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Perfectionists who get frustrated and angry with themselves when they fall short of their own expectations increase their risk of falling into depression. Photo: Alamy

Why perfectionism causes depression and how self-compassion could save your life

An Australian study uncovers the dangerous health consequences of being self-critical for not meeting your own high performance standards. But there are ways to turn that negative inner dialogue into a positive one

People who consider themselves perfectionists are usually hard on themselves when things don’t go their way. Think of the straight-A student who gets a B on an exam and chides themselves for being a “failure”; the weight-conscious woman who starves herself when she realises that she has put on a couple of pounds; or an employee who thinks even a minor mistake at work will lead to catastrophe.

According to Jackie Chan, a psychologist at the Hong Kong Psychological Counselling Centre, perfectionism is an attitude or belief that there should be absolutely no flaws in one’s performance. Perfectionists set high – sometimes unrealistic – standards for themselves, and consider themselves failures when they cannot or do not meet those standards.

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The quest for perfection starts early in many people, especially when they have parents or other authority figures such as teachers who establish perfection as the desired standard. Any mistakes they make are usually met with criticism, name-calling, shaming, or even physical punishment. They grow up eager to please and receive praise from these adults, believing that their self-worth is tied to their achievements. The media, wider society and cultural beliefs can also contribute to the desire to be “perfect”.

Perfectionism is also characterised by overly critical self-evaluations and worry about others’ judgments and criticisms. While there is nothing wrong with setting or pursuing high standards, being meticulous, or wanting things to pan out a certain way, it is important to know that perfectionism is associated with a host of negative, even dangerous, consequences. These include self-harm, chronic fatigue syndrome, obsessive-compulsive disorder, insomnia, post-traumatic stress disorder, social anxiety disorder, anxiety and depression.

Jackie Chan from the Hong Kong Psychological Counselling Centre.

The link between perfectionism and depression was the focus of a recent study by the Australian Catholic University. The study, which was published in February in the journal PLOS One, found that self-compassion, or the practice of self-kindness, can weaken the established link between perfectionism and depression.

Dr Madeleine Ferrari, lead author of the study and a lecturer in clinical psychology at the university, said people who beat themselves up when they made mistakes or fell short of their own high performance standards could be called “maladaptive perfectionists”. Having such a mindset can lead to burnout and depression.

My idea of self-compassion [is] knowing and acknowledging that, whatever happened and whatever mistakes were made, I tried my best
Nicholas Wai, executive coach

Ferrari assessed 500 Australian adolescents and 500 adults. She discovered that self-compassion either reduced the frequency of perfectionist thoughts or altered the perception towards them altogether.

“Self-compassion offers an opportunity to manage these perfectionist beliefs so people don’t fall into depression,” Ferrari said. “Together with self-kindness, it consistently reduces the strength of the relationship between maladaptive perfectionism and depression for both adolescents and adults.”

Now more than ever, adults and adolescents are under great pressure to meet exceptionally high standards, both in their personal lives and at school and work. When they become excessively focused on their mistakes, and get frustrated and angry with themselves when they fall short of their own expectations, they increase their risk of falling into depression.

It is a global problem. In Hong Kong alone, it is estimated that three out of 100 adults suffer from depression, according to the Centre for Health Protection.

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“Depression affects how one thinks and behaves,” Chan says. “It’s associated with a host of symptoms, like a loss of interest in hobbies, feelings of worthlessness, poor concentration, an inability to make decisions, self-isolation, low sex drive and increased agitation, to name a few. Depression is also problematic because it can interfere with the sufferer’s daily functioning and the way he perceives himself and the world around him.”

Chan says there is a difference between the way self-compassionate people and self-critical people handle problems. The former, for example, tend to be more resilient and have a more positive outlook when things do not go their way. Chan adds that if you are already suffering from depression, self-compassion can aid the healing process – although this might only happen later, such as after you have been through counselling.

“People with depression have already internalised the negative self-talk, so they can’t change overnight,” Chan says. “First they must embrace their depression, acknowledge their feelings and confront their symptoms. Only then will they start to accept themselves and show themselves compassion. And while self-compassion can help with depressive symptoms, it’s important to remember that effective coping skills and social support are just as crucial to healing.”

Straight-A students who suddenly get a less-than-perfect mark might consider themselves failures and put undue pressure on themselves. Photo: Alamy

Executive coach Nicholas Wai, 46, does not consider himself a perfectionist, but does admit to always setting high standards for himself. When faced with situations in which he feels he could have done or reacted better, he takes himself through a specific process to avoid getting frustrated or angry.

“I know when I start to beat myself up emotionally,” he says. “When that internal dialogue begins, I get into meditation mode and focus on my breathing. I find that meditation clears my head in that moment and gives me time in between experiencing the trigger and deciding how I’m going to react to it.”

Executive coach Nicholas Wai.

Wai says he does not engage in positive self-talk enough, but he does keep a journal of the things he tells himself about himself. He also questions himself daily on whether he has done his best to be happy, present and engaged. He says that this helps him understand himself better and keeps him in tune with his emotions.

“That’s my idea of self-compassion,” he says. “It’s knowing and acknowledging that, whatever happened and whatever mistakes were made, I tried my best.”

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He also believes that we have control over the way we perceive a problem or situation and that we can rewrite the self-critical script in our heads when things do not go as planned.

“I have a mantra that I turn to whenever I need to transform that negative inner dialogue into a positive one,” he says. “It’s a quote from the novelist Salman Rushdie, which goes: ‘Those who do not have power over the story that dominates their lives, the power to retell it, rethink it, deconstruct it, joke about it, and change it as times change, truly are powerless, because they cannot think new thoughts.’”

This article appeared in the South China Morning Post print edition as: beware the pitfalls of perfectionism
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