“When the student is ready, the tutor will appear”. He did and introduced me to the quest to find answers through reading, youtube, lectures. What I found out most recently is that the foundation of much of the anxiety started when I was 3 years old and hounded by nightmares of those close to me “dying”, being murdered by a Volkswagon car. At age of 32 a traumatic brain injury changed my destiny, the level of perfection which started from childhood, became the real rod upon my back. Perhaps this is why the neuropsychologist stressed to me that the outcomes from brain injuries differ. ADHD was not talked about in the 1960’s but with the benefit hindsight, it needs to be looked at now. Perfection is a hard task master and it consumes your brain … my advice is be alert to it and learn to accept “Enough” not “Perfection”. ADDitude “Adults Living with ADHD” is an article I can concur with. See below. (I highly recommend this article, each and every line, I can identify with … and I am a believer in lifelong learning…6 decades now).

Inside the ADHD mind

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Emotions & Shame

When Perfectionism Stems from ADHD: Challenging the Fallacy of “Not Good Enough”

Perfectionism, when unhealthy, drives a person to exhaustion striving for a flawlessness that’s neither reasonable nor healthy. Though it may seem contradictory, perfectionist traits may stem from ADHD — an overcompensation for past errors or for feeling “not good enough.” Letting go of perfectionism does not mean eliminating worries around mistakes, failure, and judgment, but rather accepting that they are part of life — and one that can help us grow.

Sharon Saline, Psy.D.

By Sharon Saline, Psy.D.

Verified Updated on February 14, 2022

Vector illustration in super mom concept, many hands working with very busy business and housework part, feeding baby, cleaning house, cooking, doing washing, working with laptop. Flat design.

Perfectionism is rarely an enviable trait. It is not on-time birthday cards and spotless kitchens, or even taxes submitted before the deadline. Perfectionism is an unhealthy obsession with flawlessness that causes people to set unattainable personal standards, compare themselves to others, and never quite feel “good enough.” It can make criticism, even constructive, cut like a knife. And it can advance mental health conditions, like anxiety.1

According to the American Psychological Association (APA), perfectionism is the tendency to demand of others or of oneself an extremely high or even flawless level of performance – above and beyond what is required by the situation.1

Though the link may seem unlikely at first glance, perfectionism is also strongly associated with attention deficit hyperactivity disorder (ADHD or ADD).2 For some, perfectionism is a psychological overcompensation for past ADHD-related errors or for feelings of inferiority. For others, it is a form of self-punishment or even procrastination. Perfectionism often stems from this: incorrectly estimating the demands of a task or situation, misunderstanding when to let some things go and the inability of accessing resources to help you cope with a perceived challenge.

Decreasing perfectionism begins with cultivating self-awareness and adopting strategies to dissolve patterns of anxiety and negative self-talk. People with ADHD may also benefit from improving the executive functions that help them combat procrastination and other self-defeating behaviors that feed into perfectionism.

Perfectionism can manifest in various ways, including the following:

  • All-or-nothing thinking; a fixed or rigid mindset (believing that mistakes represent personal, unchangeable flaws)
  • Setting unreasonable standards
  • Negative comparisons; not feeling “good enough”
  • Self-criticism; negative self-talk
  • Living by “shoulds”
  • Procrastination (to avoid failure or discomfort, perfectionists may delay tasks)
  • Fear or reluctance to ask for help
  • Sensitivity to feedback; defensiveness
  • Easily discouraged due to incomplete or imperfect results
  • Fear of social rejection; low self-esteem

[Get This Free Download: 9 Truths About ADHD and Intense Emotions]

These manifestations may be associated with any of these three main types of perfectionism identified by researchers3:

  • Self-oriented perfectionism: Associated with unrealistic, irrational standards for the self and punitive self-evaluations. This type of perfectionism can reveal a vulnerability to a host of mental health diagnoses such as generalized anxiety, depression or eating disorders.
  • Socially prescribed perfectionism: Associated with beliefs that others are harshly judging and criticizing you. With this kind of perfectionism, you may think that you must be perfect to obtain approval or acceptance from others. This type is also directly connected to social anxiety.
  • Other-oriented perfectionism: Associate with imposing rigid, unrealistic standards on others. Individuals with this type of perfectionism may evaluate others critically, often without forgiveness or empathy. As a result, they often struggle with all kinds of relationships, from professional to romantic and familial.

