In High School I Got Straight A’s and Anorexia: The Link Between Perfectionism and Anorexia Nervosa

It was only a few years ago that I discovered stiving for perfectionism wasn’t actually a helpful or healthful use of time and energy.

But deeper than this and before I could come to the above epiphany that would go on to forever change my existence was an even seemingly smaller but more profound step.

One of the true first steps to changing my relationship with myself was when I began to comprehend that striving for perfectionism was something you didn’t actually have to do.

Up until that point, it had honestly been my pre-programmed default setting to strive for perfect.  

Of course I had to be perfect. This was not up for debate.

I’d never considered another way of being.

I didn’t even know I was doing it.

It was just “me.”

Years later when I wanted to understand what had happened to me and even more importantly wanted to understand all I could about the human brain so that I could advance myself and live a successful life while helping others to find their freedom, gain greater control over their lives and live their definition of success I began to discover research that described links between certain personality “traits” and anorexia nervosa.

It quickly became blatantly and fascinatingly evident to me that one of the personality “traits” that a large proportion of people living with anorexia nervosa and other eating disorders including bulimia nervosa showed was perfectionistic tendencies1,2.   

I wasn’t alone.

I wasn’t weird or broken.

I was one of many.

My next question was what came first the chicken or the egg? Do perfectionistic tendencies exist before the anorexia nervosa and increase people’s risk of developing anorexia nervosa or is the anorexia nervosa present first and increases peoples need to strive for their self-imposed exceedingly high expectations?

The literature indicates it’s more likely the former.

Having lived with anorexia nervosa for some 15 years of my life (which I can finally say is no longer “the larger portion of my life hooray!”) I think for me the perfectionism came first.

When you’ve worked with enough people living with eating disorders it’s not all that hard to figure out why some of us might develop them. 

There are underling reasons why people fall sick with eating disorders. I no longer believe it is random or arbitrary.

Something I’ve mentioned in previous blog posts and which recently I’ve gained a deeper level of clarity on is that one of the driving forces for my doing the behaviours that would ultimately lead to my falling ill with an eating disorder was my drive to do it (all) perfect.

I may have been given the guidelines from the outside world to cut fat and eat more fruit and vegetables, but it was I who followed them. To a t. For no particular reason and for many reasons at the same time including the fact that it initially gave me a sense of achievement.

It was my project.

I loved setting and reaching goals.

I loved writing down the foods I’d eaten, colour coding my mood for that day into my neat diary and diligently recording the hours I’d run.

I loved “improving” at all those things.

Loved it.

Until I no longer wanted to do any of it and I couldn’t stop. 

What Exactly Is Perfectionism?…

I think perfectionism, like the common use of the terms OCD or strong (See my earlier blog F*ck Strong for my strong thoguhts on this topic) is another one of those words that we commonly use as if it’s funny or more often something good and something to aspire to.

Admittedly had I not experienced what it actually means in real life to live with perfectionism breathing down your neck every waking moment I’d likely think of perfectionism as a good thing also. 

Ah there’s a lot of (heartbreaking) insight, learning and understanding in experiencing things for yourself. 

The interesting thing is that the learning and the understanding of what all these things mean doesn’t come when you’re in it. It comes after. 

It comes when we can step out of the expereince we were in, gain some distance from it and reflect with intention. An experinece that simply isn’t the norm when you’re living with anorexia nervos and perfectionism. Which is one of the reasons why people living with anorexia nervosa can experience moments of insight, great clarity and understanding and easily give advice and great care to others in their position and yet, be completely unable to apply it to themselves.  

In a nutshell perfectionism is a sense of extreme self-pressure to meet exceedingly high standards and this need to meet high standards greatly impacts the way a person sees themselves1.

