Unhealthy perfectionism in students - and how to support them

Many people aim high and push themselves towards very challenging goals and targets. People with a "healthy striving for excellence” may have very high standards, but these standards are also potentially achievable. They are able to learn from mistakes, tolerate uncertainty, judge achievements in an objective and balanced way, and are motivated by healthy competition among their peers.

In contrast, people with unhealthy perfectionism react to mistakes in an extreme and highly self-critical manner and are very uncomfortable with uncertainty. They can quickly become controlled by rigid rules, and struggle with constant feelings of failure; their self-esteem is overly dependent on striving towards, and the achievement of, results.

For individuals with a healthy striving for excellence, a mistake is usually seen as temporary, isolated and perhaps also outside of their control. For those with unhealthy perfectionism, however, mistakes are perceived to be permanent, pervasive and personal.

Individuals with a healthy striving for excellence tend to be motivated by goals and hopeful for success, enjoy competing with peers, learn from their mistakes and let those around them know if they are struggling. Perfectionists, however, are driven by fear of failure, are never satisfied, always put on a brave face and feel the need to compete and win. Within a classroom setting, it can be very difficult for a teacher to recognise when a perfectionist student is struggling.

Three Ps surround perfectionism like a continuum.

Unhealthy perfectionism begins the cycle with the need to strive towards impossibly high goals, refusing to accept failure and the belief that everything must be perfect. This can lead to procrastination, with your inner critic slowing you down. While procrastinating, it’s very hard to get started, or you may start again and again and keep ripping up or thwarting your progress, beating yourself up that you are not good enough. The result of this is paralysis: a freeze mentality of “I just can’t do it” (such as writers block) or your internal voice saying “I’m totally useless … I won’t even try.”

A myth about perfectionism is that it breeds stronger performance and results. In reality, the perfectionist is likely to under-perform against peers who have a healthy appetite for excellence. This ‘crash and burn' realisation can lead to increased anxiety.

While some believe it should be, perfectionism is not a diagnosable mental health disorder. However, it can adversely affect a student’s day to day quality of life considerably, and can lead to anxiety disorders, depression, self-harm, eating disorders and even suicidal ideation.

The following warning signs, while not specifically linked to perfectionists, are likely to apply to individuals with unhealthy levels of perfectionism:

• Social isolation: a student withdrawing from their peers, clubs and communities
• Unexplained aches and pains: beyond ‘normal’ levels of headaches and illness
• Reassurance seeking: asking "is this good enough?” and "have I done enough?"
• Personal hygiene: either becoming fastidious with personal hygiene or, in some instances, allowing hygiene to slip
• Body image issues: perfectionists will commonly be very concerned with their appearance and how others may be judging them
• Perfectionism/procrastination: these traits will creep in as anxiety rises, becoming a vicious cycle
• Rigid rules: adherence to clear rules and habits can become a coping mechanism, for example setting rules around eating, daily tasks, exercise and personal weight.

Normal everyday anxiety can quickly turn into overwhelming anxiety for students. A relatively small increase in stress can push a person beyond the point of peak performance to burnout, swiftly affecting quality of life.

Talking can make a big difference, but getting the tone right is absolutely crucial.

If you have identified a student who you believe is struggling with unhealthy levels of perfectionism, then paying attention to that student and really noticing changes in their behaviours and habits can positively open the door to conversation.

For example: I (or your friends) have noticed that you...

• “seem anxious, tired, distracted, unable to get things done on time"
• “seem overwhelmed with the amount of work”
• “are spending more and more time in the library and not joining in with things you used to enjoy with your friends."

Calmly noticing, with no judgement, is a way to begin a conversation in an open and friendly manner that invites two-way dialogue. Supporting this with a phrase of encouragement and support, such as "I am here if you ever want to talk about anything that is bothering you" doesn’t push the issue, but rather shows that you care.

There are three stages – or a series of small experiments – to guiding a student on the path to making positive changes. The first is challenging rigid rules.

Perfectionists thrive on rigid rules and are likely to cultivate pessimistic thoughts about breaking a rule. For students, these rules can focus on exam performance, sporting achievements, body image, diet – or a whole array of other concerns. Rigid rules can quickly become habitual, can be very time-consuming and are extremely difficult to break.

Let’s consider Alex, who is caught up in a vicious cycle, with rigid rules around food, study, body image and exercise. Alex’s regular evening regime has become so fixed that he will never eat dinner before 10pm, and must then spend 30 minutes in the shower at 6.30am. He must check his weight daily, do 20 minutes of sit ups before every meal, and only use one type of cutlery. Alex’s adherence to rules is exhausting – and potentially very dangerous.

