ABSTRACT
In this chapter, the authors describe a new integrated treatment model for working with anorexia nervosa (AN) – SPEAKS (Specialist Psychotherapy with Emotion for Anorexia in Kent and Sussex) – that integrates Emotion Focused Therapy (EFT) and Schema Therapy. The model is based on the understanding that difficulties in processing emotion are at the heart of AN. The integration of EFT affords SPEAKS a core focus on emotion and in differentiating layers of emotions from secondary to primary to access core pain. Coping modes are viewed largely as ‘blocks’ to emotional experience, developing for understandable reasons, but ultimately denying the opportunity to resolve core pain. SPEAKS seeks to collaboratively understand and gradually moderate these coping modes so that the patients’ core pain can be felt and ultimately cared for by their Healthy Adult (HA). SPEAKS considers the HA not as a distinct mode, but, rather, a psychologically heathy sense of a core self, emerging during the therapy, which works to hear and understand all the other modes at play. Indeed, a core premise is that accessing core pain leads to a subsequent self-reorganisation of the individual such that an emergent sense of self can ‘take in’, be guided by and act on good emotional information and healthy associated needs.
