On the surface, OCD and perfectionism and can look the same; both scientific and anecdotal evidence exists that suggests people with OCD are more perfectionistic.
What is Perfectionism?
Perfectionism is refusing to accept any standard that falls below perfection. It is a personality trait characterised by aiming for flawlessness, setting unrelentingly high standards as well as over critical self-evaluations and concerns regarding others.
Perfectionists may be preoccupied with past mistakes, making future mistakes, or doubts about whether they are doing something correctly.
Perfectionism alone can be motivating and push us to achieve a lot, however, when we set expectations too high for ourselves, it can result in a perception of failure and criticism leading to self-doubts, and putting our relationships in jeopardy.
Someone who falls high on the spectrum of perfectionism as a personality trait may also have habits or rituals they follow rigidly, for example, a certain morning routine or a way of organizing their belongings. However, they’re not necessarily doing it out of anxiety.
There are two types of perfectionism: adaptive and maladaptive. The former is characterized by being goal-directed, conscientious, having effective organization, high standards, and determination.
The latter is linked with OCD because it can cause distress and excessive preoccupation with control. For example, someone with maladaptive perfectionism may experience severe distress when not excelling on a work task. Similarly, someone with OCD may experience severe distress at the thought of having to open a public doorknob to get out of a building, in fear he will be contaminated.
Conversely, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) specifies OCD as having obsessions “(eg recurrent and persistent thoughts or impulses), compulsions (eg repetitive behaviours), or both which are time-consuming and are not due to a medical condition or the effects of a substance”.
What is OCD?
OCD is identified by the presence of obsessions and compulsions perpetuating significant levels of anxiety.
The individual may acknowledge that the obsessions and compulsions are a product of their mind and acknowledge that at least one obsession or compulsion is unreasonable, excessive or irrational. These obsessions and compulsions create severe distress and significantly interfere with day-to-day functioning with the need to act out compulsions, such as checking locks, or washing hands.
The specific cause for OCD is still being investigated, however, most experts believe it involves abnormalities in the absorption and reuptake of neurotransmitters serotonin and dopamine.
OCD is ego dystonic, meaning that it is distressing to the individual and does them a disservice, whereas perfectionism can be more ego syntonic, meaning it serves the individual and can add value and order to their life. Individuals with OCD are aware their thoughts and behaviours are problematic, whereas those with perfectionism welcome their orderliness.
The key difference that discerns personality ‘quirks’ from clinical OCD, is the distressing and unwanted nature of the obsessions and compulsions that interfere with every day functioning, that may take up a significant amount of time (ie more than an hour per day) and impact quality of life. If a personality trait does not cause distress or impairment to the individual’s life, it is unlikely to meet criteria for OCD.
There are four basic components of OCD, and OCD will almost always involve these four aspects:
- Intrusive thoughts (obsessions);
- Compulsions (behaviours);
- Temporary relief; which may only last minutes until the next intrusive thought (obsession) occurs.
“Obsession” refers to a fear or anxiety that is intrusive by nature and reoccurs. The fear could be a fear of germs, contamination, getting sick, someone breaking in your house, your house burning down, or of hurting yourself.
Sometimes these fears are coupled with vivid and startling images of catastrophes and worst-case scenarios that are ongoing.
The fear in and of itself is not sufficient in meeting diagnostic criteria for OCD. To meet the OCD threshold, the obsession has to be accompanied by “compulsions”: rituals or behaviours that serve to alleviate the anxiety around the obsession.
The compulsion may be counting (to a “special” number); checking that the doors are locked a certain number of times; washing your hands in a prescribed way; checking that the stove is off a number of times; or repeating a certain saying or prayer to yourself in a specific way. While these rituals lessen the anxiety for a short time, the obsessive thought resurfaces, and the ritual has to be repeated again.
By nature: Perfectionism is a personality trait measured on a spectrum; OCD is classified as a mental disorder significantly impairing functioning and causing distress.
By definition: OCD encompasses obsessions and compulsions which are time consuming and not due to a medical condition or substance use, whereas perfectionism is defined as a disposition to view imperfection as unacceptable
Author: Tara Pisano, BA (Psych) (Hons), M Psych.
Tara Pisano is a Brisbane psychologist with a special interest in early intervention in adolescents and young adults, as this is when three quarters of mental health conditions emerge. In her practice, she draws on a range of evidence-based therapies such as CBT, DBT, IPT, ACT and Motivational Interviewing, to promote recovery and positive outcomes.
To make an appointment with Tara Pisano, try Online Booking. Alternatively, you can call M1 Psychology Loganholme on (07) 3067 9129 or Vision Psychology Wishart on (07) 3088 5422.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. 5th. Arlington, VA: American Psychiatric Association.
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- National Institute of Mental Health. (2019). Obsessive-compulsive disorder. https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml
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