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Hidden eating disorders: attachment and affect regulation in the therapeutic relationship
- Author:
- BARTH F. Diane
- Journal article citation:
- Clinical Social Work Journal, 36(4), December 2008, pp.355-365.
- Publisher:
- Springer
- Place of publication:
- New York
Whilst working as at a clinic specialising in therapy with individuals with eating disorders, the author has repeatedly encountered cases of clients hiding these symptoms from their therapists. Many authors have also noted that eating disorders are related to problems with attachment, loss and separation, and affect regulation. Difficulties in these areas make it hard for clients to be self-reflective or use insight productively. In this article, the author discusses her experience with the integration of these dynamics, which she has found to be key to successful psychotherapy with clients who hide their eating disorders.
Separate but not alone: separation-individuation issues in college students with eating disorders
- Author:
- BARTH F. Diane
- Journal article citation:
- Clinical Social Work Journal, 31(2), Summer 2003, pp.139-153.
- Publisher:
- Springer
- Place of publication:
- New York
It sometimes seems that the college experience is tailor-made for the development of eating disorders. Overwhelmed and bombarded by their feelings, college students often turn to behavioral means, like eating disorders, to cope. Contemporary research has shown that good and bad emotions alike can be managed by starvation, bingeing, overeating, purging, and/or obsessive exercise. For college students, many of the overwhelming feelings that are titrated by eating disorders are directly linked to the separation process. Adolescence has been called “a second individuation.” While authors have viewed separation-individuation as both a developmental stage and a lifetime's work, contemporary therapists often concentrate on the importance of early separation experiences. A postmodern perspective, however, recognizes the importance of connection as well as separation. Our culture is so focused on independence that many parents of college students do not recognize the importance of maintaining active contact with their older adolescents. It can be very helpful to view an eating disorder as representing a college student's attempt to negotiate separation and connection, dependence and autonomy. This article examines some of these dynamics and the implications for therapy with this population.