ABSTRACT
Chapter Seventeen addresses the challenges inherent in working with patients who are uncovering the roots of their eating disorders, including the setbacks and negative therapeutic reactions that may emerge. For the perseverant patient who has not learned from experience about the nature, nuances, and rhythms of relationships, any breach in attuned connection can become catastrophic—even potentially destroying the therapeutic alliance. Whether a response to an internal state of distress, or inadvertently evoked by the real relationship between therapist and patient, such interruptions can be thought of as essential ingredients of the “un-covery” process—developmental achievements for patients who have held and stored their emotions inside themselves and tried to process them alone with food. Breaches in connection can provide the opportunity to learn more about the patient’s sensitivities and vulnerabilities, as well as help him/her learn that relationships can survive, be repaired, and deepen despite unanticipated detours. The chapter illustrates the author’s interaction with one patient as they work their way through the patient’s anger and arrive at its source.
