Making sense of perfectionism in BPD

Perfectionism is a personality trait that almost anyone can have to varying degrees. In small doses, it may increase motivation and ambition and help you achieve your goals. There’s nothing inherently wrong with striving for excellence or wanting to avoid mistakes. However, perfectionism can have a dark side too.

Having unrealistic expectations and standards can take a toll on your mental health — especially if you criticize or punish yourself when you don’t meet them. While not an officially recognized symptom of the condition, maladaptive perfectionism is strongly associated with borderline personality disorder (BPD). This may be because people with BPD mistakenly believe they’ll be shamed or criticized if they don’t appear perfect to other people. 

Where borderline personality disorder and perfectionism intersect

BPD often causes a pattern of stormy or unstable relationships due to emotional instability and other symptoms. In response, people with BPD may desperately crave connection and a sense of belonging. At the same time, they may feel that, to be accepted, they must be perfect. So they do whatever they can to please others and gain social approval — sometimes at the expense of their own interests, independence, and values. 

The mistaken belief that perfection is required for acceptance is a core feature of socially prescribed perfectionism (SPP). SPP appears to be more prevalent among people with a subtype of BPD known as the discouraged type. People with the discouraged subtype of BPD often present as avoidant and less impulsive. They may also tend to internalize their experiences and have difficulty expressing emotions like anger.

Perfectionism can take many forms, depending on the person. So to better understand how it might show up in someone with BPD, let’s review of few examples:

• A student with BPD believes that their parents and teachers will despise them if they get anything less than an A+ on their assignments. So they frequently pull all-nighters and obsess about their grades.
• A young woman with BPD refuses to share photos on social media unless they’re taken by a professional photographer. If she doesn’t get enough likes and comments, she believes that her followers think she’s ugly.
• A teen with BPD loves playing basketball. But he refuses to shoot hoops in his driveway until after dark. He worries that, if the neighbors see him miss a shot, they’ll mock him and the whole neighborhood will hear about it.
• During his annual performance review at work, a man with BPD gets some constructive criticism. Despite the overwhelmingly positive feedback, he focuses on his few shortcomings. He thinks he’s at risk of being fired, so he becomes desperate to please his boss.
• Despite being terrified of heights, a young person with BPD accepts an invitation to go rock climbing after work with their team. They believe that declining the invitation would extinguish any hope of being accepted by their colleagues.

Could perfectionism be a sign of a separate diagnosis?

Perfectionism is a common feature of BPD. However, experiencing it doesn’t mean that you meet the other diagnostic criteria for the condition. You can also experience perfectionism without having any diagnosable mental health condition at all. 

However, ongoing struggles with perfectionistic tendencies that interrupt your ability to function can be cause for concern. In addition to accompanying BPD, perfectionism is also associated with:

• Generalized anxiety disorder (GAD)
• Social anxiety disorder (SAD)
• Obsessive-compulsive disorder (OCD)
• Major depressive disorder (MDD)
• Obsessive-compulsive personality disorder (OCPD)
• Avoidant personality disorder (AVPD)
• Dependent personality disorder (DPD)

It’s possible for a person with BPD to also have one of these conditions, as well as many other types of mental health concerns. But research suggests that personality disorders and perfectionism may be more likely to go hand in hand and can make each other worse.

How to manage BPD and perfectionism

If you have BPD and are also experiencing perfectionistic tendencies, working with a therapist can help. Specifically, dialectical behavior therapy (DBT) is an effective approach designed to support people living with BPD. DBT can help people address perfectionism and other symptoms by focusing on emotional regulation, stress tolerance, interpersonal skills, and mindfulness.

In addition to working with a therapist, some individual strategies can help you manage your perfectionism. These include:

• Identifying and challenging perfectionist thoughts: For example, maybe you’re being overly critical of yourself or constantly checking for mistakes. When that happens, see if you can come up with a different way to respond to those thoughts.
• Focusing on your strengths: Write down a list of your talents and accomplishments, large and small. Focusing on your positive attributes can help improve your confidence and self-esteem.
• Practicing self-compassion: Remember that everyone makes mistakes sometimes, even people who seem to have it all together. So try to be gentle with yourself, and remember that you don’t have to be perfect to be accepted.
• Setting attainable goals: There’s nothing wrong with having big dreams. But you can build positive momentum by setting small, achievable goals that reflect your desires, not someone else’s.

Find care with Rula

It’s OK to have high standards for yourself or others. But if you’re constantly worrying about making mistakes or appearing flawless, it could be cause for concern. Chronic, maladaptive perfectionism can be a sign of underlying mental health conditions like borderline personality disorder (BPD). 

If you’re concerned about your mental health, getting an evaluation from a therapist can help ensure that you receive an accurate diagnosis. And now, thanks to Rula, it’s easier than ever to access affordable, effective mental healthcare via convenient virtual appointments. Whether you need individual, family, or couples therapy, you can use our therapist-matching platform to find an in-network provider and schedule your first appointment for as early as tomorrow.

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