If you are struggling with an eating disorder, then this section may be helpful to you in deciding upon your treatment. You may also wish to look at my publications (under “Writings”) or YouTube videos (under “Media”).
I work with people with eating disorders who are in a place where they can truly benefit from ongoing psychotherapy. This is more difficult for the individual if they are experiencing continuing medical or psychological crises. It is very common for people with an eating disorder to have mixed feelings about getting help. On the one hand, you may be keen to get better but also be very frightened about what this may involve. These concerns are to be expected and will need to be discussed as part of your therapy. I believe that getting help must involve the development of a safe and trusting therapeutic relationship, as well as a “two track” approach. By this I mean focusing therapeutic time on self-esteem (for example, that terrible sense of “not deserving”) and relationship concerns, and also helping you to manage your disordered eating more directly. It will be important to gradually take risks with modifying your eating behaviours yet feel you have the safety and support in which to do so. This is true whether you are bingeing and purging and/or restricting your intake of food. If overexercising is a part of your behaviour, then that also can be something you get help with. It is important to move from a driven and compulsive approach to exercise to a more moderate, fun, and healthy form of exercise. The latter involves getting more in touch with your body, although I appreciate how that can be scary as well.
My approach to psychotherapy has evolved over the past 30 years of experience in working in this area with both adolescents and adults. If I needed to categorize my therapeutic approach I would say it involves aspects of cognitive-behavioural therapy, psychodynamic therapy, narrative therapy, and feminist components. I have trained more recently in an approach (Self Regulation Therapy) which aims to help clients to become better self-regulated in their nervous system (see article on this topic under “Wisdom”). This may enable clients to discharge activation which over time may have contributed to their disordered eating, especially if they have experienced trauma of any kind. Trauma which I often see is relational trauma, such as bullying and other “betrayals”. I have also trained recently in Accelerated Experiential-Dynamic Psychotherapy, an approach which integrates in many ways my previous trainings and experiences yet extends this work as well.
As a strong proponent of human potential, I believe that people with eating disorders can and do recover. A “cure” may not mean never again having challenging body image days or a tendency to again experience eating disorder type thinking or even behaviours. It does mean having the capacity to really get on with your life, and a life characterized by greater joy and a healthier approach to relationships, exercising, and eating. I believe therapy is best entered into with a sense of curiosity and willingness to explore. While it takes hard work to recover from an eating disorder, the rewards of truly living in a more open and fulfilling way may well be the results of this work.