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Perfectionism and Anxiety

When the enemy of good is better.

Source: AndreyPopov/123rf

Most people aim to do well at whatever they set out to accomplish – whether as parents, partners, professionals, students, volunteers, or friends. But there’s a group for whom doing well simply isn’t good enough. Perfectionists won’t stop until everything they touch is “flawless.” The definition of this may vary by person, but for perfectionists it means they relentlessly obsess over their efforts and results.

This so-called “stable” personality trait isn’t one with its own diagnostic criteria. But perfectionism unquestionably overlaps with anxiety, which affects nearly 1 in 5 American adults in a given year and about one-third of U.S. adults at some point in their lives, according to the National Institute of Mental Health.

Much research has revealed clear cause-and-effect relationships between perfectionistic leanings – such as the fear of making mistakes, self-critical thinking, and ridiculously high personal expectations – with anxiety and other psychological disorders, according to a 2017 paper in the Journal of Psychology and Cognition.

How Does Analysis Paralysis Fit In?

“Perfectionism . . . revolves around the question, ‘What will they think of me?’ The pervasive fear that develops from the constant threat of coming face to face with their own worthlessness can create considerable anxiety,” the paper’s authors write. It’s a complicated dance, but perfectionism can act as both a cause and symptom of anxiety disorders.

Happiness and anxiety don’t make good bedmates, however. According to research in the Journal of Positive Psychology, higher levels of anxiety, worry and stress are linked to lower happiness levels.

Perfectionism can also lead to “analysis paralysis,” a catchy term that describes how worry over making the perfect decision leads to prolonged deliberating, circular thinking delayed action, and sometimes no decision at all.

The intense feelings surrounding analysis paralysis can inevitably shift perfectionists’ to-do lists, making them lose confidence in their decision-making abilities. And being preoccupied with too many details can also result in “not seeing the forest through the trees” – not being able to see the big picture.

Bad Bedmates: Perfectionism and Sleep

Is it any wonder, then, that perfectionists often experience insomnia? A 2019 study in the journal Cognitive Processing on more than 600 adults showed that perfectionist tendencies, anxiety symptoms, and dysfunctional sleep-related cognition – which includes flawed expectations about sleep requirements, exaggerated beliefs about daytime consequences of poor sleep, and worry and helplessness related to sleep – were significantly linked to insomnia symptoms. The findings bolster the notion that perfectionism and sleep do not partner well.

Even sub-clinical anxiety can thrum through people’s days, showing up in a wide spectrum of ways that range from panic attacks to constant worry to hypervigilance. Mentally they may feel quick to react, and physically they may feel jumpy and easily startled. They may “think too much” – even about things that don’t necessarily stoke their anxiety levels. Because of this, they just don’t sleep well. Many of my patients with low-grade anxiety tell me their sleep tends to be thin – they have trouble dropping off and then rouse easily and frequently during the night.

Ironically, perfectionists can be dealt a double whammy when it comes to how their anxiety impacts slumber: Rumination over the consequences of lost sleep blends with insomnia to thwart possible coping strategies, such as daytime napping. Even minimally anxious people who “think too much” often can’t nap by day, even when they try. Their sleep deficit builds – and so does their anxiety.

Treatment Options

Besides medications, we often encourage patients to tolerate some level of imperfection in their daily lives. Learning music or engaging in art therapy is beneficial because it’s something new and to begin, people have to tolerate imperfection. Many perfectionists tend to be all or nothing, so they either do something perfectly or not at all. In the case of the latter, it leads to no improvement. Moreover, perfectionists do and practice things at which they are not good. Again, the goal is to get better at tolerating imperfection, and to notice the improvement that comes with time and practice

Where does this all lead? Perfectionists with a lifelong pattern of related anxiety and sleep difficulties owe it to themselves to consider seeking help. While perfectionism may be notoriously difficult to treat, anxiety and sleep problems can readily be addressed – offering perfectionists just a few less things to worry about.

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