Tag: evolutionary psychotherapy

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New Evidence for Evolutionary Systems Therapy

Evolutionary Systems Therapy, Evolution and Personality Lab

A paper has just been published reporting new evidence for Evolutionary Systems Therapy. The study was designed to extend what we already knew, investigating its feasibility and potential clinical utility.
Previously, an RCT and several case series had suggested the possible efficacy of Evolutionary Systems Therapy in the treatment of schizotypal traits. In this study, we compared its efficacy for other traits and the viability of the conceptualization model used.
Evolutionary Systems Therapy presupposes the existence of three interpersonal styles corresponding to the three major spectrums of psychopathology (defensive style corresponding to the spectrum of schizotypy or thought disorders; affiliative style corresponding to the internalizing spectrum; dismissing style corresponding to the externalizing spectrum). These three styles are not considered to be excluded from these spectrums but are instead identified during “difficult” times.
This new study reports new evidence for Evolutionary Systems Therapy. First, the correspondence between styles and their corresponding spectrums has been confirmed. Second, the efficacy previously demonstrated in the schizotypal spectrum was also confirmed in the other two spectrums.
Of interest was the fact that the target age was that of greatest risk for personality disorders: the 16-25 age group. This choice was intended to minimize the bias associated with the study’s small sample size and focus attention on those most at risk.

Cheli, S., Brüne, M., Goldzweig, G., Bui, S., Velicogna, F., & Cavalletti, V. (2026). Evolutionary systems therapy for personality pathology: a proof-of-concept single-arm trial. Current Psychology, 45, 375 (2026). https://doi.org/10.1007/s12144-025-08606-0 (Preprint and Supplementary Material are freely accessible at https://osf.io/urjdz/overview)

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Are none, some, or all disorders interpersonal?

Simone Cheli

This paper follows my lecture, organized by the University of Montgomery. The starting question remains the same: Are none, some, or all disorders interpersonal?

The objective of this paper is to analyze three different hypotheses on the role of the interpersonal domain in psychopathology: specifically, whether none, some, or all disorders should be considered interpersonal. In evaluating these three theoretical positions, I present a general thesis and an antithesis for each, aiming to bolster an interpersonal perspective in psychotherapy. This perspective draws on principles formulated almost a century ago by Harry Stack Sullivan. Finally, I discuss an evolutionarily informed synthesis of all these theses and antitheses. My proposed conclusion is that the history of our species, general human functioning, and thus mental health and psychopathology, have always and distinctly evolved socially. Implications for conceptualization and treatment are discussed.

Cheli, S. (2025).Are none, some, or all disorders interpersonal? Ricerca Psicoanalitica, 36(3). https://doi.org/10.4081/rp.2025.1095

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Are all disorders interpersonal?

cheli personality disorders

Today I spoke at the Workshop “Personality and Its Disturbances in Philosophy, Psychology, and Artificial Intelligence,” organized by the University of Montgomery. The presentation is part of the activities of the Evolution and Personality Lab.

The objective of the talk was to analyze three different hypotheses on the role of the interpersonal domain in psychopathology: specifically, whether none, some, or all disorders should be considered interpersonal. In evaluating these three theoretical positions, I present a general thesis and an antithesis for each, aiming to bolster an interpersonal perspective in psychotherapy. This perspective draws on principles formulated almost a century ago by Harry Stack Sullivan. The null hypothesis (“none” disorders) offers a critical analysis of modern psychopathology beginning with Freud; the quasi-interpersonal hypothesis (“some” disorders) focuses on Wright, Hopwood, and Pincus’s proposal to redefine personality disorders as interpersonal disorders; and the fully-interpersonal hypothesis (“all” disorders) reviews possible integrations between psychopathology and personality from an interpersonal perspective.

Finally, I discuss an evolutionarily-informed synthesis of all the proposed theses and antitheses. Drawing from models in evolutionary psychology and behavioral ecology—specifically the Social Brain Hypothesis, Life History Theory, and Tinbergen’s four questions—I attempt to motivate a radical interpretation of Sullivan’s thought.

My tentative conclusion is that the history of our species, human personality, and thus mental health and psychopathology, have always and distinctly evolved socially. Implications for conceptualizing and treating psychopathology are discussed.

