Eating Disorders - fieldi

154 Young Adult Women
of the symptom. First, we acknowledge together the realization
that the symptom is not working as well as it used to. Next, we
acknowledge together the symptom’s absence entirely. Therapist
and patient are totally in tandem during this process. I must overtly
acknowledge the loss and fears of not having one’s “best friend”
anymore as a way of coping with life. My patients are both terrified
and sad. I let them know that I know this, but I cannot take
away the pain and frustration. I encourage discussion about the
loss and the feelings that are rapidly surfacing. Mourning often
includes the young woman’s singing the praises of the “deceased.”
This is part of the recovery process. I listen. Usually, directly following
this stage comes the terror of, “What do I do now, ‘without
the deceased’ ” (i.e., the symptom)? Keeping in character with this
metaphor, the individual may need to resurrect the “deceased”
from time to time and become symptomatic. When the symptom
is rendered powerless by the patient, another level of mourning via
understanding is reached, usually accompanied by greater sadness,
deeper fear, and often great anxiety. Finally the patient realizes
that the notion “If I’m thin, it will all come together” is the ultimate
myth that must be put to rest. Truth, as only truth can be for
each individual, must evolve in its stead.
Because eating disorders are so pervasive, acknowledging any single
success along the way is essential in the treatment process. Furthermore,
negatives serve no purpose, as these individuals have, for
the most part, negated themselves with their own self-scorn and
hatred far beyond what the therapist will ever fully know. For these
reasons, wherever possible, I eliminate the negative implications
that arise in the treatment environment and am careful to avoid negative
verbal constructs. One does not take steps backward; one may
make a lateral move. One does not have a slip; one has an episode. And
because one cannot undo what one has already accomplished, one is
never “back to square one.” If ever the concept to “accentuate the positive,
and eliminate the negative” were to apply, it is in the treatment
of eating disorders.
There is no one exact way to treat or view individuals. I find that
we therapists only get into trouble when we generalize. I am
annoyed when I hear professionals talking about “eating-disordered
women,” as though they were Stepford Wives—all branded,