Questioning Perfectionism In Anorexia

Questioning Perfectionism In Anorexia 2


I am often told by eating disorder therapists and literature that I am a perfectionist.

I am not a perfectionist.

I was not a perfectionist before Anorexia. I was not a perfectionist during Anorexia. I am not a perfectionist now.

If you don’t believe me, ask my husband (Who is, by the way, a perfectionist — or at least much more than I!)

He will tell you that I can get four different colours out of the same tin of paint. He will tell you that I am blissfully unaware that every picture I have ever hung is crooked. He will tell you about my half-arsed efforts at washing plates. He will tell you that I am banished from doing laundry because I bung everything in together and put clothes away creased. He will tell you that I don’t study for tests. He will tell you that I will use whatever colour of cotton I saw first to darn a pair of clack socks with. He will tell you that I consider socks “darned” even with gaping holes still in them. He will tell you I consistently wear odd socks because I can’t be bothered to pair them. He will tell you that I never follow a recipe when cooking. He will tell that I send work emails without re-reading them or checking for errors. He will tell you that we don’t have a single matching plate in the house — and that most of them are cracked.He will tell you that I am more than happy to half shovel the snow off our drive and walk away. 

I am not a perfectionist.

I was going to review a load of research for this post but frankly I cannot stomach it any more as it all says the same thing. That perfectionism is common in people with Anorexia. Instead, I decided to do some research of my own. I asked my Slack group of nearly 80 adult sufferers of eating disorders. 

Turns out, I am not the only non-perfectionist Anorexia sufferer out there. Here are some of the answers I got when I asked the Slack group about this:


I don’t really identify with the perfectionist image ED patients have.  I was never a perfectionist pre ED and not really now.  I like to do well in life but who doesn’t; however if I don’t get the A star grade or if something I make is not perfect I don’t mind too much/ as long as feel did my best.  I don’t have an overly competitive nature either.

 

I am definitely not a perfectionist, but I do like to do well and better than other people.  But I get annoyed when perfectionism is listed as something that triggers an eating disorder.

 

I am a ruthless self-improver and if there are numbers, I try to beat them. But I would not label myself a perfectionist – I am all about “good enough” as long as it’s a respectable number or on the high tail of the bell curve. I wasn’t a teachers’ pet because I’m not emotional about achievement or looking for outside recognition from others. I want to do the right thing and I’m very black/white about it if the rules makes sense to me. I break other rules if they don’t make sense.

 

No perfectionism here. I’ve never identified with this trait. We’re such different characters and I think the all ed behaviours as expressed are just some form of playing out control. For me,  often expressed through rituals, doing things in a certain order particularly leading up to the evening meal, which used to be the only meal of the day! Only eating a few types of food and the same meal every day.

 

I think on the whole people with an ED are intelligent and thinkers… Often because of intelligence they are high achievers.,. Does not mean perfectionist though although of course some are.  OCD can also be common co morbidity which again might be mistaken for perfectionist trait.

 

Nope, not a perfectionist either!

 

I would say I’ve always had super high expectations of myself and others and so have become major anxious about getting things right to the point of becoming OCD about things or getting very upset snd sensitive if things haven’t gone that way. In teaching, I always wanted to do well but got extremely stressed by the scrutiny that went over the top and once one scrutiny was over, I’d be shattered and then have to think about the next. I got worked up but not sure it was bring a perfectionist. But I am def someone that overthinks, researches and analyses yo the point of it making me fixed. I need to let it go a bit (a let it go song coming on!!!)

 

I think I can definitely call myself a ‘perfectionist’ and it has only been since leaving university for the year do I realise how unhealthy it is. For example, I will often write up a paper and it will take me drafts and drafts before it is acceptable. SImilarly, if I didn’t receive the highest grade, I would be distraught. It was similar as a competitive swimmer, I would spend hours and hours training and if I lost ANYTHING, I would be filled with complete dread, making sure I trained harder for the next race

 

Hated school, hate housework, hubby totally also the tidier of us two, but when it comes to my ed, numbers, exercise etc I’m insanely accurate and ocd

 

I am a perfectionist. I have gotten better after grad school, which made me absolutely nuts. I would get a 99 and weep. I have relaxed a lot in the last year but have a long way to go.

