Atelophobia (An Overview)

In this blog we will discuss the symptoms, causes and treatment for Atelophobia.

What is Atelophobia?

Social pressures accompanied with an individual’s insecurities can cause one to have extreme anxieties related to doing the ‘best’.

People with this type of specific phobia strive or work hard to bring perfection to whatever they do. 

Individuals suffering from Atelophobia find the completion of tasks to be very time consuming and tremendously stressful.

They spend hours on trying to accomplish their goals or in the efforts to make the ‘imperfect’, perfect.

These energy consuming tasks add to the anxiety of the sufferers because they form false beliefs that whatever they do will never be perfect.  

This also lowers their confidence levels because they lose self-esteem once they come to believe that the things, they do can never be correct/perfect.

People suffering from this type of specific phobia set unreasonably high standards for the tasks they do, and because or when they are unable to meet those standards, their self-confidence decreases and they start to question their own abilities.

This recurrent strive to do ‘perfect’, if done excessively can lead to the individual developing  Obsessive-compulsive Disorder (OCD), depression or other anxiety disorders. 

Atelophobia includes a lot of obsessive thoughts or actions (as the person continues to ‘improve’, what they feel is not enough or good).

It also comprises of one criticizing or judging their own capabilities, which leads to the emergence of negative thoughts (as in depression). 

This specific phobia is not gender sensitive.

Though the ideas of what is perfect or not differs amongst individuals, Atelophobia can cause extreme anxiety. 

According to the DSM-V criteria for Atelophobia, a person must have extreme anxiety for at least 6-months.

The phobia should affect ones social and occupational functioning.

For example, the recurrent acts done to perfect a certain task at job might affect his/her job opportunities or even the relations with peers or the boss because of the compulsive behavior one does. 

Sufferers will be overly anxious about a certain task, their physical appearance or any other possible thing which they feel can be ‘perfected’. 

Atelophobia is the fear of imperfection or doing things wrong.

It starts of as someone being a ‘perfectionist’ but ends up as a constant feeling of insufficiency or things not being worthy enough. 

Symptoms 

Atelophobia, like every other specific phobia has extreme anxiety as one of its most important symptoms. 

As mentioned earlier, this phobia is subjective in terms of how individuals perceive perfection and what compulsions they do in order to lower their anxiety and attain the goal.

For example, a woman might be anxious of the way she looks, therefore she has set up a goal to do a set amount of surgeries in order to look ‘perfect’. 

This goal requires a lot of money and effort from the woman in order to achieve her desired goal.

She will therefore do anything possible to reach the level of beauty, she thinks is ‘perfect’.

She may even develop eating disorders juts because she wants to maintain an ‘ideal’ body. 

If her tasks are not completed the way they should’ve been, for instance she ran out of money to spend on further surgeries, this will give rise to negative thoughts.

She will come to believe that she cannot look ‘beautiful’ and that she isn’t ‘perfect’. This can lead to depression. 

Another example can be of a man who strives to complete certain tasks in the ‘perfect’ way to prove his abilities.

For some reason he isn’t able to do so, or he thinks the task he has done isn’t ‘perfect’, he can develop anxiety and low self-esteem issues. 

Apart from anxiety, Atelophobia has a number of other physiological symptoms.

These include: 

• Obsession over things/tasks
• Recurrent acts to bring about ‘perfection’
• Lowing of the self-esteem 
• Self-loathing 
• Setting up unreasonably high goals 
• Overly self-critical 
• Dissatisfaction from the tasks 
• Increase in muscle tension 
• Increased heartbeat 
• Migraine 

For Atelophobia to be diagnosed, one must have at least 3-5 symptoms.

Anxiety and recurrent acts or obsessions being present all the time. 

Causes 

Specific phobias including Atelophobia have no real cause as to why one suffers from them.

But like all the other phobias or anxiety disorders, this irrational fear of imperfection has a genetic explanation and an environmental explanation which includes biological reasons and personal experiences respectively.  

According to the genetic explanation, one suffers from a specific phobia either because of a genetic predisposition or family history.

If an individual has a first-degree relative with a specific phobia (Atelophobia for example), then he/she is more likely to develop the same or different specific phobia in the future.  

The inborn tendency to develop a mental disorder is called as a diathesis.

Anxiety disorders (including specific phobias) and other mental disorders have a diathesis-stress relationship.

This means that someone with a biological tendency to, for example have Atelophobia, will not show symptoms of it until and unless there is some stress or an environmental trigger instigating it. 

Therefore, environmental explanation holds great significance in the understanding of why one develops Atelophobia. 

For example, someone who was bullied at school due to the way he/she looked (racism) will become self-critical.

