ABSTRACT
Ambivalence has multifarious causes in eating disorders (ED). In addition to the valued aspects of disordered eating, fears about change generate ambivalence. Notions of ‘recovery’ might be perceived as destabilising and threatening to identity in chronic EDs. Schema therapy was designed to treat complex difficulties in which ambivalence and low self-efficacy are often pronounced. Ambivalence in EDs can be linked to three key forms of motivation-related appraisal: negative appraisals about behaviour change, positive appraisals about the status quo, and dubitable appraisals about one’s ability to change. Work with ambivalence necessitates some degree of empathic confrontation. Limited reparenting describes how schema therapists fulfil clients’ basic emotional needs within the therapeutic relationship. Identifying clients’ core values, and exploring whether maladaptive schema modes support or compromise these, encourages change. Schema therapists often use imagery to identify and modify early maladaptive schemas.