Two major components of perfectionism have been described3;

  1. Personal standards (setting and striving for high personal standards and goals)

and

  1. Evaluative concerns (negative reaction to failure, performance doubts and concern over criticism and expectations.

Common Behaviours and Characteristics of Perfectionism2

  • Increasingly high standards
  • Fear of failure/concern over mistakes
  • Procrastination
  • Difficulty in decision making
  • Reassurance seeking
  • Excessive organising or list making
  • Self-control
  • Overcompensating
  • All or nothing thinking

While these definitions and lists of common ways people experience perfectionism are useful and interesting they are a long way off fully capturing the experience of living with perfectionism.

I’m unsure of how to capture what it was to live with perfectionism.

I honestly don’t think it’s possible.

Any example I give feels as though it falls far short of the mark of conveying anything close to the reality of the pervasive and incessant need to meet this set of unspoken impossible to meet and ever increasing expectations. 

Which is exactly why I’m going to give it a go!

The following 3 examples of how perfectionism showed up in my day to day life when I was living with anorexia nervosa are simple but at the same time they make the reality of perfectionism clear.

My Personal Experience of Perfectionism: Examples from Daily Life with Anorexia Nervosa

  1. Running

I remember right before one cross-country race I suddenly got “asthma” and decided not to run.

About an hour later I ran the cross-country distance on a much harder, steeper trail and beat the winning time.

The reason I didn’t run when I wasn’t feeling 100% was my fear of “failing.” Aka my fear of running a time that didn’t live up to my (exceedingly high) expectations. If I couldn’t do it perfectly I couldn’t do it at all. 

I think perfectionism led to my missing out on many things.   

2. Food

Food became one of my biggest outlets for the perfectionism.

I had to cook everything from scratch. Adapted and altered to be “healthy” of course.

I spent a ridiculous amount of time planning food, reading recipe books, shopping, making food and thinking about food in general.

I had this lingering sense that if I could just get it right, even for one day, then everything would be ok.

Spoiler alert; that day never came.

No matter how perfect I made the 6 meals of that day, no matter how varied and different to the day before, no matter how much people enjoyed them the sense that it was good enough never came.

The sense that I was good enough never came.

3. Academic Achievement

Finally, the obvious one that I alluded to in the title of this blog. Study.

Perfectionism played a role in my dedication to study along with my desire to know things. I think learning is something human brains inherently enjoy.

On top of this and perhaps the larger component was the fact that the amount of time I dedicated to study and learning was, without question, fuelled by a need to escape reality.

It was my drug. 

Is Perfectionism Really Such a Bad Thing?

A better question to ask perhaps would be is perfectionism useful?

And my honest answer to that is no.

Maybe you think something different (and if you do, I’d love you to leave your thoughts or experience with perfectionism in the comments) but my answer is it’s not useful, not in its purest sense.

Perfectionism for those who’ve truly experienced it is exhausting and actually detracts from life vs expands it.

My sister was preparing for an interview last week and we had a laugh about sharing perfectionism as a strength because that’s the cliche’ way people view perfectionism in the interview sense, of sneekily sharing a “weakness” that’s actually a strength. 

It’s not a strength.

Striving to do well, to do your best, even to be the best is not the same as striving to be perfect.

“Perfect” is an impossibility to obtain.

The reality is perfectionism manifests as an ever-present sense of not being good enough.

Which means a lot of avoiding.

A lot of suppressing.

A lot of ignoring.

A lot of worrying.

A lot of fear.

A lot of crying.

A lot of confusion.

What Is My Experience of Perfectionism Now?

It’s an interesting question to consider… would I still describe or think of myself as a perfectionist?

The answer is a definite no.

No, I would no longer describe or think of myself as a perfectionist (I wouldn’t have been capable of writing a weekly blog for almost 3 years now if I still experienced perfectionism to the degree past me did).

Although I’ve heard other people who’ve recovered from anorexia describe themselves as still having perfectionistic tendencies so it’s possible, I’m blind to it in myself, but overall my sense is genuinely that perfectionism is no longer something I want to describe myself as.