They will feel inferior to others, who according to them look ‘perfect’ and will do every possible thing to attain that ‘perfect’ or ‘ideal’ beauty or appearance. 

Another reason why one develops Atelophobia can be overly critical parents or teachers.

A child who was excessively criticized by his parents or teachers for not gaining certain set of ‘ideal’ grades or not behaving the way an ‘ideal’ child should, will set unreasonably high goals for themselves.

 In the strive to achieve the label of a ‘perfect’ child, one will put in all their efforts and exhaust their resources, but will still feel incompetent.

This will give rise to severe anxiety and can also lead to depression or OCD if untreated. 

Treatment 

Like all the other specific phobias, Atelophobia is treated by a number of different therapies including Exposure Therapy, Cognitive-behavioral Therapy (CBT) and or medications that lower downs the anxiety or other physical symptoms. 

• Exposure Therapy 

It is one of the most frequently used ways of treating patients with Atelophobia (or any other kind of specific phobia).

In this therapy, the patient is exposed to the source of his/her fear over a certain span of time.

To begin with the therapy, the therapist exposes the patient to the least triggering stimuli.

As the therapy progresses and the patient is able to control his anxious feelings, imagery or Active-Imaginal Exposure (AIE) can be used to take the treatment a step further.

In this part of the treatment the patient is asked to visualize/imagine a situation in which he is unable to achieve his/her desired goal.

During the process of imagery, one actually feels being in that particular situation or place, experiencing various senses.

Once the person successfully, without feeling anxious clears this step of the therapy, he/she is then exposed to a real situation in which he is assigned a task, but is unable to do it ‘perfectly’ or the way the therapist desires. 

While the patient is being exposed to different intensities of stimuli during the various stages of therapy, the therapist simultaneously teaches them coping exercises.

These include, breathing techniques or muscle relaxation methods to lower their anxiety, when in an actual fear/anxiety causing situation.

This teaches them how to remain calm when exposed to the fear stimuli.

Before actually starting the exposure therapy, the therapist needs to figure out the intensity of the patients fear, as to deduce whether they will be able to undergo this treatment, without any physical or psychological harm caused to them during the exposure processes. 

However, these steps desensitize one to their fear of imperfection, by being exposed to that stimuli repeatedly, until they learn to undergo the situation without anxiety/panic attacks. 

• Cognitive-Behavioral Therapy (CBT) 

It is one of the most frequently used treatment for patients with almost all kinds of mental disorders. 

Atelophobia is defined as the irrational fear of imperfection or doing things wrong.

Thus, the therapist helps the patient in replacing these irrational thoughts with more rational ones.

The patients are helped out in analyzing and justifying the way they feel about being exposed to the situation they fear of (imperfection in this case). 

The therapists assist them in uncovering the reasons behind their fear and later they provide them with alternate, pleasant thoughts. 

The patient is told to maintain a thought diary (with ABCD column) which provides them a replacement for every irrational thought they have, when thinking about a particular situation.

The ABCD stands for: 

        i. A (antecedents) a situation or triggering event. 

        ii. B (belief) the thought that comes to one’s mind when in that triggering situation

       iii. C (consequences) the symptoms/feelings caused by that event/thought 

       iv. D (dispute) alternate, rational thoughts provided by the therapist in an attempt to dispute/challenge those irrational beliefs.

 This last section of the thought diary is what really plays a role in helping the person feel good/less anxious.  

• Dialectical Behavior Therapy (DBT) 

This is another effective therapy used to treat Atelophobia.

It is more commonly used with people suffering from personality disorders, but is also useful with patients of Atelophobia.

Coping skills are taught in the DBT group which lasts for about 6months and can have a number of people (depending on how many join the group). 

          i. Half-smiling is the first module of DBT. It is a technique that is used with patients who are distressed because of their irrational thoughts.

The technique is known as ‘Half-smiling’ because the person is first advised to think about the stimuli that fears or upsets them (for example, unable to achieve a desired goal), and while doing so they are told to lift the corners of their mouths by subtly smiling.

Smiling is not that will help one get rid of these unpleasant thoughts, it is the person’s ability to constrain itself from thinking about those thoughts while half smiling.

        ii. Mindfulness, the second module, is another technique used in DBT groups which helps the         individual in getting rid of those negative thoughts.

Individuals are told to focus on the present and be attentive to what is going on around them at the moment.

This helps in breaking the link between their mind and any negative thought that might come to them then. 

For example, a person is told to focus on his breath or on the sound of the wind, making use of their auditory sense. 

        iii. The third technique or module of DBT is distress tolerance skills.

This module teaches people to calm themselves down in healthy ways when they are distressed or emotionally overwhelmed.

