbal abuse, physical
abuse, and indirect aggression they had experienced in grades
3 through 12. They also asked the women to answer questions to
gauge whether they were perfectionists.
The researchers found that the women who recalled
experiencing indirect aggression in childhood were more likely
to become perfectionists by the time they reached college.
Verbal and physical abuse had no impact.
The authors acknowledge that the study’s retrospective
nature may have biased its findings, in that those women who
were perfectionistic might be more likely than others to
recall past events in a negative way. Even so, the authors
propose that this study provides further evidence that
perfectionism may develop as a coping mechanism that helps
people who have felt rejected in the past to assert themselves
socially, and to maintain some sense of control over a
Bardone-Cone AM, et al. “Perfectionism and Eating
Disorders: Current Status and Future Directions,”
Psychology Review (April 2007): Vol. 27, No. 3, pp.
Miller JL, et al. “Relation Between Childhood Peer
Victimization and Adult Perfectionism: Are Victims of Indirect
Aggression More Perfectionistic?”
(May–June 2007): Vol. 33, No. 3, pp. 230–41.
For more references, please see www.health.harvard.edu/mentalextra.