Moria Golan
Most patients with eating disorder (ED) are ambivalent regarding change. The more severe the eating disorder, symptoms are perceived as being preferable to the alternative distresses and patients present negative coping mechanisms such as denial and/or opposition to treatment.
This report describes clinically driven strategy for engaging patients with eating disorders to therapeutic process. It describes a structured procedure for the preliminary meeting with the patient focusing on developmental tasks, difficulties and coping mechanisms.
There is an emphasis on the process of achieving collaboratively narration of the context in which the eating disorder invaded and how it relates to the patients’ emotional issues across the life span, as well as the etiological theories in which it is rooted. We review the patients’ history from childhood through adolescence or adulthood, exploring the nature of emotional and developmental difficulties in the different ages. We track how they impacted the person’s behaviors, personality and coping mechanisms, as well as the reasons he/she was tempted to the eating disorders’ ‘shelter’. A dynamic understanding, motivational interviewing, and engagement in externalizing conversation are the means used to reveal the prices and motivate the patient to take control of his/her life and choose to be treated.