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How Does Psychotherapy for Anorexia Work?

written by: Carma Haley Shoemaker • edited by: Paul Arnold • updated: 5/18/2011

Anorexia is usually treated with some form of psychotherapy. Different approaches may work better than others. Psychiatry magazine states, “Almost every type of psychotherapy has been used on anorexic patients...” Find out information on the most common types in this article.

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    Treatment for anorexia is often a difficult, time consuming, and long process. A person is not able to overcome an eating disorder in a week, or even a month. There is no catchall treatment, and not everyone will have the same type of success. It's important to obtain information on all the methods available.

    The most common and effective treatment for anorexia is psychotherapy. There are various methods of psychotherapy for anorexia. The most utilized are individual and/or group therapy.

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    Individual Therapy

    Individual psychotherapy for anorexia aims to address the how and why of the eating disorder, as well as what influences it - the stressors, feelings, and thoughts that continue to contribute to the anorexic behaviors. Those utilizing individual therapy will learn to identify negative feelings and emotions as well as being taught how to express emotions in appropriate ways – even those that may cause feelings of discomfort or pain.

    They will also be told how to identify when assistance is needed and how to ask for it, and they will learn how to embrace their own talents and strengths to help improve self-esteem. Those seeking this type of therapy for anorexia will be given alternative coping skills to replace anorexic behaviors.

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    How it works and Benefits

    When a person uses individual psychotherapy for anorexia, they succeed by discovering what was driving their disorder, and finding tools and methods to replace the negative and dangerous behaviors the disorder prompted. The anorexic is given the information they need for proper eating schedules and methods, food choices, and how to enjoy food. In addition, anorexics learn new thought processes and patterns to replace and restructure their perfectionist thinking and constant competitiveness.

    Benefits

    Anorexics have a distorted body image and faulty thinking regarding food, eating, exercise, as well as an extremely poor self-esteem. One of the benefits of individual therapy for anorexia is the one-on-one attention that it offers. The therapist is able to keep the focus on the anorexic and not allow others to interfere or interject during therapy sessions. In addition, as anorexics tend to be very secretive and non-trusting, building a relationship with the therapist is more likely in a one-on-one situation.

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    Group Therapy

    Another option when seeking psychotherapy for anorexia treatment is group therapy. Group therapies differ depending on the type of group, group focus, members, and the amount of participation each group requires. Some groups are mixed gender while others only allow females or males. Groups may meet once a month, once a week, or several times a week. There are groups that are made up of strictly anorexics, but most eating disorder groups consist of a mixed membership – those suffering from anorexia, as well as bulimia, binge eating, or other disorders. While some groups may allow members to remain silent if they wish (at least for a period of time), most groups require some level of participation. In fact, many groups offer assignments for members to do on their own between meeting times. These assignments may be reading, journaling, or some type of project to be shared at the next group meeting.

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    How it works

    How group therapy works depends on the type of group it is. There are several common types of group methods used for group therapy treatment.

    Self-Help Groups

    While these may not be considered a “traditional” form of group therapy, they are becoming more popular and common, as they are usually led by former members who are currently successfully living without eating disorder behaviors. These types of groups often view eating disorders as a type of addiction and may require an increased level of member participation.

    Cognitive Behavioral Therapy Groups

    Cognitive Behavioral Therapy (CBT) groups stress replacing the negative thoughts and feelings of the eating disorder. Members are required to monitor their thoughts, feelings, behaviors, current body image, and weight, as these things are required in order to understand and overcome the eating disorder.

    Psycho Education Groups

    Groups that use psycho education as their method of treatment are highly structured and operate off a set format. Speakers discuss designated topics in a lecture-type format, followed by a question and answer session led by the group leader. Members are asked to take part in the Q&A sessions, as well as complete reading and homework assignments prior to each meeting.

    Psychodynamic or Interpersonal Groups

    Based on the idea of an “intra and interpersonal conflict” being the cause of the eating disorder, these types of groups work to improve underlying issues such as self-esteem, expression of emotions, communication, highlighting of talents and attributes, and accepting flaws and weaknesses.

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    Benefits

    The benefits of group psychotherapy for anorexia treatment include:

    • Anorexics learning they are not alone,
    • Support, and acceptance
    • Anorexics learn compassion and empathy for themselves and others
    • Interpersonal skills
    • Friendship
    • Confrontation of unhealthy behaviors

    In addition, group therapy offers anorexic patients certain curative factors they may not find or receive, except from other anorexics, such as validation from other group members, models of coping, peer feedback, and a positive model to show how active participation in the treatment process can work.

    Worth Noting

    According to Bridget Engel, Psy.D., Natalie Staats Reiss, Ph.D., and Mark Dombeck, of MentalHelp.net, anorexics have more success, a better chance of recovery, and a reduce risk of relapse when their therapy is completed using individual or mixed group sessions. Due to the highly competitive nature and distrust of anorexics, they tend to compare themselves to others around them, and often will compete to be the thinnest. Anorexics often benefit from a mixed group setting because they feel less threatened when comparing themselves to more “average-weight” bulimics.

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    Resources

    Engel, Bridget, Psy.D., Staats Reiss, Natalie, Ph.D., and Dombeck, Mark. MentalHelp.net. Eating Disorder Professional Treatment. (February 2007). Retrieved from http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=11766&cn=46 January 6, 2011.

    Vanderbilt University. Psychology Department. Cognitive Behavior Therapy. (February 2009). Retrieved from http://www.vanderbilt.edu/AnS/psychology/health_psychology/anorex_cogther.htm January 6, 2011.

    The New York Times. Health Guide. In-Depth Report: Psychotherapy. Anorexia Nervosa. (February 2010). Retrieved from http://health.nytimes.com/health/guides/disease/anorexia-nervosa/psychotherapy.html January 6, 2011.

    Yager, Joel (1994). Psychosocial Treatments for Eating Disorders. Psychiatry. 57: 153-168.