It’s no longer something I see as beneficial, admire, value or even respect.

I don’t have to define myself or justify my value or worthiness as a human being based on getting everything perfect.

However, no longer striving for perfectionism doesn’t meant that I don’t care, it doesn’t mean that I don’t put my whole heart into projects, friendships, relationships, study, work and it definitely doesn’t mean that I no longer achieve.

What I’ve found is that letting go of the perfectionism actually freed me up to care, to genuinely put in my best and to enjoy the achievement for what it is vs it never being “good enough.”

My achievement now comes from a place of love and freedom to learn and grow vs from a place of fear of failure and rejection (real or perceived).

And that’s fun.

And fun is more in line with my values.

Fun supports my conscious choices of how I wish to live my life.  

Words of Hope

While there might be a bunch of studies indicating perfectionism increases the risk of someone developing an eating disorder there is also a bunch of evidence showing that perfectionism and other personality “traits” that we tend to think of as fixed are in fact highly flexible and malleable i.e. highly changeable!

What this means is that what’s important to you now in the midst of the illness does not have to be important to you forever. If it feels important to you now (aka life consuming) that you get everything right, that everyone like you, that you avoid criticism and failure at all costs and so on, please know that this doesn’t have to be your future.

There are ways of rewiring and reprogramming our minds to do things differently.

There are ways of assisting our minds to focus on different things that are more in line with our true values in life.

There are ways of aligning what we think, feel and do so that we never have to be at war within ourselves again.

But remember hope is not a strategy for success.

Hope is not a strategy for recovery.

At some point if you honestly plan on having recovered as part of your future you have to get real with a plan and action.

Clinical hypnotherapy is the very best way I know of in which to achieve this means of intentionally and respectfully altering our internal environment in profound and meaningful ways that allow us to be free to be ourselves.  

The most magical gift we can ever bring to this planet.   

P.S

Alongside high perfectionism there’s a swathe of other personality traits commonly associated with eating disorders including impulsivity, harm avoidance, reward dependence, sensation seeking, neuroticism, and obsessive-compulsiveness alongside low self-directedness, assertiveness, and cooperativeness4-7.

I am thinking I will address some of these other “traits” in future posts as well as how to begin to change them so please let me know in the comments below if that would be useful to you (or someone you love and care for)?

With my whole heart I hope you found this information useful and inspiring.

Become Great. Live Great.

Bonnie.

Reference

  1. Boone L, Soenens B, Vansteenkiste, M Braet C. Is there a perfectionist in each of us? An experimental study on perfectionism and eating disorder symptoms. Appetite. 2012. 59:(2); 531–540.
  2. Brown AJ, Parman KM, Rudat DA, Craighead, LW. Disordered eating, perfectionism, and food rules. Eating Behaviors. 2012. 13:(4);347–353.
  3. Bieling PJ, Israeli AL, Antony MM. Is perfectionism good, bad, or both? Examining models of the perfectionism construct. Personality and Individual Differences. 2004. 36, 1373–1385.
  4. Fassino S, Amianto F, Gramaglia C, Facchini F, Abbate DG. Temperament and character in eating disorders: ten years of studies. Eat Weight Dirsord. 2004;9(2):81–90.
  5. Klump KL, Strober M, Bulik CM, Thornton L, Johnson C, Devlin B, et al. Personality characteristics of women before and after recovery from an eating disorder. Psychol Med. 2004;34(8):1407–18.
  6. Krug I, Root T, Bulik C, Granero R, Penelo E, Jimenez-Murcia S, et al. Redefining phenotypes in eating disorders based on personality: a latent profile analysis. Psychiatry Res. 2011;188(3):439–45.
  7. Wade TD, Tiggemann M, Bulik CM, Fairburn CG, Wray NR, Martin NG. Shared temperament risk factors for anorexia nervosa: a twin study. Psychosom Med. 2008;70(2):239–44.

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