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Perfectionism vs. People-Pleasing:

How to Tell the Difference | Amority Health

 

By: Rachel Cooper, MS, LPC-Associate 
Supervised by Amber Quaranta Leech, PHD, LPC-S

For: Amority Health - Blog - Shifting Perceptions

 

Introduction

High-achieving adults often juggle two subtle patterns: perfectionism and people-pleasing. On the surface, both can look like competence, generosity, and dedication but beneath, they may contribute to stress, anxiety, and burnout (Leiter & Maslach, 2017).

 

In this post, we’ll help you distinguish these patterns, understand their benefits and risks, and explore how therapy can help you shift toward healthier behavior.

 

What Is Perfectionism?

Perfectionism often shows as an internal pressure to meet unrealistically high standards, with fears of failure, criticism, or judgment (Flett & Hewitt, 2022). Signs include:

• Overcritical self-talk
• Difficulty delegating tasks
• Chronic dissatisfaction despite success
• Avoiding challenges that could lead to mistakes

 

What Is People-Pleasing?

People-pleasing manifests as prioritizing others’ needs over your own, often to maintain approval or avoid conflict (Gilbert, 2014). Signs include:

• Saying “yes” when you want to say “no”
• Avoiding confrontation at personal cost
• Feeling guilty when asserting boundaries
• Overextending yourself to help others

People-pleasing may overlap with perfectionism but originates in relational patterns, while perfectionism is more internally driven (Flett & Hewitt, 2022).

 

Benefits and Risks

Both patterns can support achievement, conscientiousness, and reliability, but they also come with risks such as chronic stress, anxiety, and burnout (Leiter & Maslach, 2017).

Benefits

• Both can drive achievement, reliability, and conscientiousness.
• Attention to detail, preparation, and relational harmony are enhanced.

Risks

• Chronic stress and burnout (Burnout Therapy)
• Anxiety, guilt, and self-criticism (People-Pleasing Therapy)
• Strained relationships and difficulty prioritizing personal needs (Perfectionism Therapy)

 

Shifting Perception: CBT in Therapy

Cognitive Behavioral Therapy (CBT) helps high achievers:

• Identify patterns of thought driving perfectionism and people-pleasing
• Challenge unrealistic expectations and relational anxieties
• Develop boundaries and self-compassion
• Practice small behavioral experiments to reinforce healthy change

These CBT strategies are well supported in clinical research (Beck, 2021). Solution-Focused Brief Therapy (SFBT) can also help clients shift from problem-focused thinking to strengths-based, goal-driven change (De Shazer & Dolan, 2012).

These patterns can shift from rigid rules or self-sacrifice to intentional choices aligned with your values.

 

Key Takeaway

Perfectionism and people-pleasing are not flaws; they are learned behaviors and strategies that once served a purpose. CBT and SFBT can help transform them into tools for self-awareness, balance, and authentic living.

Explore other posts in our “Shifting Perceptions” series to discover more ways to align ambition with well-being.

 

Suggestions:

• Are You Recharging or Retreating? The Real Difference Between Introverts and Poor Boundaries | Amority Health
• How To Stop Taking Things Personally: Reclaiming Your Peace Through A Shift In Perception | Amority Health
• Shifting Perception: How Seeing Differently Can Change Everything | Amority Health

 

Each post offers insights and practical tools to help high-achieving adults navigate challenges with clarity, balance, and self-compassion.

 

Written by Rachel Cooper, a therapist specializing in burnout, perfectionism, and life transitions. Learn more about therapy for high achievers at Amority Health.

📅 Schedule a Free 15-Minute Consultation

   

 

  

References

Beck, J. S. (2021). Cognitive behavior therapy: Basics and beyond (3rd ed.). Guilford Press.

De Shazer, S., & Dolan, Y. (2012). More than miracles: The state of the art of solution-focused brief therapy. Routledge.

Flett, G. L., & Hewitt, P. L. (2022). Perfectionism: A relational approach to conceptualization, assessment, and treatment. American Psychological Association.

Frost, R. O., Marten, P. A., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14(5), 449–468. https://doi.org/10.1007/BF01172967

Gilbert, P. (2014). The origins and nature of compassion-focused therapy. British Journal of Clinical Psychology, 53(1), 6–41. https://doi.org/10.1111/bjc.12043

Leiter, M. P., & Maslach, C. (2017). Burnout at work: A psychological perspective. Psychology Press.

 

 

Explore More

If this post resonated, explore more information about our services at Amority Health:

• Burnout Therapy for High Achievers
• Perfectionism & Imposter Syndrome Therapy
• Boundary Setting Therapy
• People-Pleasing Therapy