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Self-Criticism & Perfectionism Therapy in Central London (W1W) & Online

For people who achieve a lot, but feel driven, anxious, and never “good enough”

Many people I see for self-criticism and perfectionism are high-functioning on the outside. They work hard, take responsibility, and often appear capable and composed, yet internally feel under constant pressure, fear mistakes, or carry a harsh inner voice that rarely lets them rest.

Self-criticism can look like “motivation”, but over time it usually becomes costly: anxiety, burnout, procrastination, sleep disruption, relationship strain, and a shrinking sense of self.

I offer therapy for self-criticism and perfectionism in Central London (W1 / W1W) and online, working with adults whose pattern is maintained by shame, fear of judgement, overcontrol, and internal pressure, not simply “high standards”.

My work integrates evidence-based approaches including ISTDP, CBT, and psychodynamic therapy, with a strong focus on how the pattern is maintained in the present and how it can change.

When perfectionism isn’t just being conscientious

Perfectionism and self-criticism often show up as:

  • A harsh inner critic (“You should be doing more / you’re not enough”)
  • Imposter feelings, fear of being exposed or judged
  • Overpreparing, overworking, or difficulty finishing tasks
  • Procrastination (fear of not doing it perfectly)
  • Difficulty resting without guilt
  • Replaying mistakes and ruminating after interactions
  • Feeling unable to enjoy achievements for long because the bar moves again

In these cases, self-criticism isn’t random. It is often doing a job – trying to prevent shame, rejection, or loss of control.

The self-criticism/perfectionism cycle (how it keeps going)

Across different presentations, the pattern tends to follow a familiar loop:

  • A trigger appears (evaluation, feedback, uncertainty, visibility, high stakes)
  • The inner critic activates (“If I’m not perfect, I’ll fail / be judged”)
  • Anxiety and shame rise in the body (tension, adrenaline, tight chest, gut symptoms)
  • You respond by:
    • overworking / overcontrolling
    • procrastinating / avoiding
    • seeking reassurance or certainty
    • people pleasing or hiding mistakes
  • Short-term relief (you feel safer for a moment)
  • The nervous system learns self-attack = safety
  • The critic returns faster and stronger next time

Over time, the pattern becomes the default way of regulating self worth and threat.

How ISTDP understands self-criticism and perfectionism

From an ISTDP perspective, self-criticism is often an internal strategy that keeps certain emotions out of awareness because they feel unsafe, unacceptable, or costly (e.g., anger, sadness, need, vulnerability, pride).

When emotions begin to rise, the nervous system can shift into:

  • anxiety in the body (tension, breath restriction, gut symptoms)
  • overthinking/overcontrol
  • self-attack (“Don’t feel that. Do better.”)

ISTDP therapy focuses on:

  • identifying what triggers the critic
  • noticing how anxiety is carried in the body
  • reducing selfattack as a coping strategy
  • gradually increasing emotional capacity so the system doesn’t need perfectionism to feel safe

Rather than teaching you to “be nicer to yourself” as a technique, the aim is to remove the emotional conditions that make self-attack feel necessary.

How therapy helps with self-criticism and perfectionism

Therapy is active, collaborative, and focused on real change. We work to:

  • Identify your specific perfectionism pattern (overwork vs avoidance vs reassurance)
  • Understand what the critic is protecting you from (shame, judgement, conflict, vulnerability)
  • Reduce reliance on self-attack as motivation
  • Build tolerance for uncertainty and imperfection without collapse
  • Shift behaviours that keep the cycle alive (procrastination, overchecking, overpreparing)
  • Develop a steadier sense of self-respect that holds under pressure

This approach is particularly helpful for professionals and high-functioning adults who feel stuck despite insight.

What sessions usually look like

Early sessions:

  • Clarifying how the critic operates for you
  • Mapping emotional, bodily, and behavioural patterns
  • Understanding what perfectionism is “solving” in the short-term (and costing long-term)

Ongoing work:

  • Working directly with self-attack and shame patterns in session
  • Increasing tolerance for feelings that have been avoided
  • Reducing overcontrol and building more sustainable standards
  • Translating change into decisions at work, relationships, and daily life

Sessions are usually weekly initially and adapted over time.

Related ways I work

Depending on your presentation, therapy may integrate:

  • ISTDP – when perfectionism is linked to shame, emotional inhibition, and anxiety in the body
  • CBT – for perfectionism behaviours (overchecking, avoidance, reassurance loops, procrastination cycles)
  • Psychodynamic therapy – for long-standing relational themes and identity patterns
  • DIT – when self-criticism is strongly tied to relationship dynamics (when indicated)

You may also find these pages helpful:

Frequently asked questions

Is perfectionism always a bad thing?
High standards can be healthy. The problem is fear driven perfectionism that relies on anxiety and self-attack to function.

Will therapy make me less ambitious or lower my performance?
No. The aim is to help you perform without fear, overcontrol, and burnout so your effort becomes sustainable.

What if my inner critic feels like the only thing that motivates me?
That’s common. We work on building motivation through clarity, values, and self-respect rather than threat and shame.

Is this linked to anxiety or depression?
Often. Self-criticism can maintain anxiety (fear of mistakes/judgement) and depression (shutdown and hopelessness). Therapy clarifies your pattern.

Do you offer therapy in Central London?
Yes. I work in person in W1W and online.

Do you work with insurance?
I work with several major insurers. Please see Fees & Insurance for details.

Next steps

If this description fits your experience, therapy can help you change the pattern, not just manage it.