All of these perfectionistic self-loathing thoughts keep going through my head.
Here's a thought for you -- may or may not apply, but it's one that I've been working on lately:
My perfectionism is not about anyone else. It's about me not being able to feel good enough about myself unless I can attain perfection. I've set fuzzy parameters for what "perfection" means, but I know unless I constantly strive for it and feel like it's within reach, I'm a horrid useless human being.
It's not a positive motivator. A positive motivator would be looking toward a goal and working diligently to reach it. The "I have to be perfect" is more like being chased by an angry grizzly bear. If I don't achieve perfection, I get anxious.
And when we define perfection in a way that includes other people being satisfied and happy, that grizzly will catch up with us every time. Because we have no power over other people. That dude with the $9K dental work? He might have a reason to be mad. But he might also be mad because his wife is leaving him or his boss didn't promote him or any number of things.
I can only judge myself by standards that I have control over. I can only do my best. Other people's reactions -- are other people's reactions. As long as I know that I have done what's reasonable and decent, that's all I should strive for.