Understanding and Unlearning Perfectionism

By Audrey Stephenson

More than a decade ago, my clientele shifted from poor London communities with developmental trauma to high-achievers in central London with chronic anxiety. 

Quite a change on the face of it but I soon discovered that the therapeutic work with these two groups was in fact remarkably similar. 

The realisation that the mental and emotional patterns of the vulnerable trauma clients and high-achievers had so much in common was a lightbulb moment. Not only was there a basic lack of compassion for their own vulnerabilities but I could see that perfectionism was an underlying factor in these patterns, and this, alongside signs that perfectionism was increasingly prevalent among women across generations, led me to a deeper exploration of this growing phenomenon.

What is perfectionism?  

For therapy professionals, perfectionism isn’t just an above-average attention to detail.

Our focus is maladaptive perfectionism, an unhealthy combination of excessively high personal standards and overly critical self-evaluations driven by shame and fear of failure. Characterised by a harsh inner voice and rooted in a persistent anxiety about not being good enough, these unrealistic standards lead to procrastination and chronic dissatisfaction.

The goal of therapy is to do away with the inner tyrant (“you need to be amazing or you’re nothing”) and bring back the joy in excellence, not making people mediocre or somehow diminish their drive.

Finding that joy in a job well done means returning a sense of balance – a task the neurological competition is too stiff to talk your way out of. Both brain hemispheres are against the maladaptive perfectionist: the analytical left with a judgmental inner critic and the intuitive right giving rise to the nagging “not good enough” feelings.

The brain doesn’t care if you’re happy — its agenda is survival. Perfectionistic patterns persist because they’ve kept you alive. Recognising that maladaptive perfectionism is rooted in the brain’s machinery just doing its job pushes the shame aside to make space for compassion. 

The task is then somatic and sensory work to shift the neurological patterns. Psychosensory methods integrate the body and brain through movement, breath, and hypnotherapy.

Causes and consequences of perfectionism

There’s a slight genetic component and some twin studies link an overactive left hemisphere to self-critical tendencies but the evidence is that perfectionism’s origins are overwhelmingly environmental. 

The cultural conditioning of 1980s–2000s “yuppie” and corporate culture which rewarded perfectionism: “My weakness? I’m a perfectionist” is a familiar example. More recently, social media has compounded the issues by introducing new forms of socially prescribed perfectionism — the belief that others demand flawlessness.

Pressure to optimise every area of life: wellness, body, productivity, motherhood, relationships.

The constant comparison leads to a chronic not-enoughness. This is especially true with body image. Sadly, after a brief moment of body positivity, that wave has now largely faded from the cultural context, with increasing rates of perfectionism-linked disorders (anxiety, depression, OCD, eating disorders) among young girls.

The cultural expectation for women in particular to be “immaculate” and a fear of showing vulnerability or imperfection. So perfectionism becomes a strategy for worthiness and belonging.

Male mentors encouraging risk-taking (“just say yes — figure it out later”) contrasts with women’s socialisation toward caution and flawlessness.

Perfectionism is destructive to relationships because it puts up a barrier to intimacy.  

I see clients mostly women who hide panic attacks from their partner) illustrate perfectionism as a barrier to intimacy.The fear of being “seen” as imperfect leads to disconnection and loneliness.

Striving to do well becomes less about the pursuit of excellence and more about worth, “If I’m not flawless, I’m not lovable or valuable.”

What Helps

In an ideal world, there would be a cultural shift to move from impeccability to authenticity, with new models of success and womanhood that embrace imperfection. 

On the individual level, what works in my experience is a holistic approach that educates people who suffer from maladaptive perfectionism about the brain and perfectionistic patterns.

Body-based and psychosensory work is needed to break the deep-set neurological patterns. Hypnotherapy is a great tool for subconscious reprogramming alongside coaching and therapy to foster self-acceptance and joy in excellence.

In conclusion, perfectionism is not just a personality trait — it’s a survival strategy conditioned by culture. True growth lies in balancing drive with self-compassion.

This work is both individual and collective: changing the internal narrative and the external culture.

If you are struggling with anxiety and shame rooted in unhealthy standards book a discovery call to find out if working with Audrey can help you to find the joy in excellence.

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This article is based on Audrey Stephenson’s talk to the Bath and North East Somerset Women's Leadership Network in October 2025