Note to a Colleague: Anorexia

Good Morning.

Attachment

If your client is attached to you then yes, you should keep seeing her. It is my belief that attachment wounds are what give rise to the huge inner critic; therefore, attachment is the core issue behind anorexia and safe attachments are the best way to heal it.

Inner Critic

Anorexics are identified with their inner critic in many ways so coming from the heart in all interactions is experienced as healing for them and will actually give them strength to reduce the eating disorder behaviors. i.e. don't say, "You need to go to the hospital," but rather, "The people in your life really care about you and so do I. I don't feel comfortable saying nothing and I think we need to get you some help."

Denial

Don't know if your client is in any denial...there is a lot of denial with anorexia so it is important and empowering when you help them face that they do have an eating disorder.

Gentle Language

There are all these code words in an anorectic's world..."You look good" can mean "You are fat", so there are certain phrases a colleague and former anorexic has taught me to use such as "dropped some pounds" instead of "lost weight".

Expressing Emotions Skills

They restrict due to being overwhelmed with emotions, usually some combination of fear that has turned into self-hatred. Giving them other ways to express their emotions is therefore crucial (as in all therapy, but esp. here as it is life-threatening for them when they can't eat).

Assertiveness

Assertiveness skills are also crucial for anorexics as they have decided that they do not deserve to take up any space. Someone in their life somewhere along the line said they should not have emotions, feelings or a self because that other person needed to have all the space/be the only person in the room. When they learn they have a right to boundaries, i.e. they learn to assert themselves and have a self, it is truly food for their souls.

"I'm Triggered"

Teaching the term "triggered" helps them conceptualize what is happening when they are overtaken by the thinking and feelings of the eating disorder, and sets them up to see that the eating disorder is not the only reality, but is instead an episodic state of Fight, Flight, Freeze or Fawn to which there are alternatives.