Skip to main content

Specific Challenges Working with Eating Disorders

Minding the Embodied Mind and the Minded Body

  • Chapter
  • First Online:
Hunger

Abstract

Which specific competences should the MBT-ED therapist have? As stated numerous times, mentalization-based therapy (MBT) was originally developed for borderline personality disorders. The pivotal question is in what way should therapeutic approaches originally developed for borderline patients be modified to be optimal for persons with different subtypes of eating disorders? This chapter presents those additional therapist competences in detail. And, we stress the necessity of at the same time working with reduction of symptoms and promoting mentalizing. MBT-ED is a double-focused therapy: mind and bodily behaviour and symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 99.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Allen JG (2008) Psychotherapy: the artful use of science. Smith Coll Stud Soc Work 78(2–3):159–187

    Article  Google Scholar 

  • Allen JG (2012) Restoring mentalizing in attachment relationships. Treating trauma with plain old therapy. American Psychiatric Publishing, London

    Google Scholar 

  • annafreud.org (2018) A quality manual for MBT. Quality assurance and training document. http://www.annafreud.org/media/1217/a-quality-manual-for-mbt-edited-april-23rd-2014-2.pdf

  • Bateman A, Fonagy P (2012) Handbook of mentalizing in mental health practice. American Psychiatric Association, Arlington, VA

    Google Scholar 

  • Bateman A, Fonagy P (2016) Mentalization based treatment for personality disorders: a practical guide. Oxford University Press, Oxford

    Book  Google Scholar 

  • Bruch H (1973) Eating disorders. Obesity, anorexia nervosa, and the person within. Basic Books, New York

    Google Scholar 

  • Campbell M (2009) Drop-out from treatment for the eating disorders: a problem for clinicians and researchers. Eur Eat Disord Rev 17:239

    Article  Google Scholar 

  • Cochrane C, Brewerton TD, Wilson DB, Hodges EL (1993) Alexithymia in the eating disorders. Int J Eat Disord 14(2):219–222

    Article  CAS  Google Scholar 

  • Duesund L, Skårderud F (2003) Use the body and forget the body: treating anorexia nervosa with adapted physical exercise. Clin Child Psychol Psychiatry 8(1):53–72

    Article  Google Scholar 

  • Espeset EM, Gulliksen KS, Nordbo RH, Skårderud F, Holte A (2012) Fluctuations of body images in anorexia nervosa: patients’ perception of contextual triggers. Clin Psychol Psychother 19(6):518–530. https://doi.org/10.1002/cpp.760

    Article  PubMed  Google Scholar 

  • Fox JR, Power MJ (2009) Eating disorders and multi-level models of emotion: an integrated model. Clin Psychol Psychother 16:240–267

    Article  Google Scholar 

  • Geller J, Srikameswaran S (2006) Treatment non-negotiables: why we need them and how to make them work. Eur Eat Disord Rev 14(4):212–217

    Article  Google Scholar 

  • Gulliksen KS, Espeset