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Today, however, an emerging evidence-based approach called radically open dialectical behavior therapy (RO DBT) can help providers identify clients’ biotemperamental tendencies and help them develop a mindful awareness around how perfectionism shows up for them.",{"type":2229,"attrs":2317,"content":2318},{"level":2231,"textAlign":67},[2319],{"text":2320,"type":71},"Identifying perfectionism",{"type":65,"attrs":2322,"content":2323},{"textAlign":67},[2324],{"text":2325,"type":71},"Before we explore RO DBT, let’s first examine perfectionism. 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Individuals with maladaptive perfectionism find themselves in an endless loop striving to achieve the unachievable. Perfectionists may also ",{"text":2349,"type":71,"marks":2350},"use positivity to mask their anxiety",[2351],{"type":104,"attrs":2352},{"href":2353,"uuid":67,"anchor":67,"target":67,"linktype":17},"\u002Fnode\u002F19746",{"text":2355,"type":71},", with a potentially devastating impact on their mental health. ",{"type":2267,"content":2357},[2358],{"type":65,"attrs":2359,"content":2360},{"textAlign":67},[2361],{"text":2362,"type":71},"“Maladaptive perfectionism can lead to self-disappointment, disgust, even self-hatred,” Dr. Astrachan-Fletcher says. “It can even lead to the view that ‘I need to punish myself because I’m not good enough.’”",{"type":2229,"attrs":2364,"content":2365},{"level":2231,"textAlign":67},[2366],{"text":2367,"type":71},"How perfectionism and anxiety intersect",{"type":65,"attrs":2369,"content":2370},{"textAlign":67},[2371,2373,2379],{"text":2372,"type":71},"When perfectionistic tendencies develop, ",{"text":2374,"type":71,"marks":2375},"anxiety",[2376],{"type":104,"attrs":2377},{"href":2378,"uuid":67,"anchor":67,"target":67,"linktype":17},"\u002Fnode\u002F7561",{"text":2380,"type":71}," often isn’t far behind.",{"type":65,"attrs":2382,"content":2383},{"textAlign":67},[2384,2386,2391,2393,2397],{"text":2385,"type":71},"One study found that more recent generations of college students scored higher for specific types of perfectionism than students from earlier generations",{"text":2387,"type":71,"marks":2388},"[1]",[2389],{"type":2390},"superscript",{"text":2392,"type":71},". Additional research showed a correlation between perfectionism and higher risks for depression",{"text":2394,"type":71,"marks":2395},"[2]",[2396],{"type":2390},{"text":2310,"type":71},{"type":65,"attrs":2399,"content":2400},{"textAlign":67},[2401],{"text":2402,"type":71},"To see how this can occur, consider the example of a student writing a paper for class. They stay up all night trying to make their paper “perfect.” They write and rewrite, but never feel it’s good enough. This triggers feelings of anxiety. Then the student begins questioning themselves.",{"type":65,"attrs":2404,"content":2405},{"textAlign":67},[2406],{"text":2407,"type":71,"marks":2408},"“What if I didn’t understand the assignment correctly? What if my writing is garbage? What if my teacher thinks less of me after this assignment?”",[2409],{"type":2410},"italic",{"type":65,"attrs":2412,"content":2413},{"textAlign":67},[2414],{"text":2415,"type":71},"As the anxiety grows, the perfectionism gets even louder. This could lead to the student not turning in the paper out of fear that it’s “not perfect,” and even failing the class.",{"type":2229,"attrs":2417,"content":2419},{"level":2418,"textAlign":67},3,[2420],{"text":2421,"type":71},"Slippery slope: Perfectionism and eating disorders",{"type":65,"attrs":2423,"content":2424},{"textAlign":67},[2425],{"text":2426,"type":71},"Because perfectionism is closely related to