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Writer's pictureValerie Akins, LCSW, LCDC, LCAS

Therapy Styles for Perfectionism & Anxiety

Perfectionists tend to be anxious because they have unrelenting standards and expectations and fear making mistakes. Their anxiety can stem from these expectations, as they are often worried about not meeting their own standards or the standards of others. Additionally, perfectionists may engage in all-or-nothing thinking, believing that anything less than perfect is a failure, which can further contribute to their anxiety.


There are several therapy styles that work towards treating perfectionism and anxiety, such as CBT, ACT, and RO DBT. Learn about the different styles below:


Cognitive Behavioral Therapy (CBT) can help with perfectionism by addressing and challenging the negative thought patterns and behaviors associated with it. Here are some ways CBT can help:


  • Identifying Negative Thought Patterns: Clients start to recognize and identify the negative thought patterns that contribute to perfectionism, such as all-or-nothing thinking or catastrophizing.


  • Challenging Irrational Beliefs: Clients learn to challenge and replace irrational beliefs about perfectionism with more realistic and balanced thoughts.


  • Setting Realistic Goals: Clients begin setting more realistic and achievable goals, reducing the pressure to be perfect in every aspect of their lives.


  • Behavioral Experiments: CBT helps clients challenge their thoughts by testing the consequences of not following through on beliefs about imperfection.


  • Developing Coping Strategies: Clients often learn relaxation techniques to reduce anxiety or stress.


  • Improving Self-Compassion: CBT can help individuals cultivate self-compassion and self-acceptance, allowing them to be kinder to themselves because they realize thoughts do not always equate to truth.


By working through these strategies with a trained therapist, individuals struggling with perfectionism can gradually change their mindset and behaviors to lead a more balanced and fulfilling life.



Acceptance and Commitment Therapy (ACT) can help with perfectionism by teaching clients psychological flexibility to accept negative emotions and thoughts and focus on mindful, value-focused behaviors.


  • Acceptance: Acknowledge and accept that perfection is unattainable and mistakes are a natural part of the learning process.


  • Mindfulness: Practice mindfulness techniques to help stay present and observe perfectionist thoughts with awareness.


  • Values and Committed Actions: ACT helps clients understand how values differ from rigid rules or inflexible standards. Clients identify their values and focus on aligning their actions with those values rather than striving for perfection.


  • Defusion: Learn to notice unhelpful thoughts and create distance from them instead of pushing them away or avoiding them.


  • Self-Compassion: Self-compassion is interwoven into the components of ACT through acceptance, mindfulness, and defusion.



Radically Open Dialectical Behavior Therapy (RO DBT) can help with perfectionism by helping clients identify maladaptive social signals contributing to emotional loneliness and implementing behavior strategies to feel safe around others and in new situations.


  • Encouraging Flexibility: RO DBT helps individuals develop more flexibility in their thinking and behavior, letting go of rigid perfectionistic standards.


  • Promoting Self-Enquiry: The therapy focuses on cultivating healthy self-doubt so clients no longer avoid feedback and negative emotions because they can learn from new information and emotions.


  • Educating on the States of Mind: RO DBT educates clients on mindfulness concepts, such as fatalistic and fixed mindsets, and guides them towards flexible mind approaches instead.


  • Increasing Social Connection: RO DBT emphasizes the importance of social connections and relationships, which can help perfectionists shift their focus from achieving perfection to building meaningful connections with others.


  • Emphasizing Emotional Expression: By encouraging adaptive emotional expression and vulnerability, RO DBT can help perfectionists learn to accept and work through their emotions instead of striving for perfection as a way to avoid uncomfortable feelings.


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