Alternative hypotheses

Compare mechanisms

Compare function, sequence, patient language, and treatment leverage. The aim is not to choose a label—it is to identify which hypothesis best explains this person’s pattern.

Ask this

Which pattern better explains the sequence, protective function, and consequences: perfectionism or negative core beliefs?

Perfectionism

Perfectionism can drive achievement but may maintain anxiety, depression, shame, procrastination, avoidance, and burnout.

CognitionBehaviourAffect+1

Negative core beliefs

Negative core beliefs bias attention and meaning-making, often linking early experience to current automatic thoughts, affect, and behaviour.

CognitionDevelopmentalAttachment+1

Definition

AA rigid pattern of setting excessively high standards and linking worth, safety, or acceptability to flawless performance.

BGlobal, rigid, overgeneralised beliefs about the self, others, or world that shape interpretation and emotional response.

Core process

AConditional self-worth and threat appraisal attach high emotional cost to mistakes, uncertainty, or ordinary limitation.

BA schema-like belief filters events so ambiguous information is interpreted as confirming defectiveness, danger, unlovability, or failure.

Look for

AAll-or-nothing standards · Difficulty finishing

BGlobal self-statements · Persistent themes across situations

Patient language

A“If it is not perfect, it is a failure”

B“I am not good enough”

Maintaining cycle

AHigh standard -> threat of mistake -> overcontrol or avoidance -> temporary relief -> standard remains rigid

BTrigger -> negative meaning -> affect -> coping behaviour -> apparent confirmation of belief

Treatment leverage

AReduce the link between worth and flawless performance.

BWork at the level of meaning, not only surface thoughts.

Check before using

AHigh standards are flexible, values-based, and not associated with significant distress or impairment.

BThe thought is situation-specific and changes with new evidence.

Formulation language

Perfectionism appears to protect against shame through high control, but it increases self-criticism and avoidance when standards cannot be met.

Open full guide

Formulation language

A negative core belief of defectiveness appears to shape threat appraisals, self-criticism, and avoidance of disconfirming feedback.

Open full guide

Browse the map Use both hypotheses

Alternative hypotheses

Compare mechanisms

Compare function, sequence, patient language, and treatment leverage. The aim is not to choose a label—it is to identify which hypothesis best explains this person’s pattern.

Ask this

Which pattern better explains the sequence, protective function, and consequences: perfectionism or negative core beliefs?

Perfectionism

Perfectionism can drive achievement but may maintain anxiety, depression, shame, procrastination, avoidance, and burnout.

CognitionBehaviourAffect+1

Negative core beliefs

Negative core beliefs bias attention and meaning-making, often linking early experience to current automatic thoughts, affect, and behaviour.

CognitionDevelopmentalAttachment+1

Definition

AA rigid pattern of setting excessively high standards and linking worth, safety, or acceptability to flawless performance.

BGlobal, rigid, overgeneralised beliefs about the self, others, or world that shape interpretation and emotional response.

Core process

AConditional self-worth and threat appraisal attach high emotional cost to mistakes, uncertainty, or ordinary limitation.

BA schema-like belief filters events so ambiguous information is interpreted as confirming defectiveness, danger, unlovability, or failure.

Look for

AAll-or-nothing standards · Difficulty finishing

BGlobal self-statements · Persistent themes across situations

Patient language

A“If it is not perfect, it is a failure”

B“I am not good enough”

Maintaining cycle

AHigh standard -> threat of mistake -> overcontrol or avoidance -> temporary relief -> standard remains rigid

BTrigger -> negative meaning -> affect -> coping behaviour -> apparent confirmation of belief

Treatment leverage

AReduce the link between worth and flawless performance.

BWork at the level of meaning, not only surface thoughts.

Check before using

AHigh standards are flexible, values-based, and not associated with significant distress or impairment.

BThe thought is situation-specific and changes with new evidence.

Formulation language

Perfectionism appears to protect against shame through high control, but it increases self-criticism and avoidance when standards cannot be met.

Open full guide

Formulation language

A negative core belief of defectiveness appears to shape threat appraisals, self-criticism, and avoidance of disconfirming feedback.

Open full guide

Browse the map Use both hypotheses