anxiety disorders, it can also be a contributing factor leading to eating disorders.",{"type":65,"attrs":2428,"content":2429},{"textAlign":67},[2430,2432,2436],{"text":2431,"type":71},"Research from the National Institute of Mental Health",{"text":2433,"type":71,"marks":2434},"[3]",[2435],{"type":2390},{"text":2437,"type":71}," shows that anxiety disorders and eating disorders often coexist. According to their data, anxiety disorders are identified in:",{"type":2439,"content":2440},"bullet_list",[2441,2455,2468],{"type":2442,"content":2443},"list_item",[2444],{"type":65,"attrs":2445,"content":2446},{"textAlign":67},[2447,2449],{"text":2448,"type":71},"80.6% of adults with ",{"text":2450,"type":71,"marks":2451},"bulimia nervosa",[2452],{"type":104,"attrs":2453},{"href":2454,"uuid":67,"anchor":67,"target":67,"linktype":17},"\u002Fnode\u002F15726",{"type":2442,"content":2456},[2457],{"type":65,"attrs":2458,"content":2459},{"textAlign":67},[2460,2462],{"text":2461,"type":71},"65.1% of adults with ",{"text":2463,"type":71,"marks":2464},"binge eating disorder",[2465],{"type":104,"attrs":2466},{"href":2467,"uuid":67,"anchor":67,"target":67,"linktype":17},"\u002Fnode\u002F5236",{"type":2442,"content":2469},[2470],{"type":65,"attrs":2471,"content":2472},{"textAlign":67},[2473,2475],{"text":2474,"type":71},"47.9% of adults with ",{"text":2476,"type":71,"marks":2477},"anorexia nervosa",[2478],{"type":104,"attrs":2479},{"href":2480,"uuid":67,"anchor":67,"target":67,"linktype":17},"\u002Fnode\u002F5161",{"type":65,"attrs":2482,"content":2483},{"textAlign":67},[2484,2496],{"text":2485,"type":71,"marks":2486},"Laura Hill, PhD, FAED",[2487],{"type":104,"attrs":2488},{"href":2489,"uuid":2490,"anchor":67,"target":27,"linktype":31,"story":2491},"\u002Fprofile\u002Flaura-hill","7b9de4e6-6675-45d6-bab6-824ce405106e",{"name":2492,"id":2493,"uuid":2490,"slug":2494,"url":2495,"full_slug":2495,"_stopResolving":35},"Laura Hill",150616564843515,"laura-hill","profile\u002Flaura-hill",{"text":2497,"type":71},", an eating disorders specialist and adjunct associate professor of psychiatry and behavioral health at The Ohio State University, shed more light on the relationship between perfectionism and eating disorders during our Mental Note podcast.",{"type":2267,"content":2499},[2500],{"type":65,"attrs":2501,"content":2502},{"textAlign":67},[2503],{"text":2504,"type":71},"“One of the traits that is common to anorexia is perfectionism,” explains Dr. Hill. “Some people tend to avoid or pull back and inhibit themselves when something seems overwhelming. Others may show inhibition and avoidance perfectionism, which is an inability to trust your decisions. And that is a very common trait among those with anorexia and binge eating disorder.”",{"type":2229,"attrs":2506,"content":2507},{"level":2231,"textAlign":67},[2508],{"text":2509,"type":71},"The perfectionism trait and threat sensitivity",{"type":65,"attrs":2511,"content":2512},{"textAlign":67},[2513],{"text":2514,"type":71},"The roots of perfectionism can often be traced back to biotemperament, the forces that help people perceive and regulate emotions.",{"type":65,"attrs":2516,"content":2517},{"textAlign":67},[2518],{"text":2519,"type":71},"Take the example of the child at the park who would rather not engage with other children. It’s likely that one of their biotemperamental traits is threat sensitivity. So, they perceive threats (bugs, thorns, not being “as good as” the other kids at playing games) differently than others.",{"type":2267,"content":2521},[2522],{"type":65,"attrs":2523,"content":2524},{"textAlign":67},[2525],{"text":2526,"type":71},"“A higher threat sensitivity often leads to the experience