Group dynamic-relational therapy for perfectionism

Submitted: May 24, 2022
Accepted: July 29, 2022
Published: September 1, 2022
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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.

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Armusewicz, K., Steele, M., Steele, H., & Murphy, A. (2022). Assessing therapist and clinician competency in parent-infant psychotherapy: The REARING coding system (RCS) for the group attachment based intervention (GABI). Research in Psychotherapy: Psychopathology, Process and Outcome, 25(1), 23-37. https://doi.org/10.4081/ripppo.2022.562 DOI: https://doi.org/10.4081/ripppo.2022.562
Blatt, S. J. (1995). The destructiveness of perfectionism: Implications for the treatment of depression. The American Psychologist, 50(12), 1003-1020. https://doi.org/10.1037/0003-066X.50.12.1003 DOI: https://doi.org/10.1037/0003-066X.50.12.1003
Bruch, H. (1988). Conversations with anorexics (D. Czyzewski & M. A. Suhr, Eds.). New York: Basic Books.
Cheek, J., Kealy, D., Hewitt, P. L., Mikail, S. F., Flett, G. L., Ko, A., & Jia, M. (2018). Addressing the complexity of perfectionism in clinical practice. Psychodynamic Psychiatry, 46(4), 457–489. https://doi.org/10.1521/pdps.2018.46.4.457 DOI: https://doi.org/10.1521/pdps.2018.46.4.457
Flett, G. L., & Hewitt, P. L. (2022). Perfectionism in childhood and adolescence: A developmental approach. American Psychological Association. https://doi.org/10.1037/0000289-000 DOI: https://doi.org/10.1037/0000289-001
Flett, G. L., Hewitt, P. L., Blankstein, K. R., & Gray, L. (1998). Psychological distress and the frequency of perfectionistic thinking. Journal of Personality and Social Psychology, 75(5), 1363-1381. https://doi.org/10.1037/0022-3514.75.5.1363 DOI: https://doi.org/10.1037/0022-3514.75.5.1363
Fonagy, P. (2001). Attachment theory and psychoanalysis. New York: Other Press.
Fredtoft, T., Poulsen, S., Bauer, M., & Malm, M. (1996). Dependency and perfectionism: Short-term dynamic group psychotherapy for university students. Psychodynamic Counselling, 2.4 (November), 476-497. https://doi.org/10.1080/13533339608402472 DOI: https://doi.org/10.1080/13533339608402472
Handley, A. K., Egan, S. J., Kane, R. T., & Rees, C. S. (2015). A randomized controlled trial of group cognitive behavioural therapy for perfectionism. Behaviour Research and Therapy, 68, 37-47. https://doi.org/10.1016/j.brat.2015.02.006 DOI: https://doi.org/10.1016/j.brat.2015.02.006
Hewitt, P. L., & Flett, G. L. (1991a). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60(3), 456-470. https://doi.org/10.1037/0022-3514.60.3.456 DOI: https://doi.org/10.1037/0022-3514.60.3.456
Hewitt, P. L., Flett, G. L., & Mikail, S. F. (2017). Perfectionism: A relational approach to conceptualization, assessment, and treatment. New York: Guilford Press.
Hewitt, P. L., Flett, G. L., Mikail, S. F., Kealy, D., & Zhang, L. (2018). Perfectionism in the Therapeutic Context: The Perfectionism Social Disconnection Model and Clinical Process and Outcome. In J. Stoeber (Ed.) The Psychology of Perfectionism: Theory, Research, Applications. New York: Routledge. DOI: https://doi.org/10.4324/9781315536255-20
Hewitt, P. L., Flett, G. L., Sherry, S.B., & Caelian, C. (2006). Trait perfectionism dimensions and suicidal behavior. In T.E. Ellis (Ed.). Cognition and suicide: Therapy, research, and therapy (pp. 215-235). Washington, DC: American Psychological Association. https://doi.org/10.1037/11377-010 DOI: https://doi.org/10.1037/11377-010
Hewitt, P. L., Flett, G. L., Sherry, S. B., Habke, M., Parkin, M., Lam, R., McMurtry, B., Ediger, E., Fairlie, P., Stein, M. B. (2003). The interpersonal expression of perfection: Perfectionistic self-presentation and psychological distress. Journal of Personality and Social Psychology, 84(6), 1303-1325. https://doi.org/10.1037/0022-3514.84.6.1303 DOI: https://doi.org/10.1037/0022-3514.84.6.1303
Hewitt, P. L., Flett, G. L., Turnbull-Donovan, W., & Mikail, S. F. (1991b). The multidimensional perfectionism scale: Reliability, validity, and psychometric properties in psychiatric samples. Psychological Assessment, 3(3), 464-468. https://doi.org/10.1037/1040-3590.3.3.464 DOI: https://doi.org/10.1037/1040-3590.3.3.464
Hewitt, P. L., Kealy, D., Mikail, S. F., Smith, M. M., Chen, C., Sochting, I., Ge, S., Tasca, G.
A., Flett, G. L., Ko, A. (under review). The Efficacy of Group Psychotherapy for Adults with Perfectionism: A Randomized Controlled Trial of Dynamic-Relational versus Psychodynamic Supportive Treatment.
Hewitt, P. L., Mikail, S. F., Dang, S. S., Kealy, D., & Flett, G. L. (2020). Dynamic‐relational treatment of perfectionism: An illustrative case study. Journal of Clinical Psychology, 76(11), 2028-2040. https://doi.org/10.1002/jclp.23040 DOI: https://doi.org/10.1002/jclp.23040
