In 2018, I went on tour for my memoir Little Panic: Dispatches From an Anxious Life.

I spoke to thousands of people, engaging with audiences of all ages about anxiety and other mental health issues and taking questions.

I stressed often, and as gently as possible (not my strength, tbh), that anxiety often comes from inside the house. Meaning, of course, that children aren’t born anxious—they learn how to become anxious by watching and modeling the behavior of their anxious caregivers.

During one particular Q&A, a woman was beside herself because she swore, up and down, that she wasn’t anxious, and neither was her wife. She was, she told me, as she picked feverishly at her cuticles, a perfectionist.

Could it be that her perfectionism was creating her child’s anxiety? Was it possible that her perfectionism read to her child as anxiety, and that’s why her child was so anxious all the time even though she, the parent, was not anxious at all, but in fact simply a perfectionist?

Yes, yes, she decided, answering her own question—it was definitely perfectionism. Thank you so much, she said, sitting back down.

I hadn’t said a word.

When the Q&A ended, I sought out the perfectionist. There was something important I wanted to share, and it was this: Perfectionism is one of anxiety's most successful disguises, and one of the hardest to see through, because it looks, from the outside, like a virtue.

While it’s true that not all perfectionism is a maladaptive coping mechanism born from anxiety, the link between perfectionism and anxiety is profound and undeniable. Anxiety can give rise to perfectionism and perfectionism can give rise to anxiety.

It's a vicious loop.

When I found her, I braced myself for pushback and possibly even anger, but what I got instead was a relief. Her perfectionism had never really made sense to her, she admitted. Everything she’d read about perfectionism seemed to fit, except for one thing—the feeling tone of her experience as a “perfectionist” never matched the word itself.

Hearing that anxiety might be running the show allowed her to face her anxious feelings. In doing so, she could now go forward, work on her anxiety, and model what she learned for her child.

Perfectionism can rise from overcompensating out of a fear that you’re not good enough and the fear of failing. To be anxious is to be hypervigilant and attuned to tonal shifts and signals—anything that might suggest you’re being judged and your score is coming in low.

People who suffer from chronic anxiety worry they are not acceptable as they are and that the only way to be embraced by others is to be perfect. The effort to be perfect is just one maladaptive way people deal with their anxiety.

When you suffer from anxiety, you feel defective, as though you’re missing crucial parts that other people have. You grasp onto the stories your worry narrates, convincing you that they’re true.

You feel your feelings so strongly you confuse them for facts.

Because anxious people feel flawed, they worry everyone else can see their flaws, and the threat of exposure feels so shameful, it drives many anxious people to create a veneer of perfection so that everyone will be thrown off course. It’s a defense mechanism.

Anxiety can disguise itself in a variety of ways and perfectionism is just one of them.

But, perfectionism can also disguise itself.

Below are 6 common hiding places for anxiety-motivated perfectionism:

UNCERTAINTY

Perfectionists live for certainty, because uncertainty means they can’t control appearances or situations. You know who else doesn’t love uncertainty? ANXIOUS PEOPLE.

Anxious people are terrified of uncertainty.

Not knowing is an unbearable reality that tricks anxious people into thinking that reality is unbearable—a false equivalency.

Uncertainty to anxious people feels dangerous. It’s not exciting, it’s not a river of open possibility—it’s a noxious death trap. Making a mistake, handing in a project that has even one error, and having to guess at something that might open you up to being wrong is not a gamble an anxious person wants to take.

So we forestall finishing things until “they’re perfect.”

Uncertainty might invite criticism, and criticism means we’re wrong.

Perfectionism is a guard against being wrong because to be openly “wrong” exposes our fear that we’re defective or flawed, which means we’re different, unlike everyone else, and, therefore, entirely alone.

Were someone to glimpse inside, they’d discover that the perfectionist is simply performing perfection and is not, in fact, perfect. Perfectionists (and people with anxiety) equate performance with acceptability. Should we fail, should we be caught not knowing something, should we be corrected means we will stop being liked.

CONTROL

When uncertainty overwhelms and unglues us, the only way to cope is to try to make things feel certain, and the only way to do that—is to control.

Controlling is perfection from a different angle.

Because perfectionists equate performance with acceptability, they also believe that being wrong means they are unlovable. This worry leads to a sense of being out of control and so they grasp, in any way they can, to control the outcome of their behavior.

Many fixed-mindset people are perfectionists.

Striving for perfection is a misguided way to deal with uncertainty. If we can't control the world and our circumstances, we may seek to control ourselves or others. This not only distracts us, but it also distracts others from seeing the truth driving our behavior.

Control can also show up as denial by pretending things aren’t as they are. Pretending that our child doesn’t have an incurable illness or our spouse is cheating or an alcoholic.

If we carry our magical thinking to the extreme, we may even feel that we can cure such things by simply being perfect.