of anxiety,” Dr. Astrachan-Fletcher says.",{"type":65,"attrs":2528,"content":2529},{"textAlign":67},[2530],{"text":2531,"type":71},"Now, experts are addressing the relationship between biotemperament and mental health, including maladaptive perfectionism.",{"type":2229,"attrs":2533,"content":2534},{"level":2231,"textAlign":67},[2535],{"text":2536,"type":71},"RO DBT for maladaptive perfectionism",{"type":65,"attrs":2538,"content":2539},{"textAlign":67},[2540],{"text":2541,"type":71},"An innovative approach to treating mood and anxiety disorders is RO DBT. It’s a transdiagnostic methodology that’s specifically designed for individuals who exhibit signs of emotional overcontrol, such as maladaptive perfectionism.",{"type":2267,"content":2543},[2544],{"type":65,"attrs":2545,"content":2546},{"textAlign":67},[2547],{"text":2548,"type":71},"“The theory behind RO DBT is that overcontrolled people are better off pursuing what they are missing in their lives, which is true connection with at least one other person,” Dr. Astrachan-Fletcher says.",{"type":65,"attrs":2550,"content":2551},{"textAlign":67},[2552],{"text":2553,"type":71},"The RO DBT framework is structured to help individuals learn from their environments, make meaningful changes to connect with others and improve their relationships through a focus on three areas:",{"type":2439,"content":2555},[2556,2568,2579],{"type":2442,"content":2557},[2558],{"type":65,"attrs":2559,"content":2560},{"textAlign":67},[2561,2566],{"text":2562,"type":71,"marks":2563},"Openness:",[2564],{"type":2565},"bold",{"text":2567,"type":71}," Receptiveness to feedback in order to learn and grow (which can be difficult for people with a high threat sensitivity)",{"type":2442,"content":2569},[2570],{"type":65,"attrs":2571,"content":2572},{"textAlign":67},[2573,2577],{"text":2574,"type":71,"marks":2575},"Flexibility:",[2576],{"type":2565},{"text":2578,"type":71}," Adaptability in different situations",{"type":2442,"content":2580},[2581],{"type":65,"attrs":2582,"content":2583},{"textAlign":67},[2584,2588],{"text":2585,"type":71,"marks":2586},"Connectedness:",[2587],{"type":2565},{"text":2589,"type":71}," Emotional recognition and expression (valuable skills that support intimacy and healthy relationships)",{"type":2267,"content":2591},[2592],{"type":65,"attrs":2593,"content":2594},{"textAlign":67},[2595],{"text":2596,"type":71},"“The goal,” explains Dr. Astrachan-Fletcher, “is to help overcontrolled clients get to their ‘safety cue’ state so they can grow more comfortable in the vulnerability of a therapy session.”",{"type":2229,"attrs":2598,"content":2599},{"level":2231,"textAlign":67},[2600],{"text":2601,"type":71},"Encouraging a mindful relationship with perfectionism",{"type":65,"attrs":2603,"content":2604},{"textAlign":67},[2605],{"text":2606,"type":71},"When working with an individual who exhibits perfectionistic traits, it’s important for clinicians to acknowledge that their perfectionism can sometimes be a good thing, Dr. Astrachan-Fletcher explains. The key is to help your client develop a mindful awareness of their perfectionism, recognizing when it’s helpful and when it’s not.",{"type":2267,"content":2608},[2609],{"type":65,"attrs":2610,"content":2611},{"textAlign":67},[2612],{"text":2613,"type":71},"“Many people think that if they loosen their reigns on perfectionism, they will make constant mistakes and experience constant failure, but that’s not true,” Dr. Astrachan-Fletcher says. “By using RO DBT, we can teach our clients how to approach perfectionism with kindness, acceptance and curiosity so they can see both the good and bad side of perfectionism and get more comfortable with their