Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Perfectionism vs. OCD: How to Tell the Difference

8 min read
Stacy Quick, LPC

Consistent self-criticism. A desire for constant structure and organization. A deep fear of making mistakes or falling short of self-imposed or perceived standards. These are all qualities of perfectionism, a personality trait characterized by an excessive and often unrealistic desire for flawlessness and an unrelenting pursuit of high standards and achievement. 

They’re also qualities that might sound familiar to some people with OCD. While OCD and perfectionism are two very different things—OCD is a diagnosable mental health condition and perfectionism is a personality trait—there are some areas in which they overlap, which is why the two are often considered to be associated.

This association may be accurate in some cases but is often based on misconceptions. When people believe misconceptions about OCD and perfectionism, it perpetuates an inaccurate idea of OCD. Not knowing the line between perfectionism and OCD can have real consequences, going as far as keeping people from seeking treatment for OCD-related thoughts and behaviors. By identifying these misconceptions, we can develop a more accurate understanding of perfectionism and OCD, including their similarities, differences, and the best ways to manage each.

Understanding perfectionism

It’s easy to think of perfectionism as a desirable trait. After all, striving for excellence sounds like a good thing, right? And it can be, when it’s not taken too far. Non-harmful, or adaptive, perfectionism can take the form of being achievement-oriented and motivated toward success. But there’s a fine line between striving for excellence and demanding perfection—not only because perfection is impossible to achieve, but because the pursuit of it is often driven by anxiety and self-criticism.

When perfectionist behavior becomes harmful, or maladaptive, it can take a toll on our mental health and well-being. An individual who experiences perfectionism at a maladaptive level may struggle with fear of failure, negative self-talk, low self-esteem, and a preoccupation with control. Their perfectionist concerns may lead to procrastination, decreased energy, increased stress, and issues in their relationships. In some cases, perfectionism may even be accompanied by mental health issues like depression, anxiety, eating disorders, or OCD.

Misconceptions about OCD and perfectionism

It’s important to note that perfectionism isn’t a formal symptom of OCD, but it is possible for people with OCD to also have the personality trait of perfectionism. In fact, there’s even a subtype of OCD called Perfectionistic OCD, or Just Right OCD, that’s distinguished by its focus on organization and symmetry. That being said, even though society tends to associate the word perfectionism directly with OCD, the two don’t always go together.

There is an assumption that individuals with OCD always struggle with perfectionism, or that high levels of perfectionist behavior can always be labeled as OCD. While many commonalities can be found between them, it needs to be noted that many people have perfectionistic tendencies without qualifying for a diagnosis of OCD. Vice versa, many people who have OCD do not exhibit perfectionism.

This commonly-held misconception that OCD is all about order and control is a misleading generalization based on only one of the many ways the disorder can present. Misconceptions like this one can not only lead people to have inaccurate ideas about what OCD is, they may even prevent people from seeking proper treatment for the condition. People with OCD falsely believe they cannot have the disorder because they don’t fit the stereotype of being organized and meticulous.

As mentioned previously, unlike perfectionism, OCD is a diagnosable mental health condition. It’s not a personality trait. OCD is characterized by a significant impairment in functioning. Individuals with OCD can spend countless hours obsessing and performing compulsions in an attempt to relieve the anxiety and distress they feel. These symptoms often have severe impacts on an individual’s daily life, disrupting their close relationships and impacting performance in the workplace, at school, or in other important areas of their lives.

The difference between OCD and perfectionism

When considering the commonalities between OCD and perfectionism, it becomes clear why the two tend to be associated. Many people with OCD indeed set high standards for themselves, often reporting feelings of hyper-responsibility and overactive empathy. Many of their outward behaviors can also appear to be perfectionistic. People with OCD may feel the need to perform a compulsion “just right,” or to act in a way that they deem to be “flawless” in a given situation. They may fear outcomes that they perceive as failure, or disappointing others, and can go to great lengths to avoid criticism, or feedback they perceive as criticism.

But distinguishing between perfectionism and OCD isn’t based on these behaviors. The primary difference between perfectionism experienced in OCD and perfectionism as a personality characteristic often lies in motivation, or the driving force behind a person’s perfectionist behavior. Perfectionism related to OCD is likely to be motivated by extreme distress and anxiety, while perfectionism as a more general personality trait is likely to be motivated by setting high standards for oneself or others, and a preference for control and order.

When individuals with OCD engage in perfectionist behavior, they are attempting to relieve anxiety and discomfort, which can be external or internal. The behaviors they display are usually attempts at “undoing” the intrusive thoughts, images, or urges they’re experiencing, or trying to prevent bad things from happening. These obsessions are irrational and can take on many forms.

