Recent posts address new parts of eating disorder treatment that are on the forefront of how to recover in today’s climate: the cultural and personal effect of the GLP-1’s and the overarching changes due to private equity investment in residential programs. As critical as those topics are, nothing changes the central pillar of treatment: the strength of primary therapeutic relationships.
Starting with the dawn of modern treatment for eating disorders in the 1970’s and early 1980’s, therapists versed in care for people with eating disorders knew that recovery needed an open, trusting, profound relationship in order to start the process of really getting well.
Eating disorders in almost every iteration cause severe isolation, reliance on a set of thoughts and behaviors that are powerful but all encompassing and a litany of shame, guilt and blame from all corners of modern society. A disorder people almost always fall into at a young age creates a prison from which there appears to be no escape.
A primary relationship opens a window out of the prison and, over time, invites the person stuck in the eating disorder to try stepping outside the cell to see what life might be like otherwise.
In the daylight, life is not sunshine and rainbows. Moving away from an eating disorder allows for opportunities to grow, learn and change many elements of life, but those changes can be painful and hard at times even if sometimes the results can be uplifting or exhilarating too.
The promise of a wonderful life at the end of recovery is not even close to the truth. The possibility for fulfillment and finding meaning is within one’s grasp without the eating disorder keeping that person in prison.
The primary therapeutic relationship allows for open conversation, time to explore emotions and thoughts and the option for true growth into a person no longer mired in disordered thoughts and behaviors and instead able to engage with the world.
The treatment world is increasingly filled with residential programs run like a mill, online treatment by anonymous clinicians and virtual work which allows both sides to hide behind a screen. As much as the increased access to care is necessary, the focus of treatment must remain on the clinical relationship. Trust and care are the bedrock of meaningful recovery. Openness and honesty allow for the personal growth needed to move away from complete reliance on an eating disorder.
I will continue to address the ways eating disorders and the treatment field change since these factors affect the process of recovery greatly. However, the fundamentals of treatment remain unchanged. A meaningful primary therapeutic relationship will always be the necessary foundation to get well.
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