In every family, among every group of friends, and within every team at work, there tends to be that person who identifies as a perfectionist.
Whether your reaction is to support their ambition or shake your head, it’s important to understand that they’re not making this up.
While not an official medical diagnosis, perfectionism is a well-documented personality trait, marked by a striving for flawlessness and setting exceedingly high standards of performance [1]. Research into perfectionism started several decades ago and scholars have identified three main types [2]:
Self-oriented perfectionism (SOP): Setting exceedingly high standards for one’s own performance.
Others-oriented perfectionism (OOP): Setting exceedingly high standards for others’ performance.
Socially-prescribed perfectionism (SSP): Believing that society, or certain people within it, is holding one up to exceedingly high standards.
For some, perfectionism extends beyond task performance at work or home and veers into the lofty goal of perfecting one’s health. Researchers have attempted to find out which type of perfectionism is most associated with such increased health-promoting behaviors.
No association with OOP was found. Interestingly, SSP was linked to fewer health-promoting behaviors due to lower levels of perceived social support. That leaves us with SOP individuals, who were indeed found to engage more in activities that support their health and are more likely to chase health perfection [3].
One form such perfectionism takes is orthorexia — an obsession with eating healthy food. In a given population, the prevalence of orthorexia ranges between 6% and an unfathomable 75% [4].
Beyond nutrition, some individuals take their pursuit of health perfectionism to extraordinary lengths.
Think: undergoing intense pelvic floor exercises (which are recommended for urinary incontinence) just to protect sleep from being interrupted by a nighttime bathroom visit.
Who does that, you ask? Software billionaire Bryan Johnson does. It’s not just a perfect night's sleep that he’s after, however. He’s aiming to perfect every aspect of his health in order to reverse his age, and dedicating over $2 million every year to this mission.
Over 30 experts have studied Johnson and contributed to a personalized, evidence-based protocol for his health and longevity, including consuming 100+ pills daily. Johnson says his responsibility is to perfectly adhere to this protocol and ensure zero “infractions”.
Controversial or not, Johnson has cemented himself as the face of longevity over the past few years and surrounds himself with some of the most experienced figures in the industry.
That begs the question:
Should you follow similar perfectionistic health protocols to achieve longevity?
Well, the stance this article is going to adopt is a “hard no”. Let’s discuss the evidence and build not just the case against perfectionism as a prerequisite for healthy longevity but also the case for how both clash with each other. Here are five reasons perfectionism clashes with healthy longevity.
1- Pursuing Perfect Health Isn’t Sustainable
Imagine this: In your pursuit of perfect health for longevity, you decide to switch from unhealthy fats to olive oil. But then, you realize that your olive oil isn’t extra virgin. So, you switch to extra virgin olive oil. Then you discover that it isn’t cold-pressed, so you opt for cold-pressed. Then you realize it’s not single-origin, so you insist on single-origin. Then you discover it’s not harvested by hand, so you want hand-harvested. Then you find out the olives weren’t serenaded by Italian opera during their growth, so you demand opera-serenaded olives.
The goalpost keeps moving, and sooner or later, you’ll find yourself questioning the point of your original decision to switch from unhealthy fats to olive oil.
This hypothetical olive oil scenario is just a tiny part of the nutrition equation, which is itself just one part of the longevity equation. Aiming for that level of perfection on the entire equation sounds like a sustainability nightmare that nobody will endure for too long.
That’s why incorporating more sustainability-oriented goals into your health regimen goes a long way. Longevity magnate Dr. Peter Attia says, “Ultimately, it matters most that you can find something that is manageable and sustainable over the long haul. It’s better to have a 7/10 diet that you can sustain indefinitely than a 10/10 diet that you can only sustain for 3-6 months.”
We believe this advice applies to a few other pillars of longevity too, not just nutrition.
2- Perfectionism Takes a Toll on Mental Health
Let’s assume for a moment that you have the resources and determination to sustain perfect health. Unfortunately, this pursuit still comes with a hefty price tag: stress. It’s well-known that perfectionism can lead to unusually high levels of stress [5].