Do these symptoms sound familiar? Learn how you can overcome them

Recognizing that perfectionist behavior may be a result of OCD can feel difficult, but it’s an important first step to feeling better. You’re not on your own, and you can talk to a specialist who has experience treating OCD.

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What does perfectionism look like in OCD?

Within OCD’s hallmark symptoms of intrusive thoughts, obsessions, and compulsions, perfectionism can take many different forms. It’s important to note that OCD is incredibly varied in its presentations, so these symptoms can focus on any aspect of a person’s life. 

Catastrophizing, or considering worst-case scenarios: Perfectionist behavior can be the result of an intrusive thought focused on a negative outcome—often, one that’s unrealistic. These thoughts may take the form of excessive worrying about being judged by other people, making a catastrophic mistake, or something bad happening if a compulsion isn’t acted upon. These thoughts may lead the individual to feel paralyzed, not wanting to risk even the slightest possibility of their feared outcome. In extreme cases, they may even stop leaving their homes or driving, becoming confined to what they see as a “safe” area.

Fixing things to make them “just right”: Perfectionism in OCD can also be seen in compulsions related to symmetry or making things “just right.” These compulsions revolve around a need for control, either over the distress a person is feeling or over the negative outcome that their intrusive thoughts are causing them to fear. Individuals may become fixated on arranging items in a certain manner, or repeating an action until it feels “right” to them. They may even demand that other members of their family or social group follow their standards, causing them to be perceived as rigid. When things do not go according to their expectation, they may become highly upset.

Checking behaviors: Compulsions related to perfectionism in OCD can also involve checking behaviors. Similar to “just right” compulsions, these behaviors also revolve around trying to achieve a sense of control. People struggling with these behaviors may feel compelled to check over and over again to ensure that things are in order or that they have not forgotten something. For example, an individual may struggle to leave their house in the morning because they feel the need to keep coming back to check that they haven’t left the stove on, or turned off their hair straightener. This behavior might bring them a short-term sense of relief, but will ultimately keep them stuck in a cycle of feeling uncertain and then engaging in checking behaviors in an attempt to alleviate their uncertainty. This can become exhausting and lead to significant impairment in day-to-day responsibilities. 

Doubt: OCD is well-known as a disorder of doubt. The tremendous sense of uncertainty that OCD makes people feel can attach itself to anything and everything imaginable, including the things that they value the most. It makes sense, then, that OCD can create doubt around social interactions. When OCD latches onto people’s social interactions, they may wonder, “Did I say the ‘right’ thing? Did I offend someone? Are they mad at me? What if I made the wrong choice?”  Perfectionism in the form of doubt can create a constant nagging feeling of disappointment, leaving the sufferer feeling like they’ll never be “good enough.”

Self-criticism: When people are inevitably unable to meet the impossible standards OCD has set for them, they can end up feeling like they’ve failed. This perceived sense of failure can lead to a constant barrage of negative self-talk, creating feelings of anger, sadness, guilt, shame, and low self-esteem.

Treating perfectionism in OCD

Struggling with perfectionism related to OCD can be exhausting but with treatment and support, you can learn to manage OCD symptoms, including perfectionist behavior. While perfectionism in OCD can take many different forms, they can all be treated the same way: with exposure and response prevention (ERP) therapy.

ERP is a highly effective, evidence-based form of therapy that was developed specifically to treat OCD. It addresses obsessions and compulsions through a targeted approach that’s personalized to your specific needs. A successful ERP therapist will guide, support, and motivate you as you learn to manage OCD symptoms. They’ll help you develop the tools to live the life you want to live, not a life driven by OCD and perfectionism.

ERP is most effective when it’s done with the guidance of a therapist who specializes in ERP. At NOCD, our licensed therapists deeply understand OCD and are specialty-trained in treating it with ERP. We work side-by-side with the OCD experts and researchers who designed some of the world’s top OCD treatment programs—and that means the best care for our members. You can book a free 15-minute call with our team to get matched with one and get started with OCD treatment.

Access therapy that’s designed for OCD

ERP therapy was developed specifically to treat OCD and has helped many people who struggled with the condition regain their lives. All therapists at NOCD have specialty training in OCD and ERP.

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NOCD Therapists specialize in treating OCD

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Taylor Newendorp

Taylor Newendorp

Network Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Gary Vandalfsen

Gary Vandalfsen

Licensed Therapist, Psychologist

I’ve been practicing as a licensed therapist for over twenty five years. My main area of focus is OCD with specialized training in Exposure and Response Prevention therapy. I use ERP to treat people with all types of OCD themes, including aggressive, taboo, and a range of other unique types.

Madina Alam

Madina Alam

Director of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

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