How Perfectionism and Anxiety Are Holding You Back in Therapy
Whether you love therapy, dread going every week, or fall somewhere in between, if you're an anxious perfectionist, there might be some things getting in the way of truly making the most of your sessions. I’ve been working with anxious perfectionists in therapy for several years now, and I’ve noticed a few common patterns that hold them back. No judgment—so many of us have been there! Therapy is an amazing resource, offering a calm, safe space to work through deep-rooted issues. But I know it can also be tough as you're unpacking old patterns and wounds. Either way, it’s helpful to be aware of these tendencies and how they might show up in your sessions.
With that in mind, here are some ways perfectionism and anxiety might be affecting what you’re getting out of therapy—and what you can do about it:
1. You’re trying to be a “good client”
Being vulnerable in therapy can be tough, especially with someone you’ve just met. You might worry about making mistakes, not knowing enough, or not "getting it right." And if you tend to be a perfectionist, you might feel like you need to appear like you’ve got it all together (even when you don’t feel that way on the inside). Letting someone see you in all your humanness can feel uncomfortable—because, let’s face it, being human is messy.
If you also have people-pleasing tendencies (which a lot of us do!), you might find yourself trying to make your therapist for perfectionism feel comfortable, maybe by hesitating to bring up tough topics or by holding back because you’re worried it might feel like "too much" (spoiler alert: there’s no such thing as oversharing in therapy!).
How this gets in the way: Trying to be the "good client" often means holding back parts of yourself. This could be keeping you from addressing issues that might feel uncomfortable but are key to your healing process. And if you’re constantly worried about being perfect, you might miss out on the opportunity to really be seen and understood. The right therapist will accept and support you, imperfections and all, and will challenge you when needed, but always with care and empathy.
What you can do: If you notice yourself trying to be the "good client," bring it up to your therapist! It can actually be so freeing to bring up those feelings. For me, diving into these dynamics with clients is often one of the most valuable parts of the work. By normalizing what you’re going through, it helps you practice being vulnerable in a safe space. It can also deepen the connection with your therapist and open the door to working on those deeper issues that may still be in the background.
2. You’re focused on checking off the boxes
If you’re focused on ticking boxes instead of really trying things out, you might not be getting much from the tools or suggestions your therapist offers. Even if “just ticking boxes” isn’t how you typically operate, hear me out: maybe you’re worried that you won’t do it right, or that the work won’t help, so you procrastinate. Or maybe part of you is actually worried that it will help, which means you’d have to let go of old patterns—patterns that, even though they aren’t serving you anymore, still feel familiar and comfortable.
Sometimes, you might just be so focused on everything else in your life—work, family, responsibilities—that therapy falls to the bottom of the list, and you run out of time to try. It’s not about not trying hard enough, but that perfectionist mindset can make it tough to fully dive in. Therapy asks you to let go of control, embrace uncertainty, and be open to change, and that’s often a lot harder than it sounds.
How this gets in the way: Therapy takes active work—not just during sessions, but in between them too. Vulnerable self-reflection, sitting with uncomfortable emotions, and testing out new tools are important parts of the process. If you’re not engaging with them intentionally or putting in real effort, you’re likely not going to see the meaningful change you’re hoping for. Without fully committing to the work, it can feel like you’re just going through the motions.
What you can do: Of course, I recommend really trying out the tools for a bit! Like, actually trying. But if you're hesitant to try something, let your therapist know! You can explore together what's holding you back—Is it unrealistic for your life? Are you worried it won’t work? Your therapist will help adjust to make sure what you’re trying fits your real life, and if something isn’t right or you’re just not ready, that’s okay too!
3. You don’t apply what you’ve talked about outside of sessions
It’s easy to forget to apply the tools and reflections we talk about in therapy—or maybe you procrastinate trying them out. Life gets busy, and these new tools might not feel like a priority. If you're procrastinating, it might be because you're worried about doing things "wrong" or causing more harm. Or maybe it just feels too uncomfortable to step out of your usual patterns.
How this gets in the way: Therapy isn’t just about what you talk about in sessions—it's about what you do with it between sessions. That’s when you get to apply new mindset shifts, coping skills, and tools in real-life situations. Without that practice, you’re missing a huge opportunity to make lasting change.
