The Perfectionism-Anxiety Loop
By Emma Costa, LMFT-A
Have you ever caught yourself re-reading an email five times before hitting send? Have you ever worked through lunch because you “just need to finish this one last thing? Have you ever hesitated to start a project because it might not be perfect? You’re not the only person suffering through this.
Perfectionism isn’t just about being organized or wanting to do well. For many high-achievers, it’s a constant loop of anxiety, over-functioning, and burnout. The world might praise your productivity—but deep down, you’re exhausted.
What Perfectionism Really Feels Like
On the outside, perfectionism can look impressive! People may describe you as driven, organized, capable. You show up prepared and rarely miss a deadline. You’ve mastered the art of staying in control… or at least appearing like you have.
But inside, the experience is often something else entirely.
You might feel your chest tighten when plans change. The smallest mistake can send a wave of shame rushing in before you have time to think. When you try to rest, there's a quiet voice whispering that you haven’t earned it yet. You replay conversations in your head long after they’re over, looking for signs you were too much or not enough.
Sometimes the pressure builds in your stomach before you even open your eyes in the morning. You’re exhausted, but you push anyway. Not showing up perfectly feels dangerous, a risk you can’t afford to take.
That perfectionist part of you wasn’t born from nowhere. It probably was a part of your life early, at a time when being “good” meant being safe. Maybe you learned that praise came when you were useful. That love felt just a little more available when you were acheiving. Making a mistake led to cold silence or sharp words or some kind of subtle withdrawal. So you adapted. You sharpened. You learned how to stay a step ahead of criticism and how to turn it inward before anyone else could.
The perfectionist voice in you is not cruel for the sake of being cruel. It is protective. It just learned the wrong language for love.
The Anxiety Behind “I Need It Right”
Perfectionism and anxiety often show up side by side, reinforcing each other in ways that feel relentless. You might find your mind spiraling after something as small as a typo in an email, a task you forgot to do, or even the way someone looked at you in a meeting. Suddenly your chest tightens, and your thoughts start racing.
A part of you might believe that if you are not constantly on top of everything, something will fall apart. It could be your reputation, someone’s approval, or the carefully built image that says you are handling everything just fine.
Trusting others to help might feel impossible, because letting go of control opens the door to mistakes. When something does go wrong, the blame usually turns inward. The voice in your head is not trying to hurt you. It is trying to protect you. It learned to stay alert in order to keep you safe in a world where safety never felt guaranteed.
This is not laziness. It is not a cry for attention. It is your nervous system doing everything it can to guard you from shame, failure, or rejection. Even when that effort comes at the cost of your sleep, your sense of peace, or your ability to truly rest.
The Problem with Praise
High achievers are often praised for their reliability, dedication, and attention to detail. Their work ethic is admired, and their ability to push through becomes part of their identity. In environments that reward output and composure, perfectionism gets quietly reinforced. The more they perform, the more they are praised. But underneath that praise, something else is happening.
What most people do not see is the spiral that begins after one piece of critical feedback, the kind that lingers for days and echoes louder than any compliment. They do not see the weight of trying to manage everything alone, driven by a fear that letting one thing slip will mean you have failed. They rarely understand the kind of loneliness that comes from believing no one else cares as deeply or tries as hard.
Over time, the pressure builds. Eventually, the cost of perfectionism starts to outweigh the rewards. The anxiety, isolation, and emotional exhaustion become impossible to ignore.
What If It Didn’t Have to Be Perfect?
Therapy can become a space where you begin to soften that anxious, perfectionist voice instead of obeying it without question. Over time, you learn what it feels like to delegate without panic, to rest without guilt, and to say no without immediately wondering if you’ve disappointed someone. It becomes possible to separate your sense of worth from how much you produce or achieve. You begin to understand that being cared for is not something you have to earn.
You do not have to stay trapped in the cycle of overthinking and overwhelm. Healing from perfectionism does not mean you stop caring. It means you learn how to care for yourself with the same intention and effort you’ve always given to others.
If you’re exhausted from always trying to do it “right,” it’s okay to ask for help. You can build a more compassionate relationship with yourself. One where “good enough” is finally enough in therapy for perfectionism.
