Aim: Perfectionism is a multi-dimensional, pernicious personality style that contributes to a range of difficulties including psychiatric symptoms, interpersonal dysfunction, and impaired personal achievement and social functioning. Theory and research suggest that perfectionism is fueled by distorted inner representations of the self as inadequate, damaged, or isolated from others. Hence, psychodynamically-informed treatments have been developed to address perfectionism as a characterological solution to thwarted needs for self-worth, self-cohesion, and belonging. This presentation will highlight findings from a recent randomized controlled trial investigation of two such treatments delivered in a time-limited group therapy format.
Method: Patients with perfectionism were randomized to 12 sessions of either dynamic-relational therapy––focused on interpretation of relational and transference dynamics––or psychodynamically-informed supportive therapy, focused on empathic support and reinforcement of adaptive coping. Measures assessed the following outcome variables across pre-treatment, mid-treatment, post-treatment, and six-months follow-up: multidimensional trait perfectionism, perfectionistic self-presentation, psychiatric symptoms, work and social functioning, and several cognitive and self-esteem domains.
Results: Multi-level modelling accounted for the nested data structure and examined change in scores as a function of time and type of treatment; reliable change indices were also examined for each outcome variable. Findings indicated significant improvement across most domains in both types of treatment. Significant differences between types of treatment were evident in several domains, mostly favouring dynamic-relational group therapy.
Conclusion: Overall, findings indicate significant, reliable, and relatively durable improvement in multiple aspects of perfectionism and associated difficulties for both types of psychodynamic group therapy. Moreover, the findings suggest specific effects of a dynamic-relational approach focused on intra-group interactions and their correspondence to inner representations and unmet relational needs. Discussion will highlight implications for clinical intervention targeting multidimensional perfectionism as a core personality vulnerability.