What you can do: If you’re forgetting, try setting reminders on your phone, or ask a loved one to gently remind you. You could also set a daily calendar alert to journal, check in with your feelings, or use any of the other tools you talk about in sessions. If avoidance or procrastination are showing up, start with baby steps! You don’t have to implement everything at once. Starting small and working your way up often feels a lot more manageable.
4. You’re looking for perfection
Anxious perfectionists tend to get stuck in all-or-nothing thinking. If something doesn’t work immediately or doesn’t work 100%, it can be easy to write it off as ineffective or decide you’re just not doing it right. You might feel frustrated or discouraged when you don’t see quick, clear changes.
How this gets in the way: Unrealistic expectations hold us back. It’s hard to stay motivated when things aren’t going exactly as planned. If you expect a lot but don’t see immediate results, you might become discouraged or critical of yourself, which can lead to procrastination, lower self-esteem, and more.
What you can do: Remember that even small progress counts. If you’re learning new things or trying out tools, you’re likely making progress—though it may not always feel that way. As an anxious perfectionist, you might be overlooking these small wins. Take a moment to reflect on the little shifts that are happening. Recognizing even small progress can boost your confidence and motivation. Therapy is the perfect place to practice setting more realistic goals and being kind to yourself along the way.
Related read: From Anxiety to Growth: How Perfectionists Can Learn to Embrace Mistakes
5. You’re intellectualizing rather than feeling
I’m a big fan of understanding why we feel the way we do and getting to the root of our emotions. But if we lean too heavily on intellectualizing, it can become a shield that keeps us from actually feeling. Anxious perfectionists often struggle with this, which can make it tough to just sit with your emotions—an important skill in overcoming many challenges.
How this gets in the way: Over-intellectualizing often leads to avoiding emotions, which keeps us stuck in unhelpful patterns. As uncomfortable as many emotions can be, they’re essential for growth. Avoiding them doesn’t make them disappear—it just piles them up, often leading to more emotional baggage down the road.
What you can do: Your therapist might bring this up in sessions (and if they don’t, here I am again, reminding you that you can bring it up with them!), but if they don’t, you can totally bring it up yourself. Talking through this pattern can be a useful focus in your sessions. Outside of therapy, try doing emotional check-ins where you name your feelings and sit with them for a moment. A body scan (a mental check-in where you start from your toes and working your way up, noticing any tension or tight spots) can also help you notice where you're holding onto tension or other sensations. Even just a few minutes of sitting with your feelings can make a difference. You’ve got this (and I’ve got your back)!
Moving Past Perfectionism
Even if perfectionism and anxiety are holding you back in therapy right now, that doesn’t mean it has to stay that way. These patterns are common—and totally normal. Just noticing them can help you pause, reset, and even address them with your therapist. The goal is to get the most out of your therapy, so don’t hesitate to bring up these challenges along the way.
Looking for Extra Support? Therapy for Anxious Perfectionists in New York Can Help!
If perfectionism and anxiety are making therapy feel like another place where you have to "get it right," you’re not alone. It’s easy to overthink your progress, feel pressure to be the “perfect client,” or struggle to apply insights outside of sessions. But therapy isn’t about performing—it’s about growth, self-compassion, and learning to work through these patterns in a way that actually helps you. As a Licensed Mental Health Counselor and therapist for perfectionism in New York, I work with anxious perfectionists who feel stuck in their own expectations and want support in shifting those patterns. Therapy for anxious perfectionists can help you challenge perfectionism, let go of the need to have it all figured out, and actually make the most of your sessions. If you’re ready to explore therapy in a way that supports your real-life growth—without the pressure to be perfect—reach out today.
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Other Therapy Services at Balanced Connection Counseling
Perfectionism can make even therapy feel like something you need to “do right,” turning self-growth into another exhausting expectation. And when anxiety, burnout, and people-pleasing are layered on top, it can feel even harder to make space for yourself in the process. As a therapist who specializes in perfectionism, I know how tough it can be to let go of unrealistic standards—even in spaces meant for healing. That’s why I offer more than just Therapy for Perfectionism—I also provide Therapy for Anxiety, Therapy for Burnout, and Therapy for People-Pleasing to help you unpack these patterns, build self-trust, and actually get what you need from therapy. If you’ve been feeling stuck in cycles of overthinking or self-doubt, therapy can be a space to work through it—without the pressure to have it all figured out.