This stress, derived from perfectionism, has been associated with a variety of mental health issues. A comprehensive meta-analysis of 284 studies revealed a correlation between high levels of perfectionism and mental health disorders such as depression, anxiety, eating disorders, deliberate self-harm, and obsessive-compulsive disorder. The relentless pressure to be perfect can also result in physical symptoms like headaches and insomnia [6].
In the most severe cases, perfectionism has been linked to suicide. One study found that over 70% of young individuals who died by suicide had a habit of setting “exceedingly high” expectations for themselves [7].
3- Perfectionism Can Trigger Excessive Inflammation
Inflammation is a natural response of our body to infections, physical injuries, and malignancies, among other things that go wrong. It’s our body’s way of signaling the immune system to heal and repair damaged tissue, as well as defend against foreign invaders. However, when inflammation becomes chronic, it can be detrimental to our health.
Interestingly enough, perfectionism, a trait we often associate with the mind, has been linked to this physical response of excessive inflammation. A study involving a group of young Canadian adults revealed a fascinating connection. The participants, who identified with perfectionist tendencies and reported high levels of stress, showed elevated levels of C-reactive protein (CRP), a key marker of inflammation [8].
This finding suggests that the relentless pursuit of perfection, coupled with the stress it brings, may pave the way for chronic inflammation. And here’s the kicker: this increase in CRP and inflammation is essentially mind-generated, without any traditional pathology involved. This underlines the potential harm perfectionism can inflict, given its ability to elevate inflammation levels.
4- Perfectionism Is Implicated in Several Chronic Diseases
The dangerous duo of stress and inflammation, both by-products of perfectionism as we’ve seen, naturally pave the way for various chronic diseases.
One such disease is heart disease. A study investigating the link between perfectionism and heart disease focused on heart rate variability, which is the variation in the time interval between heartbeats. Lower heart rate variability, often seen in perfectionists due to their perception of daily hassles, is a sign of potential health problems as it indicates the body’s struggle to adapt to changing situations [9].
Next on the list is Irritable Bowel Disease (IBD), a disorder characterized by chronic inflammation of the digestive tract. Research has confirmed that trait perfectionism and perfectionistic self-presentation were associated with greater sickness impact for ulcerative colitis and Crohn’s disease, both forms of IBD. IBD may also intensify the social disconnection experienced by perfectionists, thereby exacerbating stress and physical symptoms [10].
Perfectionism is also linked to Chronic Fatigue Syndrome (CFS), a complex disorder characterized by extreme fatigue that can’t be explained by any underlying medical condition. Studies regarding the mechanism involved suggest that perfectionism may blunt the hypothalamic-pituitary-adrenal (HPA) axis, the body’s main stress response system [11].
While more research is ongoing regarding perfectionism and other chronic diseases, it’s clear from the ones we’ve already mentioned that perfectionism significantly impacts healthspan, the portion of life spent free from chronic diseases and disability.
5- Perfectionism Is Associated with a Shorter Lifespan
It's time to address the question on everybody's mind: Do perfectionists live longer lives than non-perfectionists? Well, a remarkable study delved into just that. The study followed 450 Canadian subjects, all aged 65 years and older, over a period of 6.5 years, assessing their health and personality traits as predictors of mortality.
The findings were startling. Self-proclaimed perfectionists had a 51% higher mortality rate compared to non-perfectionists [12]. So, it’s clear that the pursuit of perfection doesn’t just impact our healthspan, but it can also shorten our lifespan.
Bonus Reason: Centenarians Aren’t Perfectionists
All the reasons we've discussed so far build a strong case against perfectionism for those seeking long, healthy lives. But as a bonus, let's consider one more reason that supports non-perfectionism this time: centenarians.
Take the legendary Jeanne Calment, who holds the record for the longest documented lifespan of 122 years. She was known for smoking, starting at 21 and quitting at 117. She smoked in moderation, about one cigarette a day. While no health professional, including her own doctors, would advocate for smoking based on Calment's story, it's worth noting that the longest-living human ever had her fair share of "infractions". She also enjoyed wine and chocolate, again in moderation [13].
Speaking of which, moderation is a key pillar of healthy living in Blue Zones. These are regions of the world where people live much longer than average. The inhabitants of Blue Zones aren't perfectionists. They enjoy community gatherings where they indulge in their favorite foods twice a week. What is seen by some on extreme protocols such Bryan Johnson as infractions, they see as celebrations. They carry no guilt for these indulgences whatsoever.
