Group dynamic-relational therapy for perfectionism

Abstract

The interest in treating underlying core vulnerability factors or transdiagnostic processes has been a focus of much attention. In this paper we describe our application of group dynamic- relational psychotherapy to the treatment of perfectionism, a core personality vulnerability factor associated with various forms and types of dysfunction and disorders that have profound costs to the individual both socially and subjectively. Over the course of the past three decades, we developed an evidence-based integrative group treatment that targets the psychodynamic and relational underpinnings of perfectionism. The treatment is based on an integration of psychodynamic and interpersonal perspectives and therapeutic approaches. In this paper we present our model of perfectionism and describe our group dynamic-relational therapy for the treatment of its pernicious outcomes. By drawing on illustrative case material, we describe the approach as applied to one such group as it progresses through four phases of group development that we have termed engagement and pseudo attachment, pattern interruption, self-redefinition/painful authenticity, and termination. Finally, we present some of the accumulating evidence of the effectiveness and efficacy of dynamic-relational therapy.

The effectiveness of short-term dynamic/interpersonal group therapy on perfectionism; assessment of anxiety, depression and interpersonal problems

“…That is, they do not expose and express their shortcomings, mistakes and defects in their interactions (Chen et al ., 2015 ). They believe that through their perfection they can satisfy the need to be important to others, to be accepted, to belong, not to be abandoned or rejected and not to be ridiculed and so on they can positively change their inner and outer world (Mikail et al ., 2022 ; Nepon et al ., 2011 ). They experience a considerable dissimilarity between the real self and the ideal self, and as a result, they are prone to experience perfectionistic automatic thoughts and information processing (Flett et al ., 1998 ).…”

“…This therapy, especially because of its character as a group therapy and its emphasis on the verbal expression of emotions and experiences related to perfectionism (Hewitt Hewitt, Flett, & Mikail, 2017 ; Mikail et al ., 2022 ), encouraged more verbal disclosure in perfectionist individuals, but when it comes to showing and living their inadequacies, these people tend to be conservative in upholding this image of themselves; That is, if the deficiencies and weaknesses of these people are not recognizable to others, they can take care of their complete and perfect image and avoid being identified as a person with imperfection.…”

“…Hewitt and his colleagues also concluded that changes in various levels of perfectionism not only affect concurrent and simultaneous symptoms, but also show continuous and unceasing reduction in different levels of distress (Hewitt et al ., 1995 ; Hewitt et al ., 2015 ; Mikail et al ., 2022 ). This effect is due to fundamental changes in the relationship between perfectionists with others and with themselves (Mikail et al ., 2022 ).…”

“…( 2021 ) also argue that people with perfectionistic styles respond more to psychodynamic and relational treatments than symptom-oriented group therapies (Cheek et al ., 2018 ; Esposito et al ., 2021 ). Insignificantly, those meta-analytic studies have shown that other treatments, such as CBT, have indicated that the changes achieved are only in some cognitive characteristics of perfectionism, not in its more deeply rooted traits and relational features (Mikail et al ., 2022 ). Group therapy with a psychodynamic orientation working on relational dynamics, stimulating and exploring emotions and feelings, creating group belonging, encourages a strong therapeutic alliance between the patient and the therapist, and this strongly increases the continuity and commitment of the therapy and also affects the results of the treatment (Hewitt, Flett, & Mikail, 2017 ).…”

“…They argue that group therapy approaches emphasize these components by focusing on a sense of security, coherence, and acceptance through interpretive interventions, intrapersonal and interpersonal dynamics and personality vulnerabilities underlying perfectionism, and encouragement and support to take interpersonal risks. Moreover, they can play a decisive role in fundamental changes in a person’s experience of him/herself and others (Mikail et al ., 2022 ). In their first study on the effectiveness of this treatment (Hewitt et al ., 2015 ), they found a significant reduction in perfectionism scales.…”