Hypnotherapy for Perfectionism

If you rewrite a two-line email five times, or leave a project unfinished because it is not good enough yet, perfectionism is costing you. Several treatments have been used for it, and one of them, exposure-based practice, works by having you finish tasks imperfectly on purpose and see what follows. Hypnosis can help you rehearse that step; it does not replace it.

What is perfectionism?

The Wikipedia article on perfectionism) defines it as a broad personality trait: a concern with striving for flawlessness, accompanied by critical self-evaluation and worry about how others judge you. One model it describes separates three forms:

• Self-oriented: demanding perfection from yourself.
• Socially prescribed: feeling you must meet the expectations, real or imagined, that others place on you.
• Other-oriented: expecting perfection from other people.

The same model adds a public layer, the need to appear perfect by promoting a flawless image and hiding mistakes, and an inner layer of ruminating on the gap between who you are and who you think you should be.

Is some perfectionism healthy?

Researchers disagree. In 1978, D. E. Hamachek distinguished normal perfectionists, who pursue high standards without staking their self-esteem on them and enjoy the effort, from neurotic perfectionists, who chase unrealistic goals and feel dissatisfied when they fall short. The psychologists J. Stoeber and K. Otto later split perfectionism into perfectionist strivings and perfectionist concerns, and described people high in strivings but low in concerns as healthy perfectionists.

Other researchers argue that no healthy form has empirical support, and that what gets called “adaptive perfectionism” is associated with depression, eating disorders, suicidal thinking and poor health. The distinction still matters for the most serious outcomes. According to the article, perfectionist strivings are associated with suicidal thinking, while perfectionist concerns, such as fear of mistakes and of others’ judgment, predict both suicidal thinking and suicide attempts.

What does it cost?

Time, for a start. The article describes perfectionism at work as marked by low productivity and missed deadlines, as attention goes to irrelevant details. At the extreme, a person abandons the task altogether, a pattern it calls perfectionary paralysis. Procrastination and running yourself down can also serve as self-handicapping: ways of protecting your sense of competence when a result might fall short.

People with perfectionist tendencies such as fixating on mistakes tended to cope with stress through avoidance and self-criticism. The article also reports that perfectionist tendencies have been rising among young people in higher education since the late 1980s.

What treatments are used?

The article describes three:

• Cognitive behavioral therapy, in which you learn to recognize irrational thinking, such as treating an achievement as either perfect or useless, and find another way to approach the situation.
• Dynamic-relational therapy, which works on the relationship patterns that keep perfectionism going rather than on the perfectionist behavior directly.
• Exposure and response prevention, in which you deliberately stop the perfecting behavior on tasks. Anxiety may decrease over time as you find that completing a task imperfectly has no major consequences.

Perfectionism can also get in the way of therapy itself. The article notes that perfectionists, especially those focused on appearing flawless, are more likely to find first clinical interviews anxiety-provoking and to judge their own performance in them as inadequate. If therapy starts to feel like a test you are failing, that is worth saying out loud in the session.

What can hypnosis add for perfectionism?

As preparation for the exposure step. Hypnotherapy is not among the treatments the article describes, so treat it as an aid to them, not a substitute. In a session you might picture sending the email after a single draft, notice the urge to go back and check it, and stay with that discomfort until it starts to fade, then picture the rest of the day going on as normal. The aim is for the real attempt to feel less like a leap.

When is it something more serious?

The article lists perfectionism as a risk factor for obsessive-compulsive disorder, eating disorders, social anxiety, depression, self-harm and suicide, and notes that perfectionists are less likely to seek help when they need it. If your standards center on food, weight or appearance, or come with persistent low mood or thoughts of harming yourself, see a doctor or licensed therapist. In the United States, call or text 988 if you are in crisis. Outside the United States, contact your local emergency number or crisis line.

An experiment for two weeks

1. Choose one low-stakes task a day to finish at “good enough”: an email sent after one read, a tidy-enough desk, a slide with one round of edits.
2. Rate your anxiety from 0 to 10 when you stop, and again an hour later.
3. Write down any real consequence, including none.
4. Use a short self-hypnosis routine the night before to rehearse stopping early.

After two weeks, look at how the second anxiety rating has changed, and how many of the feared consequences actually arrived.

This article is general information, not medical or psychological advice; talk with a licensed clinician about your own situation.