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 worry?

Perfectionism

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

CognitionBehaviourAffect+1

Worry

Worry attempts to prepare for danger but may maintain anxiety by overestimating threat and under-testing coping.

CognitionAffectBehaviour+1

Definition

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

BRepetitive future-oriented thinking about possible threats, uncertainty, or negative outcomes.

Core process

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

BFuture threat simulations create an illusion of preparation while increasing vigilance, arousal, and safety behaviours.

Look for

AAll-or-nothing standards · Difficulty finishing

BWhat-if chains · Reassurance seeking

Patient language

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

B“What if something goes wrong?”

Maintaining cycle

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

BUncertainty -> worry -> temporary control -> more threat scanning -> more uncertainty

Treatment leverage

AReduce the link between worth and flawless performance.

BSeparate solvable problems from hypothetical threat loops.

Check before using

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

BThe main loop is past-focused rumination rather than future threat simulation.

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

Worry gives a brief sense of preparation, but it also sustains threat monitoring and prevents uncertainty tolerance.

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 worry?

Perfectionism

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

CognitionBehaviourAffect+1

Worry

Worry attempts to prepare for danger but may maintain anxiety by overestimating threat and under-testing coping.

CognitionAffectBehaviour+1

Definition

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

BRepetitive future-oriented thinking about possible threats, uncertainty, or negative outcomes.

Core process

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

BFuture threat simulations create an illusion of preparation while increasing vigilance, arousal, and safety behaviours.

Look for

AAll-or-nothing standards · Difficulty finishing

BWhat-if chains · Reassurance seeking

Patient language

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

B“What if something goes wrong?”

Maintaining cycle

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

BUncertainty -> worry -> temporary control -> more threat scanning -> more uncertainty

Treatment leverage

AReduce the link between worth and flawless performance.

BSeparate solvable problems from hypothetical threat loops.

Check before using

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

BThe main loop is past-focused rumination rather than future threat simulation.

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

Worry gives a brief sense of preparation, but it also sustains threat monitoring and prevents uncertainty tolerance.

Open full guide

Browse the map Use both hypotheses