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I don’t deserve anything good: Perfectionistic self-recrimination in a case of comorbid personality and eating disorder.
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  • Simone Cheli,
  • Veronica Cavalletti,
  • Francesco Gazzillo,
  • Martin Brüne,
  • Paul Hewitt
Simone Cheli
St John's University

Corresponding Author:chelis@stjohns.edu

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Veronica Cavalletti
Tages Onlus
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Francesco Gazzillo
University of Rome La Sapienza
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Martin Brüne
LWL University Hospital Bochum Department of Psychosomatic Medicine and Psychotherapy
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Paul Hewitt
University of British Columbia
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Abstract

In this case study we present the course of the psychotherapy of Myriam, a 19-year old female with a severe personality disorder and comorbid eating disorder. During the initial assessment she reported high levels of neuroticism that parallel the diagnosis of obsessive-compulsive personality disorder, borderline personality disorder, and anorexia nervosa. Myriam showed a severely impaired personality functioning defined by perfectionism, self-criticism, interpersonal guilt and overcontrol. Her daily experience was shaped by a self-recriminative inner dialogue associated with maladaptive patterns in the form of food, water and sleep restrictions, self-harm behaviors, and suicidal ideation. She accessed an integrative treatment based on individual (Evolutionary Systems Therapy) and group psychotherapy (Mindful Compassion for Perfectionism). At the end of 14-month intervention she remitted from all the categorical diagnoses and showed reliable changes in several measures. These outcomes were maintained at 3-month follow-up. We describe the integrative conceptualization based on Myriam’s perfectionistic self-recrimination patterns, and the consequent treatment that targeted these patterns rather than focusing on symptom reduction exclusively.
Submitted to Journal of Clinical Psychology
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Assigned to Editor
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08 Jul 2024Review(s) Completed, Editorial Evaluation Pending
11 Jul 2024Reviewer(s) Assigned