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Perfectionism in IBS

Photo by Mae Mu on Unsplash

Perfectionism, despite its name, does not necessarily equal “perfect”. Perfectionism is the tendency to set very high, inflexible standards for yourself, your performance, or your achievements. When these standards are not achieved, people will often be met with an unduly critical voice and feeling unhappy with the outcome.

There are instances where perfectionism may serve an individual well and be a beneficial quality to have. If you have an important upcoming project or need to submit your taxes accurately, it can be helpful to spend additional time to avoid mistakes and errors. In moderation, it encourages people to strive for high and produce good quality output. However, when it starts to become rigid, it can be damaging and have a significant impact on an individual’s life and subsequently their health.

The link between IBS and perfectionism is one example of health can be affected. Research shows that individuals with IBS are more likely to have perfectionistic tendencies and hold unrealistic personal expectations for themselves [1]. One of the key factors linking perfectionism and IBS is stress and the impact that subsequently has on gut functioning. The gut-brain connection is a bi-directional communication system that maintains effective operation of the gut (e.g., regulates gut movements). Stress however can come in and scramble the connection so that it becomes dysregulated thereby lead to IBS symptoms. The symptoms can also become a source of stress and interrupt your ability to meet the standard you expect. Taking a step back and accepting “good enough” often goes against the beliefs that a perfectionist holds. What these standards and expectations therefore do is guide an individual’s behaviour by driving them to push past their limits, placing the body and mind in a state of exhaustion and overwhelm in the long-term.

It’s really difficult to consistently live up to high standards. Taking a step back and accepting “good enough” often goes against the beliefs that a perfectionist holds. What these standards and expectations can do is guide an individual’s behaviour, by driving them to push past their limits. Over time, pushing in this way can place the body and mind in a state of exhaustion and overwhelm in the long-term.

Perfectionism isn’t always about achievement and growth, a part of it is a fear of failure and disapproval. There is an underlying worry of "If others see my shortcomings or mistakes, I will be judged and criticised". This can show up and present in different ways. Someone may avoid activities and socialising because they’re afraid their IBS symptoms will be triggered, and it would be hugely embarrassing if they were. Another individual may choose to spend extra time on ensuring their work contains no errors even if they've checked it already. Either way, avoidance and leaving little time for the things that matter to you can lead to no outlet for stress and becoming socially isolated. Low social support is associated with enhanced stress reactivity and a reduced ability to cope [2].

On the other end of avoidance is saying ‘yes’ to everything and finding it challenging to set boundaries, whether that is socially, professionally, or personally. Often it is driven by a sense of obligation to always show up and not let others down. This ties in with the above of pushing past your limits, taking on more than you can and not leaving enough time for factors that maintain your own wellbeing and rest, contributing to stress and IBS symptoms.

Despite sounding counterintuitive, perfectionism and procrastination can also go hand in hand. How can you want to achieve high standards but procrastinate? When the bar is set so high, it can be difficult to begin tasks because of 1) feeling unable to start until you have every detail figured out and 2) feeling overwhelmed and worrying that it won’t be completed well enough. Avoiding the task at hand feels easier than approaching it and potentially being disappointed and failing. In the moment it feels easier to delay and avoid, but procrastination can feed back into perfectionism as you feel pressure to “make up for lost time”. The cycle of pushing on and compensating for what wasn’t done is likely stressful and can lead to a crash; the body feels tired, IBS symptoms flare-up and factors that contribute to gut regularity (e.g., regular mealtimes, movement) may become inconsistent, further worsening IBS symptoms in the long-term.

Giving yourself permission to take a step back and introducing flexibility into expectations isn’t easy but is possible. In CBT for IBS, perfectionism is a key theme and it is explored via the mechanism of thoughts and behaviours. Beliefs feeding into perfectionism can be tested out in ways that allow you to start updating them and feeling comfortable with "good enough".


[1] Creed F. (2007). Cognitive behavioural model of irritable bowel syndrome. Gut, 56(8), 1039–1041.

[2] Ozbay, F., Johnson, D. C., Dimoulas, E., Morgan, C. A., Charney, D., & Southwick, S. (2007). Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont (Pa. : Township)), 4(5), 35–40.


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