Skip to main content

What Keeps Perfectionism Going?

The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concise, they provide an easy way for clients to understand at a glance why their disorders persist, and how they might be interrupted. What Keeps Perfectionism Going? is designed to help clients experiencing perfectionism understand more about their condition.

Download or send

Choose your language

Professional version

A PDF of the resource, theoretical background, suggested therapist questions and prompts.

Client version

A PDF of the resource plus client-friendly instructions where appropriate.

Editable version (PPT)

An editable Microsoft PowerPoint version of the resource.

Translation Template

Are you a qualified therapist who would like to help with our translation project?


Languages this resource is available in

  • Chinese (Simplified)
  • English (GB)
  • English (US)
  • Polish
  • Spanish (International)

Techniques associated with this resource

Mechanisms associated with this resource

Introduction & Theoretical Background

Striving to achieve your goals and ambitions can be satisfying and help you grow as an individual, but it can also become a problem. If you set demanding standards for yourself (such as how you should behave, or how much you should achieve), there’s a risk you won’t meet them. If you base your self-worth on achieving those standards, or if trying to meet them causes you a lot of trouble, you may be struggling with perfectionism. Signs of unhelpful or problematic perfectionism include:

  • Having high standards which are difficult to achieve or maintain over time. 
  • Harshly criticizing yourself when you don’t meet your standards.
  • Judging your self-worth mainly in terms of your successes and achievements in life. 
  • Discounting achievements you see as less than perfect.
  • Avoiding or postponing tasks where there’s a risk you might fail.
  • Sacrificing your interests, relationships, or rest to strive and achieve.
  • Pushing yourself to the point of feeling depressed, overwhelmed, or exhausted.
  • Fearing failure, or feeling like you always fail.

Research studies have shown that cognitive behavioral therapy (CBT) is a helpful psychological therapy for perfectionism. CBT therapists work a bit like firefighters: while the fire is burning they’re not so interested in what caused it, but are more focused on what is keeping it going, and what they can do to put it out. This is because if they can work out what keeps a problem going, they can treat the problem by ‘removing the fuel’ and interrupting this maintaining cycle.  

In 2002, three leading mental health professionals – Roz Shafran, Zafra Cooper, and Chris Fairburn – published an influential model of perfectionism, which was updated in 2010. The model describes some of the ‘parts’ that keep perfectionism going. The What Keeps Perfectionism Going? information handout describes some of the key factors which act to maintain perfectionism. It illustrates them in a vicious flower format in which each ‘petal’ represents a separate maintenance cycle. Helping clients to understand more about these processes is an essential part of cognitive therapy for perfectionism. Therapists can use this handout as a focus for discussion, or as a template from which to formulate an idiosyncratic model of a client’s experiences.

Therapist Guidance

One interesting way of thinking about perfectionism is to look at why, for some people, it does not get better by itself. This handout shows some of the most common reasons why some people keep experiencing symptoms of perfectionism. I wonder if we could look at it together and think about whether it describes some of what is happening for you?

References And Further Reading

  • Lloyd, S., Schmidt, U., Khondoker, M., & Tchanturia, K. (2015). Can psychological interventions reduce perfectionism? A systematic review and meta-analysis. Behavioural and Cognitive Psychotherapy, 43, 705-731.
  • Shafran, R., Cooper, Z., & Fairburn, C. (2002). Clinical perfectionism: A cognitive behavioural analysis. Behaviour Research and Therapy, 40, 773-791. 
  • Shafran, R., Egan, S. J., & Wade, T. (2010). Overcoming perfectionism: A self-help guide using cognitive-behavioural techniques. Constable and Robinson.
  • Suh, H., Sohn, H., Kim, T., & Lee, D. G. (2019). A review and meta-analysis of perfectionism interventions: Comparing face-to-face with online modalities. Journal of Counseling Psychology, 66, 473.