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An alternative view at needs and motivations

Yesterday I attended a symposium on needs, goals, and motivations. The introductory lecture was by Carol Dweck, followed by various perspectives based on Schema Therapy (e.g., Eskhol Rafaeli), CBT (e.g., Francesco Mancini), and Compassion Focused Therapy (e.g., Niki Petrocchi). I presented an alternative view of needs and motivations. My perspective was informed by evolutionary theory and aimed to offer a critical reading of these constructs. A special thanks to Maurizio Brasini who chaired the symposium and invited me.

In particular, I sought to emphasize two points. First, psychological constructs such as needs and motivations are created ex post to explain probabilistic processes such as natural and sexual selection. Defining general human functioning (e.g., personality) based on these low-order aspects risks making us forget a principle known since Gestaltpsychologie: the whole is not the sum of its parts.

Second, the phylogenetic trajectory of Homo sapiens is now primarily defined by cultural systems (which represent an analogue of genotypes), and many of the motivational models are almost exclusively consistent with Western cultural contexts—contexts where the individualistic, purposeful, and additive perspective on processes undoubtedly dominates.

This was an alternative view at needs and motivations of mine. A view rooted in an evolutionarily informed look at human personality.

The French philosopher François Julien, in discussing the effectiveness in East and West, cites two examples. On the one hand, Ulysses, who single-handedly resolved a decade-long war in one night. On the other, Sun Tzu, who saw the ideal of war as not taking the field. Perhaps what we think is certain is uncertain or undetermined.

For those interested, below is my presentation at the symposium:

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Personality disorders and evolutionary psychopathology

Personality disorders and evolutionary psychopathology offers an intriguing perspective. Martin Brüne and I wrote a chapter on a new book published by Cambridge University Press.

“Personality” is considered as a set of individual characteristics and behavioral dispositions based on both temperamental (partially genetic-driven) and developmental (partially culture-driven) components that are relatively stable across time and context. We suggest that these two intertwined components progressively shape autopoietic processes operating at an individual and a social level in accordance with the theory of evolution and its application to human behavior. We discuss existing evidence linking personality traits to the manifestations of personality disorders and diverse forms of psychopathology. Particular attention is dedicated to the evolutionary concept referred to as Life History Theory, considering its utility in predicting the development of personality traits. We also emphasize the need to explore sources of critique and further research, suggesting that a multifaceted approach to the understanding of personality dimensions is crucial.

We hope this chapter may foster research on personality disorders and evolutionary psychopathology. For those interested in the topic here’s our Lab on personality and evolution!

Cheli, S., & Brüne, M. (2025). When Do Personality Traits Become Pathological?: An Epistemological and Evolutionary View. In K. Banicki & P. Zachar (Eds.), Conceptualizing Personality Disorder: Perspectives from Philosophy, Psychological Science, and Psychiatry (pp. 160–178). chapter, Cambridge: Cambridge University Press.

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Personality and physical health

Personality and Health

Sara Bui and I wrote a chapter on personality and physical health for the new Palgrave Encyclopedia of Disability. In this chapter we explore the evidence about the relation between personality and physical health.

The existing approach in health highlights the importance of combining biological, psychological, and social factors to understand the mechanisms associated with the onset, adaptation, and outcomes of diseases. The area of research that has become increasingly important is the relationship between personality and physical health. Although the complexity of the interactions between the varied factors involved does not allow for conclusive answers, robust evidence confirms that personality plays a fundamental role along the entire continuum of health. In this entry we review the existing evidence, suggesting the importance of further research within a lifespan, dimensional, and evolutionary perspective on personality.

In the chapter we present an evolutionarily informed model of personality development to understand the responses and adjustment to illness and disability. This model is a revised version of the one developed by Martin Brüne and I on personality pathology.

This chapter is the second (I guess last) contribution Sara and I wrote for this interesting project.

Bui, S., Cheli, S. (2025). Personality in Physical Disability and Diseases. In: Bennett, G., Goodall, E. (eds) The Palgrave Encyclopedia of Disability. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-031-40858-8_482-1

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Evolution and Personality

Evolution and Personality in Pula

On Friday I presented the research of our Evolution and Personality Lab in Pula. The Mind & Brain Congress is a congress of psychiatry and neurology that takes place every year in the Croatian city. This year one of the invited symposiums was on “Personality development and pathology in an evolutionary perspective”. Martin Brüne (Ruhr-University Bochum), Darko Marčinko (Zaghreb University) and I discussed the research of our teams in this area. In short, it was like having our own Evolution and Personality Lab in Pula!