So yeah, a couple of perfectionists, but the majority are not. Probably just representative of the general population in that case, wouldn’t you say?


Why is there the perfectionist eating disorder suffer assumption?

 

I can see how the assumption was made. I think it is rather old fashioned.

When we are sick, we become incredibly “tight” about food and exercise. I found that with me, everything had to be “just so.” If I ate, it was very specific, and the tiniest deviation would result in me not being able to eat. One might look at that and call it perfectionism — but it wasn’t.

It was survival.

That was the only way I could eat. Having everything “just so” was the path of least resistance. One pea out of place and my anxiety would skyrocket.

Most of us have to be all-or-nothing when it comes to food and exercise. We are either restricting completely or binging completely. If we are eating, it is exact to our meal plan. “All-or-nothing” is apparently a trait of the perfectionist. Again, while we are like this with food and exercise we are like thing because of the eating disorder and not because of our personality. Now recovered, I can eat a half-cooked pizza if I am too impatient to wait for it. I can drink a cup of tea with “too much” milk in without caring. I can eat imperfectly, and I can exercise very imperfectly. I no longer have an “all-or-nothing” mindset around working out. Case to point: I can very happily leave a workout session after 15 minutes simply because I can’t be bothered. (That happened yesterday matter of fact) I can even leave a workout mid-set. 

(Note that I strongly advise people in weight restoration do not work out or exercise at all until fully recovered.)

Perfectionism is often seen as setting unrealistically high goals. Well, if you look at the bodyweight that a person with Anorexia strives to be “unrealistic” might be a word for it. But it is not unrealistic because we are trying to be perfect. It is unrealistic because we have a mental illness that is trying to starve us to death.

It’s probably actually a side-effect of starvation, not the eating disorder. The men in the Minnesota Starvation Study demonstrated food rituals and rigidity too.

 

Why do some sufferers run with it?

Now I know that some sufferers consider themselves to be perfectionists. Maybe they are. Maybe they have been perfectionist from birth. That be the case, the eating disorder is a co-incidence. Whatever.

Psychoanalytical approaches often “lead the client”

I have had doctors “suggest” to me that I am a perfectionist. When I was sick with Anorexia — and remember, eating disorders make us resistant to any treatment that will help us get well — I’d take that over being told to eat a million times over.

My GP (who had probably read some psychobabble on eating disorders) once suggested to me I was a perfectionist. I was like “great yeah, I probably am and I will work on that … can I go now?”

It is not that we are in denial, it is a symptom of an eating disorder to be resistant to treatment that involves gaining weight. Eating disorders just love psychoanalysis because it is “safe.” Talk therapy doesn’t threaten the eating disorder.

Eating disorders hate people like me who tell the sufferer the only way to get better is to eat.

Also, look at it this way: I have this intense anxiety and fear stress reaction to eating. Eating fucking HURTS. One the one had I have some idiot telling me I have to eat and on the other I have some psychoanalyst telling me I just need to work on not being such a perfectionist. Which option do I take? The one that hurts, or the other one?

 

“Quest for Perfection?” Please!

This article from Yale for example suggests that there is a high incidence of eating disorders such as Anorexia in female students at Yale because they are all trying to be perfect in every way — from grades to body shape. I would argue that if there is indeed a higher incidence of eating disorders at Yale it is because the students are intelligent. I’ve not met a dumb person with Anorexia yet.

There are so many research papers on the quest for perfection and eating disorders and I was going to write about some of them here, but I just cannot bring myself to do it because they all say pretty much the same thing; that we are starving ourselves to be perfect.

Eating disorders KILL people. That is not perfectionism gone too far. That is mental illness.

 

Why is this perfectionist assumption a problem?

