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 rumination?

Perfectionism

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

CognitionBehaviourAffect+1

Rumination

Rumination may feel like problem-solving but often maintains low mood, shame, threat, and cognitive inflexibility.

CognitionAffectBehaviour

Definition

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

BRepetitive, passive, negatively toned thinking about distress, causes, meanings, or consequences.

Core process

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

BAttention becomes repeatedly captured by unresolved negative meanings without moving into effective action or new learning.

Look for

AAll-or-nothing standards · Difficulty finishing

BLong repetitive analysis · Difficulty shifting attention

Patient language

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

B“I keep going over it”

Maintaining cycle

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

BNegative event -> repetitive analysis -> mood worsens -> more negative material becomes salient

Treatment leverage

AReduce the link between worth and flawless performance.

BMove from repetitive analysis to values-based action or specific problem-solving.

Check before using

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

BThe person is doing concrete planning that leads to action.

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

Rumination appears to keep the patient caught in repeated negative meaning-making, worsening mood and reducing behavioural movement.

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 rumination?

Perfectionism

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

CognitionBehaviourAffect+1

Rumination

Rumination may feel like problem-solving but often maintains low mood, shame, threat, and cognitive inflexibility.

CognitionAffectBehaviour

Definition

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

BRepetitive, passive, negatively toned thinking about distress, causes, meanings, or consequences.

Core process

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

BAttention becomes repeatedly captured by unresolved negative meanings without moving into effective action or new learning.

Look for

AAll-or-nothing standards · Difficulty finishing

BLong repetitive analysis · Difficulty shifting attention

Patient language

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

B“I keep going over it”

Maintaining cycle

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

BNegative event -> repetitive analysis -> mood worsens -> more negative material becomes salient

Treatment leverage

AReduce the link between worth and flawless performance.

BMove from repetitive analysis to values-based action or specific problem-solving.

Check before using

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

BThe person is doing concrete planning that leads to action.

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

Rumination appears to keep the patient caught in repeated negative meaning-making, worsening mood and reducing behavioural movement.

Open full guide

Browse the map Use both hypotheses