Several of my patients commented on a recent article in the New York Times that dealt with perfectionism (“Unhappy? Self-critical? Maybe You’re Just a Perfectionist”). It touched on a disturbing trait they recognized in themselves.

These people suffered from a variety of symptoms – anxiety, depression, problems in careers and relationships – that appeared to be unrelated, but were in fact united by a common factor. Each person was plagued by all sorts of “never-good-enough” feelings.

“Perfectionism, that’s the New York disease,” one of them laughed, and there’s truth there. New York City is an unusually competitive place that selects for and reinforces the trait.

What is it and where does it come from?
Perfectionism is a tendency to be displeased with anything that doesn’t meet extremely high standards. It can be self-oriented (setting such standards for yourself), socially prescribed (thinking others are setting them for you), or other-oriented (having high expectations of other people).

There’s disagreement about what causes it. Some researchers believe it has a genetic component. Others see it as a coping mechanism that develops to ensure a sense of control in a threatening environment, and begins in early childhood.

Is it always a bad thing?
Research suggests that perfectionism comes in two forms, a “neurotic” form characterized by excessively high standards and driven by a fear of failure, and a “normal” form characterized by more reasonable standards and some sense of satisfaction.

“It’s natural for people to want to be perfect in a few things, say their jobs – being a good editor or surgeon depend on not making mistake,” says a psychology professor quoted in the Times.

“It’s when it generalizes to other areas of life, home life, appearance, hobbies, that you begin to see real problems.”

Perfectionism vs. excellence
Many perfectionists are successful high-achievers. They don’t want to give that up. They are also often exhausted and exhausting to be around; that part needs to go.

So-called “cognitive therapy” can encourage recognition of the trait, allowing it some reign in beneficial areas while diminishing its influence elsewhere. In the long run, getting to the root causes of problems can make it diminish and recede quite naturally.

It’s a great relief to discover that there are no negative consequences to taking the weekend off – at least some of the time.