The Unforgiven

EMDR, ego state therapy, attachment repair and forgiveness in the treatment of eating disorders.

Clients with eating disorders, particularly anorexia nervosa, are among the most difficult to treat. For this reason, many clinicians choose to refer these clients elsewhere. Part of the difficulty with this population is that the clinician spends much of the time dialoguing with the adult/present part of the client’s brain, which is not where the obstacles lie.
It has been my experience that the intransigence of these clients is not only due to societal pressures and the addictive qualities of the disorder, but often due to the unaddressed presence of dissociated trauma.

This full-day presentation introduces participants to (1) the kind of history taking and goal establishment unique to clients with eating disorders, (2) the extensive preparation, which includes emotional expertise and somatic awareness (3), the inevitable presence of dissociation and the use of ego state therapy to access the source of the eating disorder, and (4) attachment repair strategies to strengthen the client for trauma processing.
The need for internal collaboration of parts of Self will be demonstrated via the use of video clips. The role of forgiveness, therefore, particularly towards one’s Self or parts of Self, will be highlighted.

Slight modifications to trauma processing given the tendency to return to the disorder, even after extensive preparation, will be reviewed. The modifications entail (A) a return to attachment/reparenting work, even during phases 3-6, as a form of titrating or "pendulating" the traumata (more use of resources) and (B) the use of dissociation strategies, e.g., use of the “conference room” technique, as well as having the eating disordered part look through the eyes with the client.

Participants will:

• learn of eating disorder assessments and medical concerns and goal establishment in the evaluation phase

• learn how to guide clients into somatic awareness

• learn basic ego state strategies to reach the eating disordered part

• learn two attachment repair strategies

• identify two modifications to the processing phase.