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During the initial assessment she reported high levels of neuroticism that parallel the diagnosis of obsessive\u2010compulsive personality disorder, borderline personality disorder, and anorexia nervosa. Myriam showed a severely impaired personality functioning defined by perfectionism, self\u2010criticism, interpersonal guilt and overcontrol. Her daily experience was shaped by a self\u2010recriminative inner dialogue associated with maladaptive patterns in the form of food, water and sleep restrictions, self\u2010harm 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\u2010month intervention she remitted from all the categorical diagnoses and showed reliable changes in several measures. These outcomes were maintained at 3\u2010month follow\u2010up. We describe the integrative conceptualization based on Myriam's perfectionistic self\u2010recrimination patterns, and the consequent treatment that targeted these patterns rather than focusing on symptom reduction exclusively.<\/jats:p>","DOI":"10.1002\/jclp.23753","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T10:19:09Z","timestamp":1732529949000},"page":"171-181","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["I Don't Deserve Anything Good: Perfectionistic Self\u2010Recrimination in a Case of Comorbid Personality and Eating Disorder"],"prefix":"10.1002","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0432-3769","authenticated-orcid":false,"given":"Simone","family":"Cheli","sequence":"first","affiliation":[{"name":"Center for Psychology and Health, Tages Charity Florence Italy"},{"name":"Department of Psychology St. John's University Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Cavalletti","sequence":"additional","affiliation":[{"name":"Center for Psychology and Health, Tages Charity Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7955-3710","authenticated-orcid":false,"given":"Francesco","family":"Gazzillo","sequence":"additional","affiliation":[{"name":"Department of Psychology La Sapienza University Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Br\u00fcne","sequence":"additional","affiliation":[{"name":"LWL University Hospital Department of Psychiatry, Psychotherapy, and Preventive Medicine, Division of Social Neuropsychiatry and Evolutionary Medicine, Ruhr University Bochum  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4474-8611","authenticated-orcid":false,"given":"Paul L.","family":"Hewitt","sequence":"additional","affiliation":[{"name":"Department of Psychology British Columbia University Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/21674086.1947.11925693"},{"key":"e_1_2_8_3_1","volume-title":"Novel Conceptual Approaches to Personality Disorders for Psychologists and Philosophers","author":"Cheli S.","year":"2024"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.23365"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-023-04610-5"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2024.05.001"},{"key":"e_1_2_8_7_1","volume-title":"The NEO Inventories: Personality Inventory\u20143 (NEO\u2010PI\u20103)","author":"Costa P. 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