OCD & Perfectionism and Certainty: Understanding the Connections and Differences

This month, we’ve been exploring the facets of OCD; its symptoms, how it presents itself, as well as how it effects the people who carry its diagnosis.

In this blog, we will talk about how perfectionism can play a part in Obsessive Compulsive Disorder and Obsessive Compulsive Patterns. Webster’s dictionary defines perfectionism as “a refusal to accept any standard short of perfection.” In theory, a desire to reach perfection could be beneficial, and helpful to achieving certain goals. Let’s begin by looking at some different ways to think about the patterns that can be associated with perfectionism. A healthy level of perfectionism may come with the following patterns or behaviors:

  • Being goal oriented
  • Having good organizational skills
  • Remaining persistent, even when things are challenging
  • Striving to do things in the most efficient manner, with the best results
  • A strong desire to do things well, and to expect the same from others


These are all examples of things someone striving for perfectionism might apply to their daily lives. A key difference I think about to where the above patterns can go from being adaptive to unhelpful or maladaptive is lack of flexibility in how one assesses expectations. Specifically some have defined Maladaptive perfectionism as the unhealthy setting of unrealistic standards combined with harsh self-criticism and low self-esteem. It can often accompanied by a sense of not feeling “good enough” and feelings of distress, anxiety and sometimes depression.

Some specific unhealthy and harmful ways to demonstrate perfectionism may include:

  • Being obsessed with the expectations of others, especially unrealistic expectations
  • Fear or phobia of making a mistake or doing something incorrectly
  • An unexplainable need to control how things are done, regardless of the outcome
  • Excessive overthinking of past mistakes, or not being able to move on from failure
  • Obsessive doubt that a task has been completely correctly


These perfectionistic tendencies have been linked to OCD, as the person carrying the diagnosis may believe it’s the only way to control—or have certainty—over their own decisions and daily lives. Especially if one’s OCD revolves around constant and obsessive checking, this type of perfectionism can easily consume an individual. Many people who struggle this way fear that if they do not do something perfectly, it can lead to a harmful or catastrophic event. For example, if I forgot to lock my door; if I do not check over and over again that I have, my home will be broken into, or harm my come to me and my family due to an intruder. Or, if I can’t be sure that I unplugged my flat iron, my home  could burn down. While the constant checking is supposed to provide a sense of security, it can have the opposite effect, as the person struggling can begin to feel panicked by not being able to remember, or worse, if the task wasn’t completed, the fear of imperfection carries a weight that they are imperfect and therefore flawed.

In addition to perfectionism, someone struggling with OCD will often have an inexplicable need for certainty, even about things that they should know are absolute. 

For example, someone struggling in this way may have intrusive thoughts telling them that they are going to harm someone. The person may find themselves thinking that they need to be certain that they will not run their car into oncoming traffic while driving. Even if they know they never would, if they find themselves thinking about doing it, they must exert mental energy convincing themselves that they won’t. This leads them to believe that committing the act is a possibility, which then leads to deep thoughts of shame, and self loathing, for even having the thought, or worse, not being certain that they won’t do it. This can make obsessions worse, as the individual will then resort to the obsessions they rely on to be certain that they don’t put the thoughts into action, leading to a vicious cycle of striving even harder for perfection or certainty.

To be clear, perfectionism is not the same thing as OCD. The patterns that lead to one are often associated with each other and they often are correlated and can exacerbate and worsen each other, but are not the same. There are people who have OCD and don’t necessarily struggle with perfectionism and certainly many people are perfectionistic and have no Obsessive compulsive symptoms or patterns. 


So what can be done to help when one is struggling with perfectionism and the obsessive need for certainty? What are the tools that are most helpful?

To start, it’s important to keep perspective, even in moments of the unexplained need to be perfect. For example, what are some of the areas of your life that you are okay with things NOT being perfect? Identify those areas, and think about what the outcome was when those things were not perfect. Now, try to apply those same consequences to the areas you’re striving for perfection in. Additionally, think of times in your life where someone you care about fell short of perfection. Did you feel they were a failure? Did it change how they felt about themselves? Most likely not. It’s important to try to apply the same expectations to yourself. 

You can also begin with the information you have, the skills you possess, and the things that are actually in your control. Set a new bar. Can doing the best you can with what you have be good enough? Understanding that you’re not responsible for controlling every outcome, especially ones you can’t predict, can give you a sense of accomplishment and freedom.

Practice mindfulness. Generally, mindfulness is the act of a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations, used as a therapeutic technique. Taking the time to do this in moments of doubt can help you redirect your thoughts to more realistic ones, instead of having unrealistic expectations for yourself and others. 

Shift your focus. Ask yourself WHY you care so much about this particular thing being done perfectly. Is it because it is really, truly important to you? Or is it because you have an obsessive need to make sure everything is done that way? While you might not be able to eliminate the need for certainty, or to do things perfectly in every area of your life, you can identify the things that—in the long run—will not be as catastrophic if they’re out of your control or not done perfectly. 

The tips mentioned above are some very quick basic skills and tips to help in these areas. With that, OCD can be a very complex set of symptoms and its often not easy to break through the symptoms and easily put strategies like those mentioned above in place quickly. If you find yourself struggling to implement skills or tools to address you symptoms it might be time to discuss it with a mental health professional who can assist you in where you may be stuck.  

There are many ways to treat OCD, and one of the most important steps is to meet with a mental health professional to help you express your thoughts, accept your uncertainty, and develop healthy habits, skills and strategies. Call today to schedule your intake appointment with one of our psychologists! And come back next month where we will be talking in depth about various treatment options for OCD. Feel free to learn more by visiting our blog page or FAQ today!


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