In my presentation I presented the evolutionarily informed conceptualization model that we have been using for a few years and the evidence collected so far. You can see the slides in the video.

First, I motivated the clinical utility of an evolutionarily informed model to personality pathology. Second, I presented data on the inter-reter reliabily, perceived utility and cross-cultural validity of the model. Third, I summarized data on treatment based on this model, namely Evolutionary Systems Therapy.

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New therapy for obsessive-compulsive personality disorder

Evolutionary Systems Therapy, Evolution and Personality Lab

Journal of Personality Disorders published our paper on a new therapy for obsessive-compulsive personality disorder. In this study we extend what we knew about the clinical utility of our treatment model, namely Evolutionary Systems Therapy.

Obsessive-compulsive personality disorder is the most common personality disorder, with a prevalence of approximately 6.5% in the general population. However, little is known about the effective psychotherapy for this disorder. In this case series, we employed evolutionary systems therapy to support five adults diagnosed with obsessive-compulsive personality disorder. Evolutionary systems therapy is a novel form of psychotherapy that integrates evolutionary psychopathology, compassion-focused therapy, and metacognitively oriented treatments. Primary outcome (personality pathology) was assessed monthly from baseline to follow-up. Secondary outcomes (anxiety, depression, perfectionism, self-criticism, overcontrol) were assessed at initial and final sessions. Moreover, we evaluated the feasibility of intervention (completion, attendance, adverse events). At the end of 6 months of treatment, all the participants reported reliable changes and remitted from diagnosis. These outcomes were maintained at 1-month and 3-month follow-ups. Further research is needed to provide evidence about the acceptability of evolutionary systems therapy in the treatment of obsessive-compulsive personality disorder.

In this five cases series we preliminarily explored the acceptability and feasibility of EST for OCPD. Despite the limitations of a cases series design – which is an important constraint on the generality of the collected outcomes – we reported promising findings. All the patients remitted from diagnosis and showed a significant downward trend in personality pathology. These changes were maintained at the 3-month follow-up. Moreover, we found reliable changes in symptoms such as anxiety and depression and in possible therapeutic targets such as perfectionism, self-criticism and overcontrol. Our study seemingly supports the importance of evolutionarily informed approaches to conceptualization and treatment, which allow distinguishing maladaptive strategies from distinctive personality features. In conclusion, we hope that there will be an increase in studies aimed at developing empirically validated treatments for a highly prevalent disorder with elevated suicidal risk such as OCPD.

This new therapy for obsessive-compulsive personality disorder confirms that Evolutionary Systems Therapy may be effective across the whole spectrum of personality disorders.

Cheli, S. Goldzweig, G. Hewitt, P., Bui, S., & Cavalletti, V. (2025). Evolutionary Systems Therapy for Obsessive-Compulsive Personality Disorder: A Five Case Series. Journal of Personality Disorders, 39(1), 61–76. https://doi.org/10.1521/pedi.2025.39.1.61

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Complex cases and comorbidities between personality and eating disorders

Complex cases and comorbidities between personality and eating disorders are tricky challanges for the clinician. Indeed, patients live their experience and (rightly!) have little interest in psychiatry, psychopathology and psychotherapy manuals. The condition of a single disorder is rare. And even in the case of complex symptoms such as eating disorders it is important to consider the functioning of the personality as a whole.

Journal of Clinical Psychology has recently accepted a paper I worked on together with an amazing international team: Veronica Cavalletti (Tages Charity, Florence), Francesco Gazzillo (University of La Sapienza, Rome), Martin Brüne (Bochum University, Bochum), and Paul Hewitt (University of British Columbia, Vancouver). Here we present a clear-cut example of complex cases and comorbidities between personality and eating disorders.

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.

The picture presents the conceptualization of the client based on the Evolutionary Systems Therapy.

For those interested in, the preprint of the paper is freely available and and the published version will have only minimal differences due to production process:

Cheli, S., Cavalletti, V., Gazzillo, F., Brüne, M., & Hewitt P.L. (2024). I don’t deserve anything good: Perfectionistic self-recrimination in a case of comorbid personality and eating disorder. Journal of Clinical Psychology. Preprint available on Authorea, July 16, 2024. https://doi.org/10.22541/au.172114929.99232229/v1 (DOI: 10.1002/jclp.23753).

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