Eating Disorders - fieldi

Young Adult Women 153
ing; in fact, it must eventually allow for optimal frustration in the
treatment process (Lonergan 1992). A patient, Ann, told me that she
had been struggling for two weeks with whether to tell me that she
was angry with me. She was bothered by having learned that I was
treating a student at her college whom she did not like very much.
As we talked, I learned that this person was not a close friend of
Ann’s but that she was a “snobby, skinny dancer.” We talked about
Ann’s jealousy of both the other student’s thinness and Ann’s having
to “share” me with her. Ann was frustrated when it became apparent
that I was not going to stop seeing the other student. We talked
about this and her fears and fantasies encompassing the situation.
She was able to tell me that she had actually considered not seeing
me anymore. Both Ann’s frustration and conflict were apparent.
These provided rich material in the treatment process and, in time,
allowed Ann to grow in her ability to tolerate and express her emotions
more readily. Conflict is essential for progress. Once an individual
feels safe enough, she must be able to tolerate, experience,
and explore the conflicts she acknowledges within herself. These
conflicts may in fact make her at odds with what appears to be an
unfair world; equally important, she may find herself at odds with
her therapist. Because anger and conflict are usually so terrifying to
our patients, they need support and encouragement to allow themselves
to express these emotions and to tolerate them.
I allow patients to talk about their fear, helplessness, and sense of
entrapment—all tied up in their symptom. I listen for their desperation
and acknowledge it. But I do not try to fix it, and cannot of
course—except in helping them to eventually fix it themselves. This
acknowledgment allows the treatment to take root. Their symptom
is their best friend and worst enemy simultaneously. I allow them to
talk about it. I tolerate the often ghastly and graphic descriptions of
their symptomatic behavior. This can be difficult for both patient
and therapist, but it is truly a test for patients to know that they are
understood and safe!
As treatment progresses, I consistently weave the connecting
threads of symptoms to feelings. Eventually patients begin to do this
for themselves. This is an exciting juncture in the treatment process
and is mutually acknowledged.
Recovery usually includes the vital concept of mourning the loss