|Posted by a.marlow on January 16, 2013 at 9:20 AM|
How does one go about offering therapy to someone suffering from an eating disorder? It's one thing to have a detailed understanding of the neurochemistry or psychoanalysis of anorexia; it's another thing to put that theoretical knowledge into practice. One thing that comes across when we compare therapists working from Freudian, Jungian, Kleinian etc. backgrounds is that the particular theory being used is far less important than the quality of the relationship between therapist and client.
So what qualities must the therapist embody in order that his/her therapeutic intervention is experienced as something positive by the client? A recent article by Gulliksen et al. in the International Journal of Eating Disorders has suggested that successful therapy, at least from the point of view of the anorexic client, involves a therapist who is generous in affection and understanding, respectful of the client's perspective, patient about change in the client's behaviour and in the development of the therapeutic relationship; actively interested in the client's personal qualities and thought processes and possessed of a sense of humour; who focuses on the client's strengths and who supports the client through difficult situations; who has experienced knowledge of eating disorders, and who is authoritative and self-confident about their expertise.
On the other hand, clients tended to view negatively those therapists who disregarded their feelings and opinions, who were passive and seemingly uninterested in the client's problems, and who pampered them, showing an attitude of pity and sympathy that could end up perpetuating the disorder.
None of this should come as a surprise, but it is sometimes more difficult in practice than in theory to embody these qualities. Moreover, before rushing to embody all of these attributes without giving them a second thought, one major weakness of the study must be considered: it only looked at how these qualities impacted upon the client's feeling of satisfaction with the treatment, not at whether these qualities led to concrete outcomes of weight gain or improved mental well-being.
Gulliksen, K. S., et al., 2012. Preferred Therapist Characteristics in Treatment of Anorexia Nervosa: The Patient’s Perspective. International Journal of Eating Disorders, 45, pp. 932-941