Hewitt, P. L., Mikail, S. F., Flett, G. L., & Dang, S. S. (2018). Specific formulation feedback in Dynamic-relational group psychotherapy of perfectionism. Psychotherapy, 55(2), 179-185. https://doi.org/10.1037/pst0000137 DOI: https://doi.org/10.1037/pst0000137
Hewitt, P. L., Mikail, S. F., Flett, G. L., Tasca, G. A., & Flynn, C. A. (2015). Psychodynamic and Interpersonal Group Psychotherapy for Perfectionism: Evaluating the Effectiveness of a Short-Term Treatment. Psychotherapy, 52(2), 205-217. https://doi.org/10.1037/pst0000016 DOI: https://doi.org/10.1037/pst0000016
Hewitt, P. L., Smith, M. M., Molnar, D. S., & Flett, G. L., Lang, T. (in preparation). Automatic Self Recriminations: Development and validation of a measure of self-critical internal dialogue.
Hewitt, P. L., Qiu, T., Flynn, C. A., Flett, G. L., Wiebe, S. A., Tasca, G. A., & Mikail, S. F. (2019). Dynamic-relational group treatment for perfectionism: Informant ratings of patient change. Psychotherapy (Chicago, Ill.), 57(2), 197-205. https://doi.org/10.1037/pst0000229 DOI: https://doi.org/10.1037/pst0000229
Hollender, M. H. (1965). Perfectionism. Comprehensive Psychiatry, 6, 94-103. DOI: https://doi.org/10.1016/S0010-440X(65)80016-5
Horney, K. (1950). Neurosis and human growth. New York, NY: Norton.
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12-19. https://doi.org/10.1037/0022-006X.59.1.12 DOI: https://doi.org/10.1037/0022-006X.59.1.12
Miller, R., Hilsenroth, M. J., & Hewitt, P. L. (2017). Perfectionism and therapeutic alliance: A review of the clinical research. Research in Psychotherapy: Psychopathology, Process and Outcome, 20(1), 19-29. https://doi.org/10.4081/ripppo.2017.264 DOI: https://doi.org/10.4081/ripppo.2017.264
Norcross, J. C., VandenBos, G. R., Freedheim, D. K. (Eds.). (2011). History of psychotherapy: Continuity and change (2nd ed). American Psychological Association. https://doi.org/10.1037/12353-000 DOI: https://doi.org/10.1037/12353-000
Pacht, A. R. (1984). Reflections on perfection. American Psychologist, 39(4), 386–390. https://doi.org/10.1037/0003-066X.39.4.386 DOI: https://doi.org/10.1037/0003-066X.39.4.386
Paquin, J. D., Abegunde, C., Hahn, A., & Fassinger, R. E. (2021). A brief history of group therapy as a field and the representation of women in its development. International Journal of Group Psychotherapy, 71(1), 13-80. https://doi.org/10.1080/00207284.2020.1798176 DOI: https://doi.org/10.1080/00207284.2020.1798176
Popolo, R., MacBeth, A., Brunello, S., Canfora, F., Ozdemir, E., Rebecchi, D., Toselli, C., Venturelli, G., Salvatore, G., & Dimaggio, G. (2018). Metacognitive interpersonal therapy in group: A feasibility study. Research in Psychotherapy: Psychopathology, Process and Outcome, 21(3), 155-163. https://doi.org/10.4081/ripppo.2018.338 DOI: https://doi.org/10.4081/ripppo.2018.338
Qanbari Alaee, E., Saed, O., Khakpoor, S., Ahmadi, R., Ali Mohammadi, M., Yoosefi Afrashteh, M., & Morovati, Z. (2022). The efficacy of transdiagnostic cognitive behavioural therapy on reducing negative affect, anxiety sensitivity and improving perceived control in children with emotional disorders - a randomized controlled trial. Research in Psychotherapy: Psychopathology, Process and Outcome, 25(1), 127-144. https://doi.org/10.4081/ripppo.2022.588 DOI: https://doi.org/10.4081/ripppo.2022.588
Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. The American Psychologist, 65(2), 98-109. https://doi.org/10.1037/a0018378 DOI: https://doi.org/10.1037/a0018378
Smith, M. M., Hewitt, P. L., Sherry, S. B., Flett, G. L., Kealy, D., Tasca, G., Ge, S., Ying, F., & Bakken, K. (under review). A meta-analytic review of the effectiveness of cognitive-behavioral therapy for perfectionism: Redux. Clinical Psychology & Psychotherapy.
Sorotzkin, B. (1985). The quest for perfection: Avoiding guilt or avoiding shame? Psychotherapy: Theory, Research, Practice, Training, 22(3), 564–571. https://doi.org/10.1037/h0085541 DOI: https://doi.org/10.1037/h0085541
Strupp, H. H., Binder, J. L. (1984). Psychotherapy In A New Key. New York: Basic Books.
Tasca. G. A, Mikail, S. F., & Hewitt, P. L. (2021). Group Psychodynamic Interpersonal DOI: https://doi.org/10.1037/0000213-000
Psychotherapy. Washington, D.C.: American Psychological Association.
Winston, A., Rosenthal, R. N., & Roberts, L. W. (2019). Learning supportive psychotherapy: An illustrated guide. American Psychiatric Association Publishing. DOI: https://doi.org/10.1176/appi.books.9781615371501.lr34
Yalom, I. D., & Leszcz, M. (2020). The Theory and Practice of Group Psychotherapy. New York: Basic Books.

How to Cite

Mikail, S. F., Hewitt, P. L., Flett, G. L., & Ge, S. (2022). Group dynamic-relational therapy for perfectionism. Research in Psychotherapy: Psychopathology, Process and Outcome, 25(3). https://doi.org/10.4081/ripppo.2022.635

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