genuine selves.”",{"id":67,"alt":67,"name":14,"focus":67,"title":67,"source":67,"filename":14,"copyright":67,"fieldtype":175,"meta_data":2615},{},"Blog","Treatment","Kyle Hardner",[2620],{"name":2618,"created_at":2621,"published_at":2622,"updated_at":2623,"id":2624,"uuid":2625,"content":2626,"slug":2635,"full_slug":2636,"sort_by_date":67,"position":2637,"tag_list":2638,"is_startpage":177,"parent_id":2639,"meta_data":67,"group_id":2640,"first_published_at":2641,"release_id":67,"lang":201,"path":67,"alternates":2642,"default_full_slug":67,"translated_slugs":67,"_stopResolving":35},"2026-03-02T14:50:22.705Z","2026-04-07T14:14:48.285Z","2026-04-07T14:14:48.335Z",150623939449825,"633b8e46-0ca0-4513-a75b-468ceb74e0cf",{"bio":2627,"_uid":2628,"status":2629,"component":2630,"categories":2631,"featured_image":2632},"\u003Cp>Kyle Hardner is a writer and content strategist based in Pennsylvania. He's led content development and creation for leading health systems and has extensive expertise writing about healthcare, diversity, equity and inclusion.\u003C\u002Fp>","b4a947cd-e973-4f59-ac3f-52d33d6120e2","Not in UKG","staff",[],{"id":2633,"alt":67,"focus":67,"title":67,"filename":2634,"copyright":67,"fieldtype":175,"is_private":177},150623928646076,"https:\u002F\u002Fs3.amazonaws.com\u002Fa.storyblok.com\u002Ff\u002F286555691919486\u002F1011x772\u002F09ec98c223\u002Fkyle-hardner_0.jpg","kyle-hardner","profile\u002Fkyle-hardner",-3010,[],148823052330811,"e62b064b-0ab7-4834-80c3-aed1b7fe39cf","2026-03-02T14:50:22.750Z",[],"\u003Col>\u003Cli>Ibrahim, A. K., Kelly, S. J., Adams, C. E., & Glazebrook, C. (2013). A systematic review of studies of depression prevalence in university students. Journal of Psychiatric Research, 47(3), 391-400. \u003Ca href=\"https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.jpsychires.2012.11.015\">https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.jpsychires.2012.11.015\u003C\u002Fa>.\u003C\u002Fli>\u003Cli>Smith, M. M., Sherry, S. B., McLarnon, M. E., Flett, G. L., Hewitt, P. L., Saklofske, D. H., & Etherson, M. E. (2018). Why does socially prescribed perfectionism place people at risk for depression? A five-month, two-wave longitudinal study of the Perfectionism Social Disconnection Model. Personality and Individual Differences, 134, 49-54. \u003Ca href=\"https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.paid.2018.05.040\">https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.paid.2018.05.040\u003C\u002Fa>.\u003C\u002Fli>\u003Cli>National Institute of Mental Health. Eating disorders. Accessed May 24, 2024. \u003Ca href=\"https:\u002F\u002Fwww.nimh.nih.gov\u002Fhealth\u002Fstatistics\u002Feating-disorders\">https:\u002F\u002Fwww.nimh.nih.gov\u002Fhealth\u002Fstatistics\u002Feating-disorders\u003C\u002Fa>.\u003Cbr> \u003C\u002Fli>\u003C\u002Fol>","Discover the connection between perfectionism and anxiety, including how both relate to eating disorders. Explore how RO DBT can address the underlying issues.",[],[],"Perfectionism and Anxiety: A Guide for Clinicians Based on RO-DBT",[],{"id":67,"alt":67,"name":14,"focus":67,"title":67,"source":67,"filename":14,"copyright":67,"fieldtype":175,"meta_data":2650},{},{"id":2652,"alt":2653,"name":14,"focus":14,"title":14,"source":14,"filename":2654,"copyright":14,"fieldtype":175,"meta_data":2655,"is_external_url":177},174351589296776,"Young woman writing in a notebook while sitting on a bed","https:\u002F\u002Fa.storyblok.com\u002Ff\u002F286555691919486\u002F2000x1333\u002F1cd32db0d4\u002Fyoung-woman-writing.jpg",{"alt":2653,"title":14,"source":14,"copyright":14},[],"Discover the connection between perfectionism and anxiety, including how