The steps in this post are the basis for the treatment for the kind of depression I discuss in my book, Perfectly Hidden Depression – which at its most severe, can become deadly – as the pressure to never fail, to never falter becomes more and more intense. 

If you’re a perfectionist, it’s highly likely that you not only feel overwhelmed by the demands you place on yourself, you can also feel increasingly burdened by the ever-higher expectations that others develop for you.

Yet you can never.. ever… allow anyone to see your struggle.

Maybe you’re the teenage quarterback who has led your team to three state championships and now you’re being carefully watched by professional scouts. Or the young mother who’s been promoted at your job for your outstanding contributions, but you stay up til 1:00 am to get that very work done. Perhaps you’re the attorney who has an almost perfect trial record, and now you’re attracting more and more difficult, time-consuming cases.

The pressure is intense. Yet not meeting these high  expectations is something you cannot imagine – and you fear. 

Years ago, my at-the-time very perfectionistic self told a therapist, If I don’t keep my thumb at my back, pushing myself every minute, I”m afraid that I’ll become a slug.” 

You believe that the pressure is required for success. You don’t believe that innately you have what it takes. Moreover, you fear that others will see your vulnerabilities.

Fear is what keeps perfectionism alive. Fear of not being on top, of looking like you don’t have it it all together, of making mistakes that will be noticed, of rejection or judgment. Fear that you won’t be as good as you were last time.  And the list goes on.

Five steps to take if you’re caught up in a perfectionist spiral… 

1. Become conscious or aware that your perfectionism is a problem.  You likely created this perfect-looking persona to emotionally survive and even thrive as a child. It became the way you shielded and protected yourself whether you were aware of it or not. It’s not a constructive way to live. Because of its tyrannical reign, it now is destructive and only leads to intense loneliness.

Let’s illustrate the difference. You’re holding a pen in your hand, gently but firmly. There’s little chance that it will fall. That’s the constructive way to hold the pen. But what if you grasp it as hard as you can? You’re still holding the pencil, but in a the way that will only lead to exhaustion. And that, over time, is very destructive. 

2. Commit to change at a reasonable pace. Your fear of change can become so significant that you’ll put up barriers, justifying your frenzied life by saying, “It won’t get done if I don’t do it.” Or, “I’m the breadwinner in the family. We can’t get along on less money.” Or you’ll set perfectionistic standards for change, and sabotage yourself before you even get started. “I’ll stop everything I’m doing.” Or, “All I’ll focus on is the kids.”

Way too much, way too soon. Change needs to be gradual and gentle. 

3. Confront the rigid rules that you’re still following — that no longer truly help. We all learned rules to follow when we were young. “Don’t chew with your mouth full.” Or, “Always be kind.” But are there rules that are keeping your more authentic self from being revealed? “I can never show anger.” Or, “I can’t quit until the job’s done.” Look for those absolute rules to determine whether they’re truly helpful today. 

4. Connect with emotions long suppressed. Perfectionists don’t like to think about messy things, and especially avoid  messy emotions. You can have trauma and loss in your life that you’ve never connected with, or in fact, rigidly suppressed. It’s hard to do, and you may need a therapist’s help to do so. 

But as Terrance Real once wrote, “If you don’t feel it, you live it.” This is very true; ignoring emotions don’t make them go away. They continue to lurk in the background, and thus silently affect your life

5. Then risk change.  The process is all about learning from mistakes and being motivated by successes. Let’s take my early writing as an example. I went through a period when I thought using sentence fragments were very cool. One commenter on the Huffington Post called me out on it, “This woman can’t even make a full sentence.” She was right; I was learning and that period needed to end.

The learning is worth the risk. And seeing yourself change is where you can find hope.


You can hear more about mental health and many other topics by listening to my podcast, SelfWork with Dr. Margaret Rutherford. Subscribe to my website and receive one weekly newsletter including my weekly blog post and podcast! If you’d like to join my FaceBook closed group, then click here and answer the membership questions! Welcome!

My book entitled Perfectly Hidden Depression has arrived and you can order here! Its message is specifically for those with a struggle with strong perfectionism which acts to mask underlying emotional pain. But the many self-help techniques described can be used by everyone who chooses to begin to address emotions long hidden away that are clouding and sabotaging your current life.

And there’s a way to send me a message! You can record by clicking below and ask your question or make a comment. You’ll have 90 seconds to do so and that time goes quickly. By recording, you’re giving SelfWork (and me) permission to use your voice on the podcast. I’ll look forward to hearing from you!

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Originally published August 15, 2021; updated and republished March 26, 2023.

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