 

Sure, it bugs me when people call me a perfectionist because I am not. But that is harmless enough. There are, however, real, harmful consequences of assuming that people with Anorexia are perfectionists. Let’s have a look at a few:

Stereotyping creates an obstacle to treatment

First hand I can tell you that due to anosognosia it can be incredibly difficult to recognize that one is ill at all. Now, add on top of that stereotypes that I don’t identify with and I have more ammo to reinforce my already strong conviction that I don’t have an eating disorder. When we tell people with Anorexia that they are perfectionists, if they are not perfectionists, they assume that because they do not identify with that trait that you must be wrong about the eating disorder too.

It treats a symptom — not the cause

I can’t tell you how many eating disorder articles I have read over the years that take a psychoanalytical approach to treating “perfectionism” in an attempt to treating an eating disorder. My “perfectionism” went in due course after I became weight restored. Like so many old-fashioned models that do not understand that the “personality” presentations of people with eating disorders are actually due to starvation they are treating the symptom not the cause.

Telling a person that they have an eating disorder because they are a perfectionist is like telling a person that they have the flu because they are sneezing. It is confusing the symptom with the cause. 

If you think that the way to treat the flu is by blocking a person’s nose so that they cannot sneeze, then you’re going to be a huge fan of the traditional approach to treating eating disorders. If you think that blocking a person’s nose to treat flu is a) unsafe, b) ineffective, c) backward, and d) a waste of time, then you are going to be looking for food-first methods like I did. 

The treatment is not telling someone to be less of a perfectionist — the treatment is food!

 

It wastes time

It is a waste of time to send someone who is underweight home with a list of ways to stop being such a perfectionist. They need a list of ways to help themselves eat. They need support to weight restore. They need food.

if you live in the USA and don’t have baller health insurance it also wastes a ton of money.

 

It assumes eating disorders are a choice

Furthermore — and this is why I get hot under the collar about this sort of thing — assuming that people with eating disorders are perfectionist assumes that we are “choosing” to be this way because we think it makes us good or whatever. Bullshit. Having an eating disorder is a living hell. An eating disorder is a mental illness. We do not choose to do it because we are trying to be good.

 

It confuses triggers with cause

Many sufferers also get caught up here because the action that triggered their eating disorder may well have been a choice. But here is where you need to understand the difference between the trigger and the cause. The trigger may well have been a diet, but that only triggered the eating disorder, it did not cause it.

The eating disorder caused the eating disorder. The diet activated it. Diets can activate eating disorders because they create an energy deficit. An energy deficit — in a person genetically predisposed to having an eating disorder — is what activates or triggers the illness.

Now, triggers need to be treated so that they do not re-trigger the illness. However, they need to be treated after the illness is treated. Triggers need to be addressed after weight restoration has taken place. Therapy comes after food.

 

Stereotypes discriminate; but eating disorders don’t!

If we believe that only white, middle-class, perfectionist teenage girls get Anorexia then we are effectively putting blinkers on. We do not then see or diagnose the illnesses in the people who get eating disorders who do not fall into this description.

Eating disorders do not discriminate. They affect all people of all types from all races, gender, age, and personality type. If we believe that only girls get eating disorders we will miss spotting them in boys. If we believe only teenagers get eating disorders we will miss spotting them in children and adults. If we believe that only perfectionists get eating disorders we will miss spotting them in non-perfectionists — like me. 🙂

 

Anyhow, that’s my opinion. Now tell me yours!

 

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About Tabitha Farrar

I work as Head of Marketing for a software startup in Boulder. As a recovered Anorexia sufferer, I advocate for proper understanding of eating disorders in my spare time. On that note, I wrote a book about my own journey into eating again called Love Fat.


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2 thoughts on “Questioning Perfectionism In Anorexia

  • Caroline Blaire

    These old myths have certainly misled the general public and much education needs to happen. I supported TWO daughters in their recovery from anorexia and I can attest that this is not a trait of all those suffering with the illness. Certainly, by mere chance, someone that tends to be a perfectionist can develop anorexia, but it is not cause or required trait. From personal experience, one daughter struggled with anxiety and tended to be a perfectionist, but my other daughter could care less about details, about anything! Nice article!
    My hope is the general population continues to learn accurate information. Not only are incorrect assumptions made about what led to the development of the illness, but many may have necessary treatment delayed due to these types of myths.