Routinely, people suffering anorexia nervosa (and its milder variant, diet obsession) do not feel they have any problem. They like being thin, they like the feeling of being in control and in women a good many even like the cessation of their periods. Far from wanting to gain weight, they feel that if their thinness is taken away they will be losing their dearest (perhaps only) treasure and achievement. Yet underneath all that, there are likely to be profound wounds, feelings of inadequacy, deep family dynamics, and a terror of change.
While I am clear that extreme underweight is medically unhealthy, I don’t assume that someone who comes to see me wants to put on weight. Provided their health is not acutely at risk, I am happy to offer a safe and un-pressured opportunity for someone in this situation to explore their feelings and work on whatever aspect of the situation seems important to them, and come to their own conclusions about what to do.
Paradoxically, often people can change more easily when there is no pressure from outside to change. The pressure to change is a kind of conditional love. It’s a message, “you are OK! – provided you eat.” As long as health is not in danger, then it is much the most useful thing to make friends with all parts of the person, the part that doesn’t wants to eat as well as the part that does, the part that fears change as well as the part that wants change. From this truely radical self-acceptance arises the safety to change. This is not being laissez-faire about people starving themselves to death. It’s just an honouring that the problem has a perceived validity and a respect that people can make their own best choices, given the opportunity,
That said, if however I were to feel that the person may be at serious medical risk, then I am in professional duty bound to not continue to work with that person unless their doctor is informed of the health danger. Treatment of eating disorders where there is medical danger and the person is unable to see their weight loss (or binge/purging) as a problem, requires specialised treatment and typically a multi-disciplinary team approach. In general, I work with people with mild to moderate anorexia or bulemia. When people have severe or life-threatening eating disorders they need to be part of the Bristol NHS “STEPS” programme. I hear good reports of this from my clients. I have worked with people post-STEPS whose weight has stabilised and who want to bring healing to deeper emotional aspects.
My approach with emotional eating is warm, human and sympathetic, with an emphasis on self-love and self-forgiveness. To take the first step to re-gaining control of your eating, please ring me directly. Leave a message and I’ll call you back. I’m happy to answer questions or arrange, in Bristol, a free, no-obligation half-hour introductory meeting. My approach is friendly, respectful, and very effective. Please click here for contact information.