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A few years and an entire pandemic ago, I was traveling around the country (and in Canada) on tour for my memoir Little Panic (about growing up with an undiagnosed panic disorder, and how recognizing something was wrong with me without knowing its name shaped the course of my entire life). I spoke to thousands of people, engaging with audiences of all ages about anxiety and other mental health issues, and taking questions.
I stressed often, and as gently as possible (not my strength, tbh), that anxiety often comes from inside the house. Meaning, of course, that children aren’t born anxious—they learn how to become anxious by watching and modeling the behavior of their anxious caregivers.
During one particular Q&A, a woman was beside herself because she swore, up and down, that she wasn’t anxious, and neither was her wife. She was, she told me, as she picked feverishly at her cuticles, a perfectionist. Could it be that her perfectionism was creating her child’s anxiety? Was it possible that her perfectionism read to her child as anxiety and that’s why her child was so anxious all the time even though she, the parent, was not anxious at all, but in fact simply just a perfectionist? Yes, yes, she decided, answering her own question—it was definitely the perfectionism. Thank you so much, she said, sitting back down. I hadn’t actually said a word.
When the Q&A ended, I sought out the perfectionist. There was something really important I wanted her to know, and it was this: Anxiety disguises itself in pretty innovative ways. Perfectionism is just one of them. While it’s true that not all perfectionism is a maladaptive coping mechanism for anxiety, the link between perfectionism and anxiety is profound and undeniable. Anxiety can give rise to perfectionism and perfectionism can give rise to anxiety. It's a vicious loop.

Original art for How to Live is by Edwina White
When I found her, I braced myself for pushback and possibly even anger, but what I got instead was relief. Her perfectionism had never really made sense to her, she admitted. Everything she’d read about perfectionism seemed to fit, except for one thing—the feeling-tone of her experience as a “perfectionist” never matched the word itself. Hearing that anxiety might be running the show gave her permission to actually feel her anxious feelings. In doing so, she could now go forward, work on her anxiety, and model what she learned for her child.
Perfectionism can rise from overcompensating out of a fear that you’re not good enough, and the fear of failing. To be anxious is to be hypervigilantly attuned to tonal shifts and signals—anything that might suggest you’re being judged and your score is coming in low. People who suffer from chronic anxiety worry they are not acceptable as they are, and that the only way to be embraced by others is to be absolutely perfect. The effort to be perfect is just one maladaptive way people deal with their anxiety.
When you suffer from anxiety, you feel defective, as though you’re missing crucial parts that other people have. You grasp onto the stories your worry narrates, convincing you that they’re true. You feel your feelings so strongly, you confuse them for facts. Because anxious people feel flawed, they worry people can see their flaws, and the threat of exposure feels so shameful, it drives many anxious people to create a veneer of perfection so that everyone will be thrown off course. It’s a defense mechanism.
Anxiety can disguise itself in a variety of ways and perfectionism is just one of them. But, perfectionism can also disguise itself. Here are some reasons and ways that anxiety-motivated perfectionism hides itself:

GETTY IMAGES / Tara Moore
Perfectionists live for certainty, because uncertainty means they can’t control appearances or situations. You know who else doesn’t love uncertainty? ANXIOUS PEOPLE.
Anxious people are terrified of uncertainty. Not knowing is an unbearable reality that tricks anxious people into thinking that reality is unbearable—a false equivalency. Uncertainty to anxious people feels dangerous. It’s not exciting, it’s not a river of open possibility—it’s a noxious death trap. Making a mistake, handing in a project that has even one error in it, having to guess at something that might open you up to being wrong, is not a gamble an anxious person wants to take, and so we forestall finishing things until “they’re perfect.” Uncertainty might invite criticism, and criticism means we’re wrong.
Perfectionism is a guard against being wrong, because to be openly “wrong” exposes our fear that we’re defective or flawed, which means we’re different, unlike everyone else, and therefore, entirely alone. Were someone to glimpse inside, they’d discover that the perfectionist is simply performing perfection and is not, in fact, perfect. Perfectionists (and people with anxiety) equate performance with acceptability. Should we fail, should we be caught not knowing something, should we be corrected means we will stop being liked.