At its core, perfectionism is related to anxiety. Anxiety doesn’t like discomfort and uncertainty, and it tries to make the resulting feelings of fear and worry go away immediately.

Perfectionism acts as a maladaptive, inefficient coping mechanism for managing anxiety. Perfectionists try to avoid a possible disappointment, potential embarrassment or inevitable punishment due to failure. To prevent stress and reduce insecurity, perfectionists create and impose rigid standards that they must meet to feel worthwhile. But these high, difficult-to-meet standards can end up fueling anxiety just the same, driving a vicious cycle.

[Read: You’re Not Perfect, So Stop Trying to Be]

In adults with ADHD, the rates of anxiety disorder approach 50% and symptoms tend to be more severe when ADHD is in the picture.4 This comorbidity contributes significantly to the prevalence of perfectionism in individuals with ADHD.

Perfectionism and ADHD Overlap

Perfectionism and ADHD share many traits, including the following:

  • Fear of failure and of disappointing others. People living with ADHD frequently experience moments when they’re aware that they’re struggling or have missed the mark in some way, and they don’t know how to make it better. (These moments can evolve into persistent worries that lead to chronic, low-level anxiety.) Older teens and adults with ADHD will often engage in perfectionistic behaviors to avoid unpleasant or embarrassing outcomes.
  • Setting unrealistic or impossible standards of performance. Many people with ADHD blame themselves for things that aren’t their responsibility, or they beat themselves up over relatively small mistakes.
  • All-or-nothing thinking. If it’s not perfect, it must be a failure.
  • Constant comparison to others. People with ADHD often critically compare themselves to neurotypical peers.
  • Sensitivity to criticism, sometimes intensifying to the level of rejection sensitive dysphoria.
  • Easily discouraged by setbacks. It can be hard to begin again, especially when the initial motivation was hard to muster.
  • Rejecting praise, or believing that you don’t really deserve success (shrugging it off as luck)
  • Depending on others for validation and approval. 

Perfectionism, Procrastination, and ADHD

ADHD and perfectionism also share the trait of procrastination. Putting off tasks is a known challenge with ADHD, and it often occurs when a task seems too large, takes too much effort or appears downright unappealing.

Procrastination is also inherent in perfectionism, however the nature of the delay may differ:

  • Perfectionism procrastination results in an inability to start or finish a task if certain idealistic conditions aren’t in place. These “successful” conditions are believed to limit mistakes and reduce future shame.
  • Avoidance procrastination results in putting off or delaying a task that seems too difficult or extremely unpleasant. In this scenario, a lack of confidence in one’s ability adds to someone’s difficulty in gauging how to measure and approach the task. This type of procrastination is often the product of a previous experience of failure.
  • Productive procrastination results in engaging in less-urgent tasks that are more easily accomplished and delaying the more urgent, unattractive ones because of underlying doubts or fears. This delay tactic provides short-term relief but increases long-term stress.

How to Escape the Trap of Perfectionism

1. Build Awareness

  • Practice mindfulness. Neutrally observe a judgmental thought when it arrives. Notice how your body feels when you’re overwhelmed or drifting into perfectionistic territory. Reflect on tools to stay centered rather than getting hooked by thoughts about unattainable excellence.
  • Investigate perfectionism with curiosity. Notice when you push yourself to do something perfectly or criticize yourself for fumbling. What standard are you trying to meet and why? Identify the underlying worry and try shifting to wondering about an outcome instead of predicting a negative one..
  • Address the psychological precursors of perfectionism. Do you need to feel accepted, good enough and praised? These core psychological desires among other hopes for validation, inclusion and connection frequently lie underneath perfectionism and go along with having ADHD.
  • Address imposter syndrome, fear of failure, and shame. “People don’t know the failure I truly am.” “If I mess up, I’m a bad person.” Sounds familiar? Expectations of judgment, humiliation, or rejection due to mistakes reflect a fundamental, false belief of deficiency that often accompanies ADHD and perfectionism.
  • Create and repeat soothing, supportive phrases such as “I’m trying my best, and sometimes it doesn’t work out” or “We all make mistakes. It doesn’t mean I’m a bad person.” Save these phrases in your phone or on a sticky note so you can refer to them later. They will help you talk back to the negative voice and nurture your positive attributes during stressful moments.