both relate to eating disorders. See how RO-DBT can help you address these traits in therapy.",{"id":67,"alt":67,"name":14,"focus":67,"title":67,"source":67,"filename":14,"copyright":67,"fieldtype":175,"meta_data":2659},{},[],"perfectionism-anxiety-rodbt","resources\u002Fperfectionism-anxiety-rodbt",-6580,[],109705324666269,"ffe5cfd8-ee3d-4a3c-a82d-72ac6a43fbdf","2024-05-31T01:00:18.000Z",[],[],[],{"cache-control":2672,"connection":2673,"content-encoding":2674,"content-type":2675,"date":2676,"etag":2677,"referrer-policy":2678,"sb-be-version":2679,"server":2680,"strict-transport-security":2681,"transfer-encoding":2682,"vary":2683,"via":2684,"x-amz-cf-id":2685,"x-amz-cf-pop":2686,"x-cache":2687,"x-content-type-options":2688,"x-frame-options":2689,"x-permitted-cross-domain-policies":2690,"x-request-id":2691,"x-runtime":2692,"x-xss-protection":1974},"max-age=0, public, s-maxage=604800, stale-if-error=3600","keep-alive","gzip","application\u002Fjson; charset=utf-8","Fri, 30 Oct 2026 18:40:00 GMT","W\u002F\"50ba7ee7591efa526bec016f90d24481\"","strict-origin-when-cross-origin","5.996.4","nginx","max-age=31536000","chunked","Origin,Accept-Encoding","1.1 3c6bb832c5323be7cf066aba5d1e22ea.cloudfront.net (CloudFront)","dUvhbYVwrmSpGxOWzDrawhgaMhpma2EWGDWUJDBRPZvWxgBt1BBuww==","IAD55-P6","Hit from cloudfront","nosniff","SAMEORIGIN","none","bf5b5166-c588-4066-b22b-503b9fc84446","0.031727",{"data":2694,"headers":2909,"perPage":2919,"total":2920},{"stories":2695,"cv":203,"rels":2907,"links":2908},[2696,2742,2800,2847],{"name":2697,"created_at":2698,"published_at":2699,"updated_at":2700,"id":2701,"uuid":2702,"content":2703,"slug":2736,"full_slug":2737,"sort_by_date":67,"position":2738,"tag_list":2739,"is_startpage":177,"parent_id":1896,"meta_data":67,"group_id":2740,"first_published_at":2699,"release_id":67,"lang":201,"path":67,"alternates":2741,"default_full_slug":67,"translated_slugs":67},"Her 12-year-old had an eating disorder. Caregiving meant healing herself, too","2026-09-01T15:45:22.326Z","2026-09-01T15:50:15.477Z","2026-09-01T15:50:15.488Z",215400129878194,"144a223b-01fa-4566-b26c-2f6b6cd373ed",{"_uid":2704,"body":2705,"authors":2723,"excerpt":14,"summary":2725,"component":1878,"categories":2726,"article_type":1880,"external_link":2727,"featured_image":2728,"external_link_text":2733,"listing_thumbnail_image":2734},"38fb8d5c-e5f1-4819-9fc0-7ff6e5e2d061",{"type":62,"attrs":2706,"content":2707},{"backgroundColor":67},[2708,2713,2718],{"type":65,"attrs":2709,"content":2710},{"textAlign":67},[2711],{"text":2712,"type":71},"Beth Ayn Stansfield, of Virginia, was excited when her preteen told her she wanted to start running together.",{"type":65,"attrs":2714,"content":2715},{"textAlign":67},[2716],{"text":2717,"type":71},"\"Initially, she came home from school one day, middle school, and announced that she just wanted to get healthy and that she was going to go on a diet,\" Stansfield said. \"At that time, I didn't give it much thought because I was on the South Beach diet.\"",{"type":65,"attrs":2719,"content":2720},{"textAlign":67},[2721],{"text":2722,"type":71},"Stansfield enjoyed bonding with her daughter, Carly, through food and exercise, especially working out together as a way to have fun and relieve stress. But she soon realized that for Carly, \"it started to become extreme.