Instead, these celebrations are part of an overall healthy lifestyle that includes eating whole foods, staying physically active, engaging in community work, and simply enjoying life.
References:
[1] Stoeber, J. (2016). Perfectionism. Encyclopedia of Personality and Individual Differences, 1–7. https://doi.org/10.1007/978-3-319-28099-8_2027-1
[2] Hewitt, P. L., Flett, G. L., Turnbull-Donovan, W., & Mikail, S. F. (1991). The Multidimensional Perfectionism Scale: Reliability, validity, and psychometric properties in psychiatric samples. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3(3), 464–468. https://doi.org/10.1037/1040-3590.3.3.464
[3] Harrison, F., & Craddock, A. E. (2015). How attempts to meet others’ unrealistic expectations affect health: health-promoting behaviours as a mediator between perfectionism and physical health. Psychology, Health & Medicine, 21(3), 386–400. https://doi.org/10.1080/13548506.2015.1062524
[4] Niedzielski, A., & Kaźmierczak-Wojtaś, N. (2021). Prevalence of Orthorexia Nervosa and Its Diagnostic Tools—A Literature Review. International Journal of Environmental Research and Public Health, 18(10), 5488. https://doi.org/10.3390/ijerph18105488
[5] Flett, G. L., Nepon, T., Hewitt, P. L., & Fitzgerald, K. (2016). Perfectionism, Components of Stress Reactivity, and Depressive Symptoms. Journal of Psychopathology and Behavioral Assessment, 38(4), 645–654. https://doi.org/10.1007/s10862-016-9554-x
[6] Limburg, K., Watson, H. J., Hagger, M. S., & Egan, S. J. (2016). The Relationship Between Perfectionism and Psychopathology: A Meta-Analysis. Journal of Clinical Psychology, 73(10), 1301–1326. https://doi.org/10.1002/jclp.22435
[7] Törnblom, A. W., Werbart, A., & Rydelius, P.-A. (2013). Shame Behind the Masks: The Parents’ Perspective on Their Sons’ Suicide. Archives of Suicide Research, 17(3), 242–261. https://doi.org/10.1080/13811118.2013.805644
[8] Molnar, D. S., Moore, J., O’Leary, D. D., MacNeil, A. J., & Wade, T. J. (2021). Perfectionistic cognitions, Interleukin-6, and C-Reactive protein: A test of the perfectionism diathesis stress model. Brain, Behavior, & Immunity - Health, 13, 100211. https://doi.org/10.1016/j.bbih.2021.100211
[9] Corson, A. T., Loveless, J. P., Mochrie, K. D., & Whited, M. C. (2018). Perfectionism in Relation to Stress and Cardiovascular Disease Among Gifted Individuals and the Need for Affective Interventions. Roeper Review, 40(1), 46–55. https://doi.org/10.1080/02783193.2017.1393711
[10] Flett, G. L., Baricza, C., Gupta, A., Hewitt, P. L., & Endler, N. S. (2011). Perfectionism, psychosocial impact and coping with irritable bowel disease: A study of patients with Crohn’s disease and ulcerative colitis. Journal of Health Psychology, 16(4), 561–571. https://doi.org/10.1177/1359105310383601
[11] Kempke, S., Boudewijn Van Houdenhove, Claes, S., & Luyten, P. (2015). The Role of Perfectionism in Chronic Fatigue Syndrome. Perfectionism, Health, and Well-Being, 101–118. https://doi.org/10.1007/978-3-319-18582-8_5
[12] Fry, P. S., & Debats, D. L. (2009). Perfectionism and the Five-factor Personality Traits as Predictors of Mortality in Older Adults. Journal of Health Psychology, 14(4), 513–524. https://doi.org/10.1177/1359105309103571
[13] Robin-Champigneul, F. (2020). Jeanne Calment’s Unique 122-Year Life Span: Facts and Factors; Longevity History in Her Genealogical Tree. Rejuvenation Research, 23(1), 19–47. https://doi.org/10.1089/rej.2019.2298