2. Shift Your Focus

  • Pay attention to what’s working instead of what isn’t. Notice the good as much as or more than you notice challenges. Try to track the positives in your day using voice memos, journaling, or sticky notes. Research shows that gratitude reduces negativity and fosters a positive outlook.5
  • Learn to enjoy small achievements as much as big ones. This is notoriously difficult for any perfectionist, but with practice, you’ll learn to set accurate expectations for yourself and others. By appreciating the “little” things, you will soon notice how they add up to a larger sense of self-worth.
  • Stop comparing your insides to people’s outsides. Avoid “compare and despair.” Many people hide their worries and fears. Don’t assume they’re in a better place because they look or act more put together. Instead of looking sideways, glance backward to acknowledge how far you’ve come and forward to acknowledge where you’re going.

3. Accept Mistakes

  • Know that learning – and making mistakes – are essential parts of living. A fixed mindset limits you to believe that mistakes represent personal, unchangeable flaws. With a growth mindset (or one of a “recovering perfectionist”), you know that you can stumble, pick yourself up, and try again.
  • Practice self-compassion. Be kinder to yourself when things don’t turn out as you hope. Avoid harsh self-talk and turn your attention away from the internal noise of worthlessness. (This is where mindfulness helps.) Play music, or shift to anything else that will distract you from the negative thoughts.
  • Notice your progress. Anxiety erases memories of success. If you have trouble remembering your successes, enlist a friend or a loved one to help jog your memory. Keep track of these moments of triumph because they offer you hope for the future.

4. Receive Feedback with Grace

  • Feedback is a fundamental part of life. Someone will always have something to say about you and your actions. Try to accept what you hear, negative or positive, with neutrality and grace. Consider the source and mull it over before deciding if it has validity.
  • Use reflective listening to deflect an overly emotional response. After you receive feedback, ask “What I heard you say is X, did I get that right?” This will ground you and prevent impulsive emotions from taking over. Plus, you acknowledge what they said without being defensive.
  • Determine if there is any truth to what you hear. Do you deny a compliment? Can you learn something from the feedback and make a change? Think: How can this feedback help me move forward in my life?
  • Acknowledge feedback and be accountable without accepting unnecessary blame. Your goal is to stay present, avoid defensiveness, and stop a shame spiral triggered by critical feedback. Apply what makes sense to you and use it for your advancement. This about you being a fuller version of yourself, not a better one.

5. Set Realistic Goals

  • Use your own compass to determine what’s possible. Start to consider what you can actually handle rather than blindly applying unachievable standards set by others. Think about what you would like to move toward versus what you think you should.
  • Set limits if you’re unsure about meeting a request. Be honest with yourself about what you can actually handle. If you are unsure, take the time you need to figure it out.
  • Differentiate your goals. There are goals that we can complete most of the time with minimal support, those that we can tackle with some support (middle range), and those that are not in our wheelhouse yet (top tier). Knowing how to classify your goals will dictate how much space and resources you need to accomplish them. Try to have no more than two major goals at one time.

6. Improve Executive Functioning Skills Tied to Perfectionism

  • Time management: Address the time blindness that comes with ADHD by externalizing time and reminders, and by following routines. Use electronic and paper calendars to note deadlines and use alerts and alarm for reminders.
  • Organization: Use lists to do a brain dump and then prioritize your to-dos by separating out actions for certain days or actions based on similarities. Use organization systems that make sense for your brain. Remember, aim for efficacy, not perfection.
  • Planning and prioritization: Use the Eisenhower Matrix to organize tasks by urgency and importance. Consider how you like to approach tasks: Do you prefer to start with easy tasks to warm up and then move to something harder? What types of things distract you? How can you prevent last-minute rushes and crises?
  • Emotional control: Find simple ways to support yourself when you feel uncomfortable such as affirmations, deep breaths, or reminders of past successes. Create a plan when you are feeling calm about what you can do when you are activated. Write it down on your phone and then look at when big feelings begin to rumble.
  • Metacognition: Tap into your state of mind and think about your thinking. Ask: “How am I doing? What’s helped me before, which I could apply to this situation?” Reflect on open-ended questions that foster honest thinking, without criticism and “shoulds.”

Every so often, it’s natural to worry and feel pressure to perform well. Overcoming perfectionism does not mean eliminating these worries, but rather changing your reaction to them. Follow an approach of radical acceptance. Value who you are: a mix of strengths and challenges just like everyone else, without judgment. When you believe in your ability to grow, learn, and adapt, you will increase your resilience and be able to confront your anxieties around “not getting it right.” Instead, you’ll focus on the many ways you do.

Perfectionism and ADHD: Next Steps

The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, “Perfectionism and ADHD: Making ‘Good Enough’ Work for You” [Video Replay & Podcast #385] with Sharon Saline, Psy.D., which was broadcast live on January 19, 2022.


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Sources

1 American Psychological Association. (n.d.). Perfectionism. In APA dictionary of psychology. Retrieved January 27, 2022, from https://dictionary.apa.org/perfectionism

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2 Strohmeier, C. W., Rosenfield, B., DiTomasso, R. A., & Ramsay, J. R. (2016). Assessment of the relationship between self-reported cognitive distortions and adult ADHD, anxiety, depression, and hopelessness. Psychiatry research, 238, 153–158. https://doi.org/10.1016/j.psychres.2016.02.034

3 Flett, G.L., Greene, A. & Hewitt, P.L. (2004). Dimensions of perfectionism and anxiety sensitivity. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 22, 39-57. https://doi.org/10.1023/B:JORE.0000011576.18538.8e

4Katzman, M.A., Bilkey, T.S., Chokka, P.R. et al. (2017.) Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry 17, 302. https://doi.org/10.1186/s12888-017-1463-3

5 Cunha, L. F., Pellanda, L. C., & Reppold, C. T. (2019). Positive Psychology and Gratitude Interventions: A Randomized Clinical Trial. Frontiers in psychology, 10, 584. https://doi.org/10.3389/fpsyg.2019.00584

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Before leaving this article: Michelle Marcella Clarke was diagnosed with breast cancer in 2017. Yesterday I met with Professor John Crown, Oncologist, he mentioned it was now into the fifth year since we first met. This is a positive because there has been no relapse.

I wrote a book during the period with cancer, sadly my mother died while I was having chemo.

Book is published by Amazon. Fortune Favours the Brave, by Michelle Marcella Clarke

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About michelleclarke2015

Life event that changes all: Horse riding accident in Zimbabwe in 1993, a fractured skull et al including bipolar anxiety, chronic fatigue …. co-morbidities (Nietzche 'He who has the reason why can deal with any how' details my health history from 1993 to date). 17th 2017 August operation for breast cancer (no indications just an appointment came from BreastCheck through the Post). Trinity College Dublin Business Economics and Social Studies (but no degree) 1997-2003; UCD 1997/1998 night classes) essays, projects, writings. Trinity Horizon Programme 1997/98 (Centre for Women Studies Trinity College Dublin/St. Patrick's Foundation (Professor McKeon) EU Horizon funded: research study of 15 women (I was one of this group and it became the cornerstone of my journey to now 2017) over 9 mth period diagnosed with depression and their reintegration into society, with special emphasis on work, arts, further education; Notes from time at Trinity Horizon Project 1997/98; Articles written for Irishhealth.com 2003/2004; St Patricks Foundation monthly lecture notes for a specific period in time; Selection of Poetry including poems written by people I know; Quotations 1998-2017; other writings mainly with theme of social justice under the heading Citizen Journalism Ireland. Letters written to friends about life in Zimbabwe; Family history including Michael Comyn KC, my grandfather, my grandmother's family, the O'Donnellan ffrench Blake-Forsters; Moral wrong: An acrimonious divorce but the real injustice was the Catholic Church granting an annulment – you can read it and make your own judgment, I have mine. Topics I have written about include annual Brain Awareness week, Mashonaland Irish Associataion in Zimbabwe, Suicide (a life sentence to those left behind); Nostalgia: Tara Hill, Co. Meath.
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