Perfectionism, Process-Based Therapy & The Anxious Perfectionist
Breaking the Rules: A Clinician's Guide to Treating OCDShow Notes
In this episode of Breaking the Rules, we’re joined by researcher and clinician Dr. Clarissa Ong to unpack the complex relationship between perfectionism, anxiety, and OCD — and to explore how process-based therapy, particularly ACT, offers a powerful lens for understanding and treating these patterns.
Drawing on her research and her book The Anxious Perfectionist, Clarissa helps us move beyond surface-level symptoms and into the underlying processes that drive rigidity, rule-following, self-criticism, and all-or-nothing thinking.
We explore perfectionism not as a simple personality trait, but as a pattern of inflexible rule-governed behaviour — one that can show up across OCD, generalized anxiety, depression, eating disorders, and beyond. The conversation dives into how values can become fused with perfectionistic rules, how therapy itself can become “a thing to perfect,” and why flexibility — not flawless performance — is the real treatment target.
💬 Key themes: • Perfectionism as rigidity around internal rules and standards • The overlap between perfectionism, OCD, and generalized anxiety • Why perfectionism is often more process than diagnosis • ACT vs CBT in the treatment of perfectionism • Experiential work vs intellectualizing in therapy • How values can become hijacked by perfectionism • The “all-or-nothing” trap and treatment drop-off • The role of context in determining helpful vs unhelpful striving • Therapist perfectionism and projected expectations • Letting go of the need to be liked
This conversation is especially valuable for clinicians wanting to deepen their formulations beyond symptom reduction and into process-based change.
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