ABSTRACT

This chapter discusses how an interpersonal/relational psychoanalytic approach to working with eating disorders illuminates the links between symptom and meaning, action and words, isolation and relatedness. In working with patients with eating disorders, clinicians discovers the disowned or dissociated parts of a person, they experience and witness various self-states and body-states. The chapter focusses on symptom-focused approaches around the food and food behaviors and feelings in order to establish the physiological, medical, and psychological stability that will allow for the normalization of eating. A verbal contract is an agreement made between patient and therapist regarding substituting alternative behaviors for disordered eating behaviors or thinking. Using food metaphors is one way of speaking an eating disordered patient's language. The detailed inquiry can promote a sense of safety that enables the patient to reveal information, including the disclosure of an eating disorder, sometimes for the first time. Food journaling may also serve as a container for the out-of-control feelings related to food.