The Association Between Perfectionism and MC

By Wayne Persky

​A search of the archives of the Discussion and Support Forum associated with our website shows that most of us (although certainly not all of us), are perfectionists, overachievers, early adapters, type A personalities, or some combination of these traits. This article will focus on perfectionism, since it appears to apply to more microscopic colitis (MC) patients than the other listed attributes.

Perfectionism is a mixed blessing

​Perfectionism can inspire us to perform at our best level, and produce high-quality work. But on the other hand, it can cause us to endure unnecessary stress and anxiety, and it can annoy those who work with us, or associate with us outside of work.

Perfectionists have shaped our history.

​Some of the most talented and accomplished individuals who have molded our civilization were perfectionists. Ludwig van Beethoven, (Johannes Chrysostomus Wolfgangus Theophilus) Mozart, Johannes Brahms, (Pyotr Ilyich) Tchaikovsky, Claude Monet, Michelangelo (di Lodovico Buonarroti Simoni), Leonardo da Vinci, Charles Darwin, Vincent van Gogh and Johann Wolfgang von Goethe were all perfectionists. And so was Thomas Jefferson, Benjamin Franklin, Bing Crosby, Fred Astaire, Marilyn Monroe, Elvis Presley, Karen Carpenter, and Michael Jackson. Studies show that the best researchers are perfectionists, and perfectionism is linked with higher IQs, and a tendency to be cautious.

Winston Churchill once said, "perfection is the enemy of progress."

​And unfortunately, most of the perfectionists who have achieved fame in history, had troubled souls. Many of them tried to be so perfect, that it often took years to complete a work of art, and some of them were notorious for failing to complete many or even most of their projects.

Perfectionists are especially bothered by criticism.

​According to an article posted on the Psychology Today website, perfectionism is driven by an intense desire to avoid failure or criticism (Psychology Today Staff, n.d.).[1] The standards that perfectionists set for themselves, and others, are unrealistically high, and consequently, they are quick to criticize.

Unfortunately, perfectionism has been shown to be associated with IBD.

​A study involving 90 pediatric IBD cases, and 76 of their caregivers, revealed that 59% reported elevated rates of perfectionism, and 33% of them had symptoms in the clinical range (Piercy, Stinson, Church, Walters, Frost, and Ahola Kohut, 2020).[2]
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Research based on 51 patients who had either Crohn's disease or ulcerative colitis, published in 2011, showed that “perfectionism and perfectionistic self-presentation were associated with greater sickness impact” (Flett, Baricza, Gupta, Hewitt, and Endler, 2011).[3]

Many of us (MC patients) are perfectionists.

I'm a perfectionist. If you have MC, and you believe that you're not a perfectionist, take the online quiz provided by National Public Radio (NPR) at the following link (Tagle, 2023, January 30):[4]

https://www.npr.org/2023/01/25/1151414475/the-five-kinds-of-perfectionists

If the results show that you are not a perfectionist, then there is a good chance that you may be well aware of the primary initial trigger that lead to the development of your disease. It was probably triggered by an antibiotic, or some other medication, or a known source of stress, such as stopping a long-term smoking habit, PTSD (posttraumatic stress syndrome), or maybe a parasitic infection, or a similar digestive system problem.

If the results confirm that you are indeed a perfectionist, then there's a very good chance that perfectionism may have helped to trigger, or at least played a significant role, in the initial development of your MC.

History records many possible associations between perfectionism and IBD.

• Beethoven

Beethoven, for example, had many of the same symptoms that many of us have had, for most of his adult life. He had abdominal pain, diarrhea, vomiting, joint pain, and exhaustion (Pauwels, 2022).[5] Interestingly, historians have recorded that Beethoven himself noted that the 4th movement of his 2nd symphony was written as a musical description of the rumblings in his bowels (Poole, 2015, January 14).[6] That sounds very familiar, doesn't it? Most of us have experienced the loud gurgling noises in our intestines that are unique to active IBD.

• Tchaikovsky

Although it's possible that Tchaikovsky might have had an IBD, because the records show that he suffered from "abdominal colic", his actual cause of death appears to have been cholera (Kornhauser, 2010).[7] It's recorded that he drank a glass of unboiled water, and a few hours later, the vomiting and diarrhea began. He died four days later.

• Charles Darwin

Darwin had digestive problems for most of his life, and he kept notes describing his symptoms in detail (for his doctors). He had problems with facial eczema and other dermatology issues that began in childhood, severe anxiety issues, abdominal pain and gastric distress, fatigue, gas, and occasional vomiting, but notably, he never complained of diarrhea (Thomson, 2009).[8] His doctors were never able to pinpoint the cause of his symptoms.

Modern attempts at diagnosing his issues range from giardiasis (beaver fever) to Crohn's disease, with mentions of the possibility of adrenal disease, or Chagas. Naturally, no one has brought up the possibility that he might have had MC (possibly because he didn't have diarrhea), even though his symptoms are a good match for MC, including the severe anxiety issue, which is a common symptom of a chronic magnesium deficiency (MC depletes magnesium). And of course, now, we know that MC is not always associated with diarrhea.

