The price of perfection: the link between perfectionism and suicidal behavior

Abstract

Suicide is a leading cause of preventable death, injury, and disability worldwide. Suicide behavior may adopt multiple variants, from mild to more severe suicidality expressions: suicidal ideation, suicide plan, suicide attempt, and completed suicide (death by suicide). Major efforts have been made in science and in the clinical practice to develop predictive models that shed a light on why people shift to severe suicidality expressions. Unfortunately, theoretical frameworks on suicide are partial and their contributions to an integrated intervention development remain quite limited. Suicide behavior may be a transdiagnostic symptom present across multiple disorders. Moreover, psychosocial factors that aggravate mental disorders may put individuals at a higher risk of suicidal behavior. In this regard, perfectionism is worth mentioning. Perfectionism constitutes a multidimensional set of thinking and behavioral actions linked to success in real life contexts that drive individuals to struggle to achieve high levels of achievement and ‘perfect’ performance. However, perfectionism may act as a double-edged sword, as people may feel overwhelmed and unable to meet unrealistic self-oriented standards. Perfectionism has been associated with numerous mental disorders and suicide behavior. Some research is needed in order to determine how suicidal expressions might be induced by a perfectionism influence and other related pathophysiological underpinnings. The aim of this chapter is to present some evidence on the link between suicide and perfectionism, as well as to describe related pathophysiological mechanisms. Perfectionistic thinking may contribute to rigid thinking styles and feelings of inferiority and hopelessness. Poor interpersonal performance may interact with perfectionistic style and hopelessness, leading to suicidal ideation and more severe forms of suicidality. Perfection is an unattainable goal that may put people at a high risk of self-criticism and emotional distress. Furthermore, prevention programs and clinical treatments for suicide behavior should address perfectionism to provide more effective therapeutical options and improve the patient’s quality of life.