GETTY IMAGES / Malte Mueller
When uncertainty overwhelms and unglues us, the only way to cope is to try to make things feel certain, and the only way to do that—is to control. Controlling is perfection from a different angle. Because perfectionists equate performance with acceptability, they also believe that being wrong means they are unlovable. This worry leads to a sense of being out of control and so they grasp, in any way they can, to control the outcome of their behavior. Many fixed mindset people are perfectionists.
Striving for perfection is a misguided way to deal with uncertainty. If we can't control the world and our circumstances, then we may seek to control ourselves or others. This not only distracts us, it distracts others from seeing the truth that is driving our behavior.
Control can also show up as denial. By pretending things aren’t as they are. Pretending that our child doesn’t have an incurable illness, or our spouse is cheating or an alcoholic. If we carry our magical thinking to the extreme, we may even feel that we can cure such things by simply being perfect.

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If, as a child, you were raised to believe that love was conditional, based on achievement, attractiveness, popularity, or some other measure your parents or caretakers valued then you might have learned that the premise of love is about what you can do for others. When you grow up receiving love with conditions, you probably believe that love is based on external measures and rewards, and not on an internal sense of self-worth. When love is predicated upon outside validation, approval, and praise, young people understand that to be seen and valued, they must perform to a high standard. Love then becomes dependent on pleasing others rather than on revealing who you are. This exhausting and misdirected route to love leads straight to anxiety and depression.

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Another way that anxiety shows up as perfectionism and one that’s wildly misunderstood, is Hypochondriasis. Just like hypervigilance, scanning your body in an effort to catch anything out of the ordinary before it kills you, is just another way of trying to control not getting sick and not dying. The intolerance of uncertainty leads to control. When SOME people get sick (me), they tend to announce every single ailment. This (naturally) leads people to think I’m a hypochondriac, or a complainer, or even negative, but that’s not actually what’s happening. What’s happening is that I’m afraid of disappointing people, afraid that if I’m sick, I won’t meet their expectations (because I equate performance with acceptance) so I pre-empt their expectations by lowering them. I am fending off any chance of disappointing people. So, I let them know up front: I am going to disappoint you, which helps me cope with the fear that I am going to let people down by not performing.


GETTY IMAGES / Westend61
Anxious people are typically hypercritical and defensive or are profoundly self-critical. These behaviors (especially self-criticism) are strong indicators of anxiety. People who defend against criticism are defending against being perceived as wrong, terrified, as I said earlier, to be seen for what they fear they truly are: defective. Criticism threatens to expose people, and the push back can be intense, and defiant. A form of fighting back without being physical. This defensiveness is a way of protecting yourself from feeling uncomfortable and from feeling the negative feelings that threaten to push you into uncertain territory—the dangerous unknown, a place no anxious person wants to go.

GETTY IMAGES / Johnny Johnson
The underside of perfection is the need for approval, and the need for approval comes from deep insecurity, a fear that being exactly who and how you are isn’t enough. People who suffer from perfectionism that’s driven by anxiety feel uniquely unqualified, which is why they must prove to everyone around them just how qualified they are. Whenever someone is overcompensating it’s quite clear to those around them what they are subconsciously announcing they are afraid of.
Anxiety and perfectionism are powered by the union of irrational and false beliefs. They are birthed by the would should could and ought to’s. And living in the should and coulds is a thinking mistake that we actually DO have control over.
The Stoic philosopher Epictetus pointed out that people become disturbed and angry when their expectations about the world clashes with reality.
We cannot reset our reality, but we can reset out expectations. When we are stuck in our perfectionist ways, we are operating from a fixed mindset and not a growth mindset.
It is not the thing itself which upsets us, it is how we are thinking about the thing that upsets us. When we expect the universe to give us exactly what we want, exactly as we want it, we are going to live in constant disappointment and despair, but if you can practice accepting and facing what the universe gives you, the chasm where your frustration and anger lives—in between what you want vs what is—will close.
Practice: The next time you are stuck in traffic or on public transportation and you are running late for something important, try to remind yourself that stress and raised blood pressure will not change the situation that you’re in, it will not shift reality, so you might as well accept the reality and deal with the consequences when they happen, instead of compounding an already stressful situation by trying to control (with rage) the uncontrollable.
And you? Do you consider yourself a perfectionist? Can you see the roots of anxiety poking through?
Let me know in the comments!
Thank you for reading.
Until next week, I am…

Amanda

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