Yet gentle support and guidance can help Alex to consider challenging one rigid rule at a time, with simple behavioural experiments using SMART baby steps to slowly reverse this cycle: for example, “I will stop checking my weight one day a week."

Failure to achieve these steps does not matter; just attempting to challenge thinking and to do things in a slightly less rigid way is a big step in the right direction.

Solution-focused questioning can encourage students to reframe a rule as a guideline. For a competitive runner aiming for a personal best, these questions would encourage the student to move from a hard-and-fast rule ("I must finish the race in under 10 minutes”) to a guideline ("I will do my best and finish as close to 10 minutes as the conditions allow on the day, and I want to enjoy the experience”). It encourages the student to come up with their own guidelines, allows for circumstances beyond the individuals’ control and reframes the situation before it transpires, challenging expectations and negative feelings of self-worth before these have an opportunity to fully arise.

Common negative beliefs can fuel perfectionist tendencies; cognitive restructuring looks to directly challenge these beliefs and encourage a different way of thinking.

Consider the case of Andrew, a year 9 student who is devastated to receive a result of 75% in his Geography exam paper. While Andrew's classmates received results between 50-80% and are generally happy with the exam feedback, Andrew has a rigid rule that he must get at least 80% in every test that he takes.

Andrew’s internal interpretation of the exam result is one of disappointment, feeling sad, depressed and anxious at his failure to get a higher mark: this is normal for an unhealthy perfectionist, who is more likely to catastrophise with black-and-white thinking, negative labelling and dwell on the negatives.

Cognitive restructuring aims to challenge these negative thoughts and beliefs by challenging the evidence, asking: can the negative be re-framed into something more positive?

Martin Seligman, one of the foremost promoters of positive psychology within the scientific community, coined the following ABCDEF model to challenge negative thoughts and learn optimism:

• Adversity: I only got 75%
• Belief: I am not clever enough for this school
• Consequence: There’s no point in trying; I want to give up
• Disputation: I was in the top 30%; the test was really hard and I was stressed about being late … I would like to be higher but there are things outside my control
• Energisation: These are all facts; actually thinking about these facts means I can feel more positive and confident about this result and future tests
• Functional New Thought: I can appreciate that having a strict rule makes me really anxious. When I look at the bigger picture, I can see I did well in the test.

Success with the disputation process takes time; the student needs to accept the situation and then be open and willing to reframe the situation for their future.

An effective method of keeping communication lines open with anxious students is OARS – which can help keep the conversation reflective and mindful:

• Open questions: Skilful questioning style
• Affirmations: Praise to build confidence and motivation
• Reflective listening: Skilful listening style
• Summarising: Demonstrating you have understood, pulling the conversation together and planning the next chat together.

Let’s put this theory into an example phrase that we can all relate to: “"you’re not listening to me.” Open questions would include "can you help me understand?” and "what does listening look like?" The affirmation could be "thank you for telling me how you're feeling" or "you were brave to tell me that." The reflection may play back the emotion that is on show ("so you feel angry about…”)

Motivational language should always convey that the student can come up with their own ideas, providing affirmations and recognising the challenges that the student faces by conveying empathy. For every open question asked, the student should receive three reflections back: this not only builds self-esteem but also gives the student crucial thinking time to absorb and digest the motivational language.

Taking the time to do this shows that you believe in the student’s ability to problem solve and come up with their own ideas, are prepared to listen, empathise with their difficulties and care. Attending to the students’ feelings, labelling the emotions, validating these feelings and then providing a soothing response can really help.

Gentle nudging and guidance, supported by open questions, listening and reflection, can be really powerful and effective for supporting students to overcome unhealthy perfectionism and allay feelings of anxiety.

It’s important to talk about perfectionism openly with all students and discuss when it can be problematic. This open conversation can enable peers to support one another, as can practicing teamwork and helping others. Efforts should be praised, over and above the absolute result, and creativity and risk-taking should always be encouraged, as without failure there can never be success (it can actually be helpful to consider ‘fail’ as ‘first attempt in learning’).

Curiosity and contingency planning should be encouraged among students, and students should be invited to give feedback in a regular forum. An unexpected event, now and again, can also be a positive experience for perfectionist students: a test without any notice, for example, removes the possibility of students fretting and becoming anxious beforehand, and builds tolerance for uncertainty.

Perfectionism: when striving for excellence becomes unhealthy by Professor Roz Shafran

For teenagers:

The Perfectionism Workbook for Teens

The Myth of the Perfect Girl

For younger children:

• Nobody’s Perfect by Ellen Flanagan Burns (aimed at children aged 8-12)
• Perfect Petunias by Lynn Jenkins (aimed at children aged 4-8)