Understanding Atelophobia, The Fear of Imperfection

We all have days when nothing we do feels good enough. For most people, this feeling passes and doesn’t necessarily impact daily living. But for others, a fear of imperfection turns into a debilitating phobia called atelophobia that intrudes on every part of their life.

What is atelophobia?

To understand what atelophobia is, you first need a working definition of a phobia, which is a type of anxiety disorder that presents as a fear that is persistent, unrealistic, and excessive. This fear — also known as a specific phobia — can be about a person, situation, object, or animal.

While we all experience situations that create fear, often with phobias there is no real threat or danger. This perceived threat can disrupt daily routines, strain relationships, limit your ability to work, and reduce self-esteem. According to the National Institute of Mental Health, an estimated 12.5 percent of Americans will experience a specific phobia.

Atelophobia is often referred to as perfectionism. And while it is considered extreme perfectionism, Dr. Gail Saltz, associate professor of psychiatry at the New York Presbyterian Hospital Weill-Cornell Medical College says more than that, it is a true irrational fear of making any mistake.

“As with any phobia, people with atelophobia think about the fear of making a mistake in any way; it makes them avoid doing things because they would rather do nothing than do something and risk a mistake, this is the avoidance,” explains Saltz.

They also obsess a lot about mistakes they have made, she says, or imagine mistakes they could make. “These thoughts cause them to have overwhelming anxiety, which may make them feel panicky, nauseous, short of breath, dizzy, or experience a rapid heartbeat.”

Atelophobia often leads to constant judgment and negative evaluation that you do not believe you’re doing things perfectly, correctly, or the right way. Licensed clinical psychologist, Menije Boduryan-Turner, PsyD, says this need for perfectionism is different from having ambition or striving for excellence.

“We all innately wish to be successful; however, on some level, we can anticipate, accept, and tolerate shortcomings, mistakes, and failed attempts,” she says. “People with atelophobia feel crushed by even the idea of a failed attempt, and they often feel miserable and depressed.”

What are the symptoms?

The symptoms of atelophobia originate similarly to other phobias — with a trigger.

Boduryan-Turner says for atelophobia the feared stimuli can be very subjective because what you might view as imperfection someone else might view as fine or perfect.

Emotional distress is a common symptom of atelophobia. This can manifest as an increase in anxiety, panic, excessive fear, hypervigilance, hyperalertness, poor concentration.

Due to the mind and body connection, physiologically Boduryan-Turner says you may experience:

• hyperventilation
• muscle tension
• headache
• stomach pain

Other symptoms, according to Boduryan-Turner, include:

• indecisiveness
• procrastination
• avoidance
• reassurance seeking
• excessive checking of your work for mistakes

She also points out that excessive fear and anxiety can lead to sleep disturbances and changes in appetite.

Additionally, a 2015 review of studies found a strong correlation between perfectionism and burnout. Researchers discovered that perfectionistic concerns, which relate to fears and doubt about personal performance, can lead to burnout in the workplace.

It’s important to note that atelophobia is different from atychiphobia, which is a fear of failure.

What causes atelophobia?

Atelophobia can be biologic, meaning it’s in your wiring to be insecure, sensitive, and perfectionistic. But Saltz says it’s often a result of a traumatic experience related to terrible experiences with failures or pressures to be perfect.

Additionally, Boduryan-Turner says since perfectionism is a personality trait that’s learned and reinforced through experience, we know that environmental factors play a significant role. “When you grow up in an environment that is critical and rigid as well as had very little room for making mistakes and being flexible, you don’t learn how to tolerate and accept imperfection,” she explains.

How is atelophobia diagnosed?

Diagnosing atelophobia needs to be done by a mental health professional such as a psychiatrist, psychologist, or licensed therapist. They’ll base a diagnosis on the diagnostic criteria for specific phobias in the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association.

“We diagnose and treat emotional distress only when it is experienced in high intensity and frequency,” says Boduryan-Turner. She explains that the person suffering from the fear must report difficulty in controlling the fear, which leads to impairment in their social and occupational functioning.

“Most often, people who have atelophobia, may also seek therapy to address a comorbid diagnosis such as clinical depression, anxiety, and/or substance use,” says Saltz. That’s because atelophobia can cause depression, excessive substance use, and panic when it is debilitating and paralyzing.

Finding help for atelophobia

If you or someone you love is dealing with atelophobia, seeking help is the first step in learning how to let go of perfectionistic qualities.

There are therapists, psychologists, and psychiatrists with expertise in phobias, anxiety disorders, and perfectionist issues that can work with you to develop a treatment plan that may include psychotherapy, medication, or support groups.

Not sure where to start? Here are a few links to help you locate a therapist in your area that can treat phobias.

• Association for Behavioral and Cognitive Therapists
• Anxiety and Depression Association of America

How is atelophobia treated?

Like other specific phobias, atelophobia can be treated with a combination of psychotherapy, medication, and lifestyle changes.

The good news, says Saltz, treatment is effective and ranges from psychodynamic psychotherapy to understand unconscious drivers of the need to be perfect to cognitive behavioral therapy (CBT) to change negative thought patterns, and exposure therapy to desensitize the person to failure.

Boduryan-Turner points to research showing that CBT is most effective in treating anxiety, fear, and depression. “Through cognitive restructuring, the goal is to change one’s underlying thoughts and belief system, and through behavioral therapy, we work on exposure to the fear stimuli, such as making mistakes and modify the behavioral response,” she says.

In the recent years, Boduryan-Turner says mindfulness is proving to be an effective supplement to CBT. And in some cases, she says medication to treat the comorbid symptoms, such as anxiety, depressed mood, and sleep impairment can also be considered.

What’s the outlook for people with atelophobia?

Treating atelophobia, like all other phobias, takes time. In order to be effective, you need to seek professional help. Working with a mental health expert allows you to address the thoughts and beliefs behind your fear of making mistakes or not being perfect, while also learning new ways to address and cope with these fears.

Finding ways to minimize the physical and emotional symptoms associated with atelophobia is also critical for your overall health. A 2016 study found that people with a specific phobia have an increased probability for respiratory, heart, vascular, and cardiac disease.

If you’re willing to commit to regular therapy and work with your therapist to treat other conditions that may accompany atelophobia, the prognosis is positive.

The bottom line

Feeling overwhelmed by the fear of imperfection can severely impact your life. Always worrying about making mistakes or not being good enough, can be paralyzing and prevent you from performing many tasks at work, home, and in your personal life.

That’s why it’s important to seek help. Treatments such as cognitive behavioral therapy, psychodynamic psychotherapy, and mindfulness can help to manage and overcome atelophobia.

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