Starving for affection: attachment narrative therapy with eating disorders
The eating disorders, especially anorexia and bulimia, are among the most dangerous and most dif¿ cult to treat of the various mental health problems (Bruch 1973; Ward et al. 2001). In this chapter a multi-level perspective will be presented, exploring the experiences of young adults and including a focus on attachment patterns, family relationships and the cultural contexts underlying eating disorders. Though the emphasis will be on anorexia, the model offered is also seen as applicable to bulimia. The discussion will not rely excessively on diagnostic categories and it is suggested that there is often an overlap between restricting and purging forms of eating disorders. These symptoms may also be coupled with depression, anxiety, obsessive compulsive behaviours and even deliberate self-harm (Fairbairn and Brownell 2002). In including a family perspective, it is emphasised that the formulation is not intended to be ‘parent blaming’.