High Achiever Burnout and The Hidden Cost of Perfectionism at Work
- Jul 11, 2025
- 6 min read
Written by Roje Khalique, Founder of rkTherapy
Roje Khalique is a visionary clinical consultant with 20 years of experience in mental health. She is the founder of rkTherapy, a London-based bespoke psychology consultancy, and a specialist in culturally attuned Cognitive Behavioural Therapy (CBT).
In today's achievement-driven culture, perfectionism is often worn like a badge of honour, a sign of ambition, responsibility, and grit. But behind the polished CVs, pristine presentations, and packed schedules, we regularly meet high-performing professionals who are exhausted, anxious, and deeply self-critical. Their struggle is not obvious to the outside world. It is internal, relentless, and unrelenting. At the core of their experience is something we call clinical perfectionism, a quiet but corrosive force that often goes unnoticed until it fuels burnout, anxiety, and depression.
Clinical perfectionism: Beyond high standards
We must be clear, striving for excellence is not the problem. The issue is why and how we strive. Clinical perfectionism is a term psychologists use to describe a specific and harmful form of perfectionism where a person's self-worth becomes overly dependent on achieving personally demanding standards, even when those standards lead to significant negative consequences.
This definition, grounded in the work of researchers like Shafran, Cooper, and Fairburn, distinguishes clinical perfectionism from healthy goal setting. It is not about doing well, it's about never being good enough, no matter how well you do, and anything less than ‘perfect’ is deemed ‘unacceptable’. Where healthy striving is flexible and growth-oriented, clinical perfectionism is rigid, self-critical, and fear-based. The inner dialogue of someone with clinical perfectionism often sounds like this:
The internal dialogue:
"If I don't get this exactly right or perfectly, then I've failed."
"I can't stop until it's perfect."
"If I relax, I'll fall behind or lose everything."
"Anything less than flawless is unacceptable."
What it looks like in real life
In our work with high-achieving professionals, doctors, lawyers, investment professionals, entrepreneurs, creatives, and executives, clinical perfectionism often manifests as:
Behavioural patterns:
Chronic procrastination, rooted in fear of not doing things perfectly
Inability to mentally switch off, even at home or on holiday
A constant sense of rushing, multitasking, and chasing the next task or goal, never feeling satisfied or fulfilled.
Fear of saying no, letting others down, or appearing "not good enough"
Being a "high performer" at work while secretly struggling with anxiety or burnout
A deep identity conflict: needing to be the perfect professional, parent, partner, all at once
Many clients trace this pattern back to early experiences with high parental expectations, conditional praise, or environments where love, safety, or approval were earned only through achievement.
The science: Understanding the perfectionism-anxiety-burnout cycle
Studies have confirmed what many professionals feel but struggle to articulate: Research consistently reveals how perfectionism affects our mental health and well-being. When scientists analysed dozens of studies together, they found that people who are highly self-critical and fear making mistakes are significantly more likely to experience anxiety, depression, and obsessive-compulsive behaviours.
Research has shown that perfectionism and self-esteem move in opposite directions. The more perfectionistic someone becomes, the worse they tend to feel about themselves overall. This helps explain why even major achievements can leave perfectionists feeling empty or inadequate, that nagging sense that nothing is ever ‘good enough’.
Perhaps most striking is what happens in our bodies. Studies using physiological measurements have shown that perfectionists have difficulty disengaging from their stress response. While most people's nervous systems naturally calm down after a stressful event, perfectionists often remain in a state of high alert. Their bodies stay primed for danger (fight, flight, or freeze), making it genuinely difficult to relax or feel at peace, even when everything is going well.
This explains why perfectionism is not just about having high standards; it is about being trapped in a vicious cycle where our minds and bodies struggle to find rest, even after we have accomplished exactly what we set out to do.
Where perfectionism masquerades as excellence
Some careers seem to celebrate the very traits that can harm mental health, rewarding relentless self-criticism and impossible standards until people experience burnout, stress, and anxiety.
The legal world
Several UK law firms continue to operate under high-performance cultures where anything less than perfection is discouraged. A 2022 survey of over 100 UK lawyers found that over 92% reported experiencing work-related stress or burnout, with over a quarter stating that it occurred daily. Almost two-thirds believed their mental and physical health had been negatively impacted, while fewer than one in four felt supported by their employer when stressed or burned out.
These findings align with broader workplace research, which shows that 91% of UK workers reported high or extreme stress levels in 2025, with professional service industries among the most affected.
