In my practice the children and adolescents that are most referred for help are those who are aggressive, disruptive, violent, hyperactive, apathetic - and have lost motivation to learn. The second most referred group are children and young people who are shy, timid, fearful, school phobic, depressed and isolated.

The children who are rarely referred are those who are perfectionistic, who put extreme pressure on themselves to academically (or otherwise) perform, who cannot tolerate even positive criticism or direction and will avoid any challenges that they feel they would not be "tops" in.

These young people tend to fret and worry around examination times, tend to be emotionally and socially illiterate and often isolated from their peer group. Even though they are more emotionally and suicidally at risk than their aggressive, hyperactive, or shy and timid peers, they are often the apple of their parents' and teachers' eyes.

This is not surprising as they do not disrupt homes or classrooms and they bring home the prizes and achieve highly in classrooms. Nonetheless, these children need as much, if not more, help as those students who are avoiding or hostile to learning.

However, while syndromes have been created to describe children with learning problems, and drugs developed to control their difficult behaviour, I know of no such investigations or professional endeavour into those children who are perfectionistic!

The signs of perfectionism are not too difficult to detect:

Chronic fear of failure

Addiction to success

Long hours studying or working or practising

Fear and fretting around examination or appraisal times

Intolerance of even positive criticism

Avoidance of challenges where others are likely to be better than them

Drop-out from activities where their performance falls short of "perfect"

Social isolation

Being easily upset

Thriving on success

Children who are perfectionistic are often labelled "gifted" - what is sad is that only 3 per cent of so-called "gifted" children make any important social contribution as adults.

There is a major difference between children and adults who love and enjoy academic and other activities and those addicted to them; the latter are driven by fear and the former by challenge and adventure. The fears that drive those who are perfectionistic are fears of failure, criticism and rejection.

Perfectionism in children and adults is an addiction to success. The addiction to success is very powerful and it is difficult to overcome, because, unlike other addictions (alcohol, drugs, food, smoking), those who are success-driven are reinforced strongly for their over-dedication. Perfectionism in children can give them phenomenal academic or other success (in sports, for example), status, praise and adulation.

Where there is addiction to success, self-worth and work are strongly intertwined and any falling short of a perfect performance can pose a serious threat to emotional and social well-being.

The implication inherent in perfectionism is that "without a perfect performance I am valueless and worthless". It is for this very reason that children and adults are highly at risk - even a small drop in performance can plummet them into despair or dropping-out from the activity that has been their means of proving themselves in the world.

I have helped children, adolescents and young adults who dropped-out from school or university because they fell short of their perfectionistic standards. I have also seen young adults who showed amazing promise in a particular sport but dropped out because of fear of not being able to maintain the high performance, or following a poor display.

Probably the saddest aspect of perfectionism is the absence of deep and unconditional loving relationships: success addiction can often be an emotional desert that must subconsciously strike at the very heart of those driven to succeed.

However, if you are success addicted and you give priority to relationships, you risk the only acceptance and visibility you have known - the conditional recognition for successful performance in the "desired" behaviour (academic, sports, domestic, work etc).

Perfectionism is not a weakness, but it is a protection that blocks a person's progress in life. Those who are perfectionistic have cleverly learned to gain visibility and recognition through their "success" and this defence will be maintained until unconditionality is present - where the child or adult is cherished for self and not for what they do.

The focus in helping those who are success-addicted needs to be on self-worth, not on their perfectionism. It is not wise to attempt to take a weapon away from anybody, but the need for a weapon disappears in the solid and safe world of unconditional love.

Dr Tony Humphreys is a consultant clinical psychologist and author of Self-Esteem: The Key to Your Child's Education