Helping clients recover from eating disorders isn't a short, linear process, and relapse is inevitably part of the journey. Cathy worked diligently with me for five years. Learning to trust me and build a sense of attachment took many months, and there were times when she relapsed. When work was particularly stressful, for example, or when her 12-year-old expressed an interest in dating, Cathy's fears about what it meant for her daughter to become sexually active triggered old emotions, and she occasionally purged.
In time, she found alternative ways to soothe upsetting emotions, and these discoveries eventually led to a sense of resolution and healing. She loved journaling and processed her childhood neglect and abuse through original poems, by writing letters to her parents (which she didn't mail), and by communicating with her younger internal parts. Over time, starving and purging lost their purpose. She no longer needed them to soothe or punish her body and could find new comfort, pleasure, and security from healthier resources.
Make no mistake: treatment with eating-disordered clients is hard and challenging. Nevertheless, I now approach these clients with optimism, an open mind, and an open heart. Over the years, they've taught me that therapy has the greatest impact when I step away from the temptation to get into a power struggle and empower clients to do a large part of the healing work themselves. These days, my appointment book really is filled up—often with eating disordered clients, who, I now know, really can get better.
Lisa Ferentz, L.C.S.W.-C., is the founder and president of The Institute for Advanced Psychotherapy Training and Education, which offers certificate programs in advanced trauma treatment. A trauma specialist, consultant, and educator, she was voted the 2009 Social Worker of the Year by the Maryland Society for Clinical Social Work. She's currently finishing the book Treating Self-Destructive Behaviors in Traumatized Clients: A Clinician's Guide.
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