For Eating Disorders Awareness Week 2018 a psychodynamic therapist talks about her hopes for clients who come to her with eating disorders ...

Working as a psychodynamic therapist I see a lot of clients who have eating disorders.

Some may be coming to talk about issues directly linked to their eating, for others talking about their eating is a side issue that they often don’t convey as important.

Why it's important to visit the GP

Often clients will not want to go and see their GP alongside coming to therapy. Even though I’m working psychodynamically, asking someone to visit their GP is an important step.

'If it does do anything, I hope therapy allows a client to connect how they’re eating with how they’re feeling'

If a visit to a GP isn’t included in the timeline then it can feel that everything talked about in therapy is hidden and doesn’t exist in the real world.

Someone might not want to visit their GP because they’ve had a fruitless previous experience where they felt they received little help. They might have heard from their friends that it only makes things worse. Or the fear may be that going to a GP will mean they will put on weight.

Going to a GP helps to make having an eating disorder feel more real.

'I hope therapy allows a client to connect how they’re eating with how they’re feeling'

But feeling for the first time that you actually have an eating disorder can have a number of consequences. Hopefully, one is that the person will receive help.

Another consequence might be that once referred, the person may feel like they have to live up to the diagnosis of having an eating disorder. They may begin to eat less, to feel like they are worth being helped.

As a therapist who works short term it can often feel like six sessions doesn’t really help that much at all. But maybe that doesn't do it justice.

It's hard work sitting in a room talking about yourself for 50 minutes. From the first session to the sixth, something shifts and the client becomes more engaged in their own story. They're not just a docile passenger anymore, they've got life's remote control in their hands. 

My hopes for clients

I hope therapy allows a client to connect how they’re eating with how they’re feeling.

I hope it allows them to truly feel that their feelings can take up space. That they don’t have to make themselves small for anyone. That they are entitled to feel exactly how they’re feeling, like a wild flower without human intervention. 

I hope going to therapy can help someone to go some way in working out what their eating disorder means for them.

It’s different for everyone.

For one client an eating disorder may be an expression of a wish to stay childlike, for another it may be a response to an overly controlling parent – and an attempt to exert control of their own.

But it’s never just one thing. It’s always more complicated than that and everything is intertwined.

'I am not the expert when it comes to working out what an eating disorder means. The client is'

Just because psychodynamic therapy doesn’t overtly make suggestions or give someone homework it doesn’t mean that it’s an easy ride. You need to take part, engage and do the work.

I am not the expert when it comes to working out what an eating disorder means. The client is. They’re the ones who make the connections, they often get it more right than I do.

And after reading this I hope that more people with an eating disorder might give therapy a try. To get stuck in with the work of feeling hopeful.