Eating Disorders - fieldi

152 Young Adult Women
ity to be—were they not suffering from the often crippling effects of
their self-imposed starvation or their binge-purge obsession.
I try to be aware of the complexities of the eating disorders as we
know them. I believe it is essential for people working with individuals
suffering from eating disorders to have worked through their
own issues regarding body image, weight, and food. Our astute
awareness of countertransferential material is essential. For example,
if a patient says to a therapist, “It may be okay for you to be five
pounds overweight, but it is not okay for me,” the therapist, ideally,
must react to the patient’s distress, and not her own. If, as a therapist,
I get caught up in my patient’s innuendo, I cannot be as effective
in understanding and exploring her own desperation as I would want
to be.
I work in a style that can best be described as eclectic with a psychodynamic
base. I will try almost anything within professional
parameters to foster a safe, nonthreatening arena in which an individual
and I can explore together the depths of the suffering—or
oftentimes break through the defenses and denial in order to first
acknowledge the suffering. I present myself as three-dimensional. I
gingerly let out a little of me over time, becoming more human and
less of a blank slate. I am considerably active in my work, believing
that engaging the individual early on is essential to a good therapeutic
fit. Because many of the people whom I see are so rigidly onedimensional—though
they can play at being many roles, like the
chameleon—I must provide them with a nurturing womb in which
to grow as they attempt to risk being more real. I laugh with them,
and I even poke fun at my own obsessionalism at times. Then, ideally,
they can begin to take themselves less seriously.
Trust in all therapeutic settings is essential. In this population
trust is a prerequisite to getting work done. Usually, in order to trust
someone, a person must first feel safe and relatively comfortable. As
therapists, I believe we have to make this happen for these people
because they come in, for the most part, so guarded against their
own feelings and so defended! They are terrified that I am going to
make them give up their lifeline (i.e., symptoms)—and, let’s face it,
I am going to do just that if I am successful.
As the therapeutic relationship strengthens, so does the work
progress. The womb mentioned earlier need not be totally nurtur-