• Vincent van Gogh

One of the most celebrated creative artists of all time was Vincent Van Gogh, and he himself described his symptoms in many of his letters and documents. Those symptoms included poor digestion, regular stomach upset, hallucinations, nightmares, stupor, absentmindedness, anxiety, and insomnia (Bhattacharyya, and Rai, 2015).[9] Again, those symptoms are familiar to most of us.

• Thomas Jefferson

Among other symptoms, Thomas Jefferson had headaches, dysentery, rheumatism, and multiple bone fractures (suggesting osteoporosis) (Schneeberg, 2008).[10] With those symptoms, he certainly might have had an IBD.
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• Michael Jackson

Michael Jackson was diagnosed with Crohn's disease.

Is perfectionism a personality disorder?

​Although perfectionism is a trait often seen in individuals who have obsessive-compulsive personality disorder (OCD), perfectionism is simply a trait, and not a personality disorder. Perfectionists usually do not seek professional help for their condition, because they are typically happy with their lifestyle, and they don't believe anything is wrong (Discovery Mood & Anxiety Program, n.d.).[11] Consequently, if any problems do arise, because of this attribute, perfectionists are usually the last to realize that they even have the trait.

Perfectionism occurs in three forms.

​According to the Psychology Today article cited above, there are three different types of perfectionism (Psychology Today Staff, n.d.).

1. Self oriented (imposing unrealistic perfection requirements on ourselves).
2. Other oriented (expecting perfection from others).
3. Socially prescribed (believing that others expect perfection from us).

Perfectionism is a gift, but it can become a liability.

​According to a Harvard Business Review online article, those of us who are perfectionists can learn to control any issues that might arise if (or when) our perfectionism becomes a problem, by following certain guidelines (Knight, 2019, April 29).[12]
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1. We should learn to recognize the point of diminishing returns.
2. We should be aware of our standards, and make sure they are realistic.
3. We should learn how to recognize the difference between normal problem-solving andneedlessly pondering an issue.
4. We should learn to avoid working toward the goal of perfection, and instead, evaluate our work by measurable results.
5. And we should learn that it's okay to ask others for their opinions and insight, whenever we become stuck on a project.

​Remember, perfectionism is like virtually everything else in our lives — in moderation, it's fine. But when it becomes an obsession, it can stop being an advantage, and destroy our productivity.

References

1. Psychology Today Staff. (n.d.). Perfectionism. [Web log Message].Psychology Today, Retrieved from https://www.psychologytoday.com/us/basics/perfectionism

​2. Piercy, J., Stinson, J., Church, P. C., Walters, T. D., Frost, K., and Ahola Kohut, S. (2020).Trait Perfectionism and Psychosocial Outcomes in Adolescents With Inflammatory Bowel Disease. Journal of Pediatric Gastroenterology and Nutrition, 70(3), pp 318-323. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31821232/

​3, Flett, G. L., Baricza, C., Gupta, A., Hewitt, P. L., and Endler, N. S. (2011). Perfectionism, psychosocial impact and coping with irritable bowel disease: A study of patients with Crohn’s disease and ulcerative colitis. Journal of Health Psychology, 16(4), pp 561–571. Retrieved from https://journals.sagepub.com/doi/abs/10.1177/1359105310383601?journalCode=hpqa&

​4. Tagle, A. (2023, January 30). What kind of perfectionist are you? Take this 7-question quiz to find out. [Web log message]. NPR, Retrieved from https://www.npr.org/2023/01/25/1151414475/the-five-kinds-of-perfectionists

5. Pauwels, E. K. J. (2022). Ten Famous Composers of the Romantic Era and Their Causes of Death. Medical Principles and Practice, 31(1), p 20–28. Retrieved from https://karger.com/mpp/article/31/1/20/825060/Ten-Famous-Composers-of-the-Romantic-Era-and-Their

6. Poole, R. (2015, January 14). Beethoven’s musical electrocardiograms. The Pharmaceutical Journal, Retrieved from https://pharmaceutical-journal.com/article/opinion/beethovens-musical-electrocardiograms

7. Kornhauser, P. (2010). The cause of P.I. Tchaikovsky's (1840-1893) death: cholera, suicide, or both? Acta medico-historica Adriatica, 9(1), p 145-72. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21073251/

8. Thomson, K. (2009). Darwin's Enigmatic Health. American Scientist, 97(3), p 198. Retrieved from https://www.americanscientist.org/article/darwins-enigmatic-health

9. Bhattacharyya, K. B., and Rai, S. (2015). The neuropsychiatric ailment of Vincent Van Gogh. Annals of Indian Academy of Neurology, 18(1), pp 6-9. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4350215/

10. Schneeberg, N. G. (2008). The medical history of Thomas Jefferson (1743-1826). Journal of Medical Biography, 16(2), pp 118–125. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18463085/

11. Discovery Mood & Anxiety Program. (n.d.). How Perfectionism Drastically Differs from OCD. Retrieved from https://discoverymood.com/blog/perfectionism-differs-ocd/
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12. Knight, R. (2019, April 29). How to Manage Your Perfectionism. [Web log message]. Harvard Business Review, Retrieved from https://hbr.org/2019/04/how-to-manage-your-perfectionism