Mindful Compassion for Perfectionism: A new RCT!

Mindful compassion for perfectionism

Last week I posted about Roz Shafran’s paper on perfectionism, now I’m again here talking about the same topic! Another interesting news, so I hope I won’t bore you! Clinicaltrial.gov (the worldwide database of funded clinical studies) has reviewed and published today our protocol of the new randomized controlled trial (RCT) on Mindful Compassion for Perfectionism (MCP).

As Shafran suggested, there are only three interventions specifically tailored on perfectionistic traits: cognitive behavioral therapy for perfectionism (Shafran et al., 2023), dynamic relational therapy (Hewitt et al., 2019), and MCP (Cheli et al., 2022). MCP is a form of group psychotherapy that integrates the conceptualization model of dynamic relational therapy with experiential techniques informed by or directly derived from Compassion Focused Therapy (Gilbert et al., 2014). Veronica Cavalletti and I developed this integrative intervention with the scientific support of Paul Hewitt.

To date, some case series have confirmed the feasibility of the MCP. This new RCT is aimed at pilot-testing the effectiveness of the proposed intervention. The study is a waiting-list controlled trial. We are going to start recruiting by nex Monday and have the first group as soon as possible!

National Library of Medicine (U.S.). (2023, January- ). Mindful Compassion for Perfectionism (MCP). Identifier NCT00103181. https://clinicaltrials.gov/ct2/show/NCT00103181

Effective treatments for perfectionism


Roz Shafran and colleagues just published an overview of existing effective treatments for perfectionism. They presented their own model and then discussed the existing alternatives.

I was very surprised and happy to see how our protocol was one of the three interventions specifically tailored on perfectionistic traits! In short, Shafran was summarizing evidence and roots of the model with strongest evidence: that is, Cognitive Behavioral Therapy for Perfectionism. This is a tailored form of CBT targeting maladpative beliefs and biases in those struggling with perfectionism. The second model reviewed was the Dynamic Relational Therapy developed by Paul Hewitt and colleagues. Hewitt suggests to consider perfectionism as a set of interpersonal styles comprising of spefici traits, interpersonal and intrapersonal components. Finally, Shafran presented our Mindful Compassion for Perfectionism that integrates the Dynamic Relational Therapy with Compassion Focused Therapy.

As I anticipated, our model is far from being considered evidence-based. We published two cases series (see pubblications) where reporting preliminary evidence for the feasibility of the model, and we are now outlining a randomized controlled trial to better understand its clinical utility. Cavalletti, Hewitt, Flett and I published a first paper introducing the group format and its rationale, and then a second cases series about.

I appreciated Shafran’s recognition, which confirms the importance of specific interventions for specific traits or psychopathological manifestations.

Shafran, R., Egan, S.J., & Wade, T.D: (2023). Coming of age: A reflection of the first 21 years of cognitive behaviour therapy for perfectionism, Behaviour Research and Therapy,
104258. https://doi.org/10.1016/j.brat.2023.104258

The link between narcissism and perfectionism

I am ready for the upcoming congress of the European Society for the Study of Personality Disoders (ESSPD) where I join a symposium chaired by Elsa Ronningstam (Harvard Medical School) on recent advances in narcissism.

My team and I just concluded a study on the interwined path of narcissism and perfectionism. In a sample of healthy young adults we explored over time wheter perfectionistic traits and strategies explained the relationship between narcissim and psychopathology.

We found that the higher the perfectionistic strategies the higher the psychopathology associated with narcissistic traits. But perfectionism did not predict variation of narcissism over time. We interpret these results through an evolutionary perspective. Those with prominent narcissistic traits are often triggered by a social rank motive. We hypothesize that perfectionistic strategies are the “tools” used to pursue or recover a desidered social rank. This would be consistent with a common fluctuation of mental states in narcissism and with weak or non significant mediating role of perfectionism in the relationship between past and present narcissism.