Reports suggest that for junior lawyers at some top-tier commercial firms, 70-hour work weeks have become the norm. Interviews and industry publications describe an environment where being constantly available is expected, answering emails at all hours, working weekends, and sustaining 18-hour days to close deals. In therapy, commonly reported issues include a lack of support, limited recognition, and overwhelming expectations, which have led many to feel their personal goals and health are being compromised. What is often perceived externally as "commitment" may reflect internalised perfectionism, impostor syndrome, and chronic fatigue.
The investment industry
High-pressure cultures also persist in investment banking. Industry data suggests junior bankers regularly clock 80 to 90-hour work weeks, with signs of long-term physical and emotional exhaustion becoming more visible.
A study reported that 72% of investment bankers said they were considering leaving the industry due to burnout, and 51% reported knowing colleagues planning to exit. In therapy, clients often share experiences of sleep deprivation, panic attacks, and stress-related health problems. Despite increased awareness, many professionals report limited access to evidence-based mental health support. In some environments, the culture has equated self-care with weakness, discouraging individuals from setting healthy boundaries.
Other high-risk professions
The challenges seen in law and finance are echoed across several other high-demand industries. Recent UK-based studies reveal concerning rates of burnout linked to perfectionism and emotional strain:
Physiotherapists: A 2024 UK study found that 96% reported moderate to high levels of burnout, with perfectionism accounting for over 60% of the variance.
Accountants: According to CABA’s 2024 survey, 74% of accountants reported burnout symptoms, and one-third experienced depression or panic attacks.
These roles often involve high stakes, low tolerance for error, and a reluctance to seek support, all of which create conditions where burnout can thrive. In many cases, clinical perfectionism becomes culturally reinforced, and the impact is visible primarily through rising mental health concerns.
How clinical perfectionism affects the brain and body
Perfectionism means the brain treats "less than perfect" like a threat. This keeps the stress response chronically activated, even in safe settings like home, weekends, or sleep. Over time, this leads to:
Neurological and physical impact:
Anxious hyper-vigilance (always scanning the environment for potential failure)
Emotional dysregulation (difficulty relaxing or calming down after small mistakes)
Cognitive rigidity (all-or-nothing thinking, catastrophic and anxious/fear-based predictions)
Physical symptoms (insomnia, fatigue, jaw tension, gut issues, flare-ups of long-term health conditions)
Without regular "safety signals", which are moments where the brain can rest, recharge, and feel accepted as it is, the nervous system remains in constant overdrive. This is why perfectionism is not just a mindset problem. It is a whole-system overload.
Treatment: What helps
The good news? Clinical perfectionism is treatable. Therapy that directly targets perfectionism, rather than just its side effects, has shown strong results:
Evidence-based approaches:
Cognitive Behavioural Therapy (CBT) protocols for perfectionism lead to significant, lasting reductions in self-critical thinking, anxiety, and burnout.
Compassion-focused therapy (CFT) approaches and nervous-system regulation techniques help retrain the brain to feel safe without perfection.
Exposure Therapy that introduces small behavioural experiments (e.g., doing tasks to "80%" instead of 100%) can rewire the unhelpful belief that imperfection equals failure.
A message of hope
If you resonate with this article, if you are outwardly successful but inwardly anxious, exhausted, or silently suffering, know this: You are not alone. You are not broken. And you do not have to keep performing your way into peace.
At rkTherapy, we specialise in working with high-achieving professionals who are ready to redefine success, not by doing less, but by doing it from a place of safety, balance, and sustainable self-worth.
If clinical perfectionism is running your life, it's time to reclaim your energy, self-trust, and peace. Private therapy for high-achieving professionals.
Book a confidential consultation with rkTherapy today and start your journey back to a high-performance life that does not cost your emotional wellbeing.
Contact: info@rktherapy.co.uk
Read more from Roje Khalique
Roje Khalique, Founder of rkTherapy
Roje is a clinical practitioner for a wide range of anxiety disorders and depression. She is dedicated to making quality psychological support accessible to high-achieving professionals in the legal and finance industries in London's high-stakes corporate world. During COVID-19 she recognised a global and increasing need for evidence-based support and developed a Cognitive Behavioural Therapy (CBT) online, virtual platform and a mobile app. Designed to fit the demanding schedules of professionals not only in London but across Europe, the US, the Middle East, and Asia.