\" At first Carly eliminated sweets. Then she cut out all carbs. Stansfield then noticed her daughter sometimes skipped meals altogether.",[2724],"1d5cd4af-12a4-4c28-911c-6884dbf73df1","USA Today recently put a spotlight on the lived experience perspective of ERC National Family Advocate Beth Ayn Stansfield who shared her story of supporting a daughter in eating disorder treatment while also recognizing her own complex relationship with food. This thoughtful article highlights a situation many caregivers may go through while caring for a child with an eating disorder -- and addresses the complexities of living in a diet-culture and GLP-1-driven society.",[],"https:\u002F\u002Fwww.usatoday.com\u002Fstory\u002Flife\u002Fhealth-wellness\u002F2026\u002F07\u002F27\u002Fchild-parent-eating-disorder-recovery\u002F90997723007\u002F",{"id":2729,"alt":2730,"name":14,"focus":14,"title":14,"source":14,"filename":2731,"copyright":14,"fieldtype":175,"meta_data":2732,"is_external_url":177},215400775769246,"Beth Ayn Stansfield with daughters posing at the beach","https:\u002F\u002Fa.storyblok.com\u002Ff\u002F286555691919486\u002F441x460\u002F0389a68824\u002Fbeth-ayn-stansfield-daughters.png",{"alt":2730,"title":14,"source":14,"copyright":14},"Read more",{"id":2729,"alt":2730,"name":14,"focus":14,"title":14,"source":14,"filename":2731,"copyright":14,"fieldtype":175,"meta_data":2735,"is_external_url":177},{"alt":2730,"title":14,"source":14,"copyright":14},"child-parent-eating-disorder-recovery","news\u002Fchild-parent-eating-disorder-recovery",-4900,[],"a551d1fa-fc6c-40a7-b5ba-de204a97bcb8",[],{"name":2743,"created_at":2744,"published_at":2745,"updated_at":2746,"id":2747,"uuid":2748,"content":2749,"slug":2794,"full_slug":2795,"sort_by_date":67,"position":2796,"tag_list":2797,"is_startpage":177,"parent_id":1896,"meta_data":67,"group_id":2798,"first_published_at":2745,"release_id":67,"lang":201,"path":67,"alternates":2799,"default_full_slug":67,"translated_slugs":67},"Parents may not know: Baltimore expert warns AI chatbots can encourage disordered eating","2026-09-01T15:33:29.337Z","2026-09-01T15:38:20.050Z","2026-09-01T15:38:20.062Z",215397209483565,"a7148c77-c3c7-46bd-b0da-98b153f79503",{"_uid":2750,"body":2751,"authors":2779,"excerpt":14,"summary":2781,"component":1878,"categories":2782,"article_type":1914,"external_link":2783,"featured_image":2784,"external_link_text":2733,"listing_thumbnail_image":2791},"54d16e8d-7833-4742-afab-7bfb61cd093e",{"type":62,"attrs":2752,"content":2753},{"backgroundColor":67},[2754,2759,2764,2769,2774],{"type":65,"attrs":2755,"content":2756},{"textAlign":67},[2757],{"text":2758,"type":71},"HUNT VALLEY, Md. — Psychologists are warning parents about a new trend of kids using artificial intelligence chatbots as a \"secret eating disorder coach.\"",{"type":65,"attrs":2760,"content":2761},{"textAlign":67},[2762],{"text":2763,"type":71},"Not only do the chatbots give tips on weight loss, but they may also encourage disordered eating.",{"type":65,"attrs":2765,"content":2766},{"textAlign":67},[2767],{"text":2768,"type":71},"Dr. Kaitlin Slaven, an expert with the Eating Recovery Center in Baltimore, told WBAL-TV 11 News that parents may have no idea it's going on.",{"type":65,"attrs":2770,"content":2771},{"textAlign":67},[2772],{"text":2773,"type":71},"\"These chatbots are equipped with tools to be able to sort of gather information and learn. And so, as somebody is inputting information about 'I'm trying to lose weight,' and the chatbot is saying, 'Good job, you're losing weight.' And so, they start to adapt to what is happening and they start to almost encourage the behavior,\" Slaven explained.",{"type":65,"attrs":2775,"content":2776},{"textAlign":67},[2777],{"text":2778,"type":71},"Slaven advises parents to pay attention to clues.",[2780],"86c19221-c58b-4139-9138-a4cde149c18f","ERC's Dr. Kaitlin Slaven was a featured guest recently on WBAL to share insight about how AI chatbots are impacting eating disorders in kids. 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