Demanding Perfectionism and Your Health: Ten Types of Perfectionism and How They May Be Adversely Affecting Your Physical and Mental Heath

By Elliot D. Cohen, PhD, author of Making Peace with Imperfection

Perfectionism has been touted as an admirable and productive philosophy of life by many who live it. But before proudly proclaiming yourself a perfectionist, let’s define our terms because there is both a healthy sense and a very pernicious one. This blog will help you check to see if you are an unhealthy perfectionist.

Aspirational Perfectionism

In the healthy sense, being a perfectionist means that you are constantly aspiring to be perfect, shooting for the stars, attempting to become better and better at what you do, realizing that there is no limit to how good you can get. But if you screw up or fail to accomplish your immediate goal, you are still cool about it. “Well, I can learn from my mistake, and continue to improve.” Notice that in this case, perfection is an ideal, something to shoot for, but not likely something you will ever achieve. You are comfortable with this and welcome the challenge of continuing to grow and prosper. The sky is the limit, and you shoot for the stars, but you do not DEMAND that you reach them!

Demanding Perfectionism

In contrast, being a perfectionist may mean that you demand no less than perfection in whatever you do, or at least in some things—your job, sports, school, etc. In this sense, making a mistake is a sign of being a failure, a weakness, or ineptitude. If others disappoint your perfectionistic expectations, you may likewise see them as incompetent, stupid, losers, or otherwise deficient. For some perfectionists of this ilk, if things don’t go their way, the world itself is a sucky place, or just not one that passes muster. In short, you may DEMAND perfection of yourself, others, and/or the world—or some part of it. And, as a result, you live in a perpetual state of stress. Even when you are at the top of your game, there is always the possibility of screwing up tomorrow, so you suffer intense anxiety even then; and when you fall short as you inevitably shall, you suffer intense guilt (“I should have been better prepared”), or dark depression (“I’m just a big loser, after all”). These are fighting words, and enough to drive a demanding perfectionist to attempt suicide.[1]

Additionally, this demanding form of perfectionism has been linked to chronic diseases such as fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome.[2] It has also been at the root of eating disorders such as anorexia nervosa.[3] And, since it creates intense, ongoing stress, it has also been linked to high blood pressure[4] and cardiovascular disease.[5] Further research suggests that it is negatively linked to recovery from diseases such Crohn’s disease, ulcerative colitis, and heart attacks; and can even predict earlier mortality.[6]

Further, consider that, without your mental and physical health, you are not likely to perform well at the things that matter the most to you, at least not in the long run. More likely you will do worse due to the needless stress you foist upon yourself.[7] So, not only is demanding perfectionism unhealthy, it’s also self-defeating!

So, if you’re a demanding perfectionist, you have some very good reasons to overcome it! But are you, indeed, a demanding perfectionist versus an aspirational perfectionist?

Ten Types of Demanding Perfectionism

In fact, there is not just one form of demanding perfectionism. In my latest book, Making Peace with Imperfection, I identify, examine, and provide specific practical exercises for overcoming each of ten different types of demanding perfectionism. Table 1 lists each type of perfectionism along with its respective demand.

Table 1

Type of Demanding Perfectionism


  1. Achievement
I must not fail or make mistakes.
  1. Approval
I must get others to approve of me.
  1. Moral
I must not do anything morally wrong.
  1. Control
I must be in control.
  1. Expectation
Others must meet up to my expectations.
  1. Ego-Centered
Others must share my believes, values, or desires.
  1. Treatment
Others must treat me fairly.
  1. Existential
Bad things must not happen.
  1. Neatness
Things must be neat and tidy.
  1. Certainty
I must be certain before I make a decision.

Notice that each of the demands in the Demand column of Table 1 contains a “must.” In using this term (or a related one such as “should” or “ought”), demand perfectionists prescribe that reality conform to their preferences, for example, that other people always approve of them. However, as the Buddhists admonish,[8] in clinging to the idea that reality be as you prefer, you set yourself up for great suffering; for reality will be as it is, not as you prefer it to be!

Take the Demanding Perfectionism Inventory Now!