Individuals are allowed to make wise, rational decisions and take immediate action, rather than being captured by emotionally destructive thoughts that might make the situation worse.

Reality acceptance skills are also learnt under this model so that people fully accept reality and later make plans on how to address the problem/fearful aspects to it.

• Mindfulness-Based Stress Reduction (MBSR) 

MBSR is a meditation therapy, used to manage stress or anxiety.

It is an 8-week program which includes group sessions. Mindfulness meditation and Hatha yoga are practiced in these sessions, lectures and group discussions are also done to talk about mental health and increase interactivity.

In mindfulness meditation the person is told to, for example focus on the sensations felt while breathing or the rhythm of the chest rising and falling during the process.

This distracts the person’s attention from something stressful to something which is neutral and soothing.

Pursed lip breathing can also be exercised by the patient.

In this technique the person inhales from the noes, purses his/her lips (like one does when blowing a candle) and then exhales through the pursed lips, so that the duration for the air to be expelled from the body takes time.

When exhaling takes longer than inhaling, this soothes the brain and avoids feelings of anxiety. 

For quick and effective treatment, patients are also given a set of home works, for example 45 minutes’ yoga and meditation 6 days a week and to record their results/feelings in a book or diary for 15minutes a day.

• Yoga/Meditation 

They are not just one of the many treatment therapies used for Atelophobia, instead they are one of the most common ways of relaxation used by many people.

Yoga tends to stimulate the meditative state of one’s mind while a person is in a particular yoga posture.

Through yoga/meditation the mind is diverted towards something more productive and calmer, allowing the person to escape the negative, distress causing thoughts.

 Out of a number of yoga types, one can benefit from any yoga posture they like. Hatha yoga is one of the different types of yoga.

The breathing techniques or the imagery, one creates while in a yoga posture are the real factors that makes the person feel less anxious and diverts their mind, away from the thoughts about not being to ‘perfect’ something or one’s own inabilities.

• Drug Therapy 

Drugs are used to reduce the physical symptoms caused by Atelophobia.

Drugs are very quick in effectiveness, as they start showing progress in the patients’ health, at least 2 weeks after the medicine is taken.

This type of biological treatment is usually more effective if the cause of a phobia is only genetic.

 However, these drugs/medicines are not to be taken without a doctor’s prescription or consultation.

Two types of drugs are used in the treatment of this phobia:

          i. Anti-anxiety Drugs

These include medicines called as Diazepam.

They are most commonly used with patients who experience panic attacks and also lowers the anxiety by binding to receptor cells of the brain that cause these unpleasant symptoms. 

         ii. Antidepressant Drugs

These drugs as the name suggest don’t treat depression only, but are also very effective in treating phobias.

Medicines like Zoloft reduce the anxious feelings of a person and makes him feel calm.

They need to be taken on a daily basis but not without a doctor’s advice. 

Whether the cause of Atelophobia, or any other type of specific phobia is genetics, environmental or both, the best and the most effective way of treating them is by using a combination of both biological treatments (drugs) with cognitive treatment (for example CBT/exposure therapy).

Titles to read 

• The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are

by Brené Brown

• Atelophobia: Overcoming the Fear of Imperfection

by Sandy Wilkins

• D I F F E R E N T: addictions fears imperfections weaknesses scars emotions struggles strengths stories

by Meleta Marrs

• How to Be an Imperfectionist: The New Way to Self-Acceptance, Fearless Living, and Freedom from Perfectionism

by Stephen Guise

Frequently Asked Questions 

Q1) Is Atelophobia similar to OCD?

We can say that the anxiety that drives one to obsessively think about a certain thing and then repeatedly trying to ‘perfect’ it, can be seen as similar to the obsessions-compulsions one experiences in OCD.

However, both are separate disorders and cannot be classified as one. 

Q2) What are the symptoms of Atelophobia?

Recurrent obsessive thoughts about own imperfection, extreme anxiety, fixation over one thing, poor self-esteem and low self-confidence are a few symptoms of Atelophobia. 

Q3) How is Atelophobia cured? 

It is treated with Exposure Therapy, CBT, DBT and or medicinal drugs. 

Q4) Are men more likely to have Atelophobia? 

Specific phobias are not gender sensitive thus it will be incorrect to claim that either of the two has a higher chance.

However, it is claimed that women are more prone to develop specific phobias then men.

Citations  

• https://psychtimes.com/atelophobia-fear-of-imperfection/
• https://www.healthline.com/health/mental-health/atelophobia#causes
• https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t11/
• https://www.verywellmind.com/research-findings-on-the-genetics-of-phobias-2671935