Treat “other people demand perfection from me” as a feeling to address, not established fact
Feeling that others require perfection and will reject you for falling short is associated with more suicidal thoughts. Self-imposed perfectionism has a much weaker relationship, about one-third as strong. After accounting for initial suicidal thoughts, perceived external demands still predicted a small increase in later thoughts.
What it takes
Free. The hard part is seeing the thought as something to work with rather than an accurate measurement of others' expectations.
What you may gain
A random-effects meta-analysis of 45 studies included 11,747 undergraduates, medical students, community adults and psychiatric patients. Weighted correlations with suicidal ideation were r=.28 for perfectionistic concerns (95% CI .24–.32; 42 studies, 7,936 people), a composite of socially prescribed perfectionism, concern over mistakes, doubts about actions and gaps between standards and reality. Socially prescribed perfectionism alone also had r=.28 (.25–.32; 30 studies, 3,640 people). Perfectionistic strivings, combining self-oriented perfectionism and personal standards, had r=.10 (.07–.13; 31 studies, 4,588 people). Parental criticism had r=.20 (.11–.29). For suicide attempts, perfectionistic concerns had r=.12 (.07–.17; 15 studies, 5,275 people), and socially prescribed perfectionism r=.19 (.08–.29; 8 studies, 689 people). In longitudinal studies controlling for baseline ideation, socially prescribed perfectionism retained a small positive association with later ideation; self- and other-oriented perfectionism showed no clear association.
Context & considerations
Most studies were one-time questionnaires, so temporal order is unclear. Correlations around .28 explain only several percent to roughly a tenth of variation. Outcomes were ideation and attempts, not death, so the book's surrogate-outcome rule gives a small benefit rating. The authors found possible publication bias for concerns and attempts; estimating missing studies did not reverse the direction. High standards themselves need not be abandoned. The distinction is where the standard comes from and whether falling short means “I am worthless.” Like pessimistic expectations, this can be addressed as a symptom. For suicidal thoughts, call 12356 in China and move lethal means away. See helping someone else and depression screening for children.
Research & references
Smith MM, Sherry SB, Chen S, Saklofske DH, Mushquash C, Flett GL, Hewitt PL (2018). The perniciousness of perfectionism: A meta-analytic review of the perfectionism-suicide relationship. Journal of Personality, 86(3), 522–542. https://doi.org/10.1111/jopy.12333