Do you have any of the above types of demand perfectionism? To find out, ask yourself if any of these psychological descriptions sounds like you:[9]

  1. I am hard on myself when I fail, make a mistake, or otherwise fall short of my goal. In such cases I experience self-doubts, put myself down, or keep thinking about my perceived inadequacy.
  1. I feel insecure about myself if I don’t get the approval of others (or certain others), and I try very hard to get their approval.
  1. I experience strong guilt when I think I have done something morally wrong or unethical. In such cases, I question my self-worth and keep thinking about it.
  1. I experience strong anxiety about the possibility of not being able to control or prevent bad things from happening to others or myself. I keep thinking about such possibilities and what I might do to try to prevent them.
  1. I get upset when I think that others (or certain others) have messed up or otherwise have not met up to my expectation/s. I then take a negative attitude toward them.
  1. I get disturbed when others disagree with me, don’t share my point of view, or don’t want to do things my way.
  1. I get very upset when I think others have treated me badly. In such cases I have a hard time letting it go and dealing with it in a way that does not negatively affect me behaviorally and emotionally.
  1. I get upset when I think about the bad things in my life, in the lives of others, or in the world. I keep thinking about them and have a hard time getting them out of my head and relaxing.
  1. I get upset when things are messy, out of order, or not in the condition I think they must be.
  1. I experience anxiety when there is a possibility, even a very small one, of something bad happening, or having happened, and it makes it difficult for me to relax. While the assurances of others may help to some extent, the mere possibility still feels like a dark cloud hanging over me.

Table 2 points to the specific type/s of demand perfectionism you may have, based on your responses to the Demand Perfectionism Inventory.

Table 2

If you identify with description  # Then you are this type of perfectionist:





















If you have identified one or more of the types of perfectionism in Table 2, then you are likely creating needless stress that can have untoward effects on your physical as well as mental health. The good news is that demand perfectionism can be overcome by making suitable cognitive and behavioral changes through practice.[10] This is in your power, so you need not suffer the adverse health consequences of demand perfectionism.

[1] Hicks, J. (July 28, 2017). Study suggests link between perfectionism and suicide Vice

[2] Sirois, F.M. and Molnar, D.S. (2014) Perfectionism and maladaptive coping styles in patients with chronic fatigue syndrome, irritable bowel syndrome and fibromyalgia/arthritis and in healthy controls. Psychotherapy and Psychosomatics, 83 (6). 384 – 385. ISSN0033-3190.…pdf

[3] Lloyd, S., Yiend, J., Schmidt, U., and Tchanturia, K. (2014). Perfectionism in anorexia nervosa: Novel performance based evidence. PLOS One, 9(10).

[4] Curran, T, and A.P. Hill (2019) Perfectionism is increasing over time: a meta-analysis of birth cohort

differences from 1989 to 2016. Psychological Bulletin 145(4). Washington, DC: American Psychological Association.

[5] Corson,, A.T. (2018). Perfectionism in relation to stress and cardiovascular disease among gifted individuals and the need for affective interventions. Roeper Review. 20(1).

[6] Flett, G. (2012). The Price of perfectionism. Washington, DC: Association for Psychological Science.

[7] Ruggeri, A. (February, 21, 2018). The Dangerous downsides of perfectionism. BBC.

[8] Hanson, R. (n.d.). The Second noble truth – The noble truth of the cause of suffering. Website.

[9] This inventory is reprinted here from Cohen, E.D. (2019). Making peace with imperfection: Discover your perfectionism type, end the cycle of criticism, and embrace self-acceptance, Oakland, CA: Impact.

[10] Cohen, E.D. (December 22, 2018). Do you make harmful perfectionistic demands? Psychology Today.

colorful wads of patter on a flat surface

Elliot D. Cohen, PhD, is professor and chair of the department of humanities at Indian River State College, adjunct professor of clinical ethics at the Florida State University College of Medicine, and director of the Logic-Based Therapy & Consultation Institute. Author of numerous books and articles, he is a principal founder of philosophical counseling in the United States, and inventor of logic-based therapy. He writes a blog for Psychology Today, and has been quoted in major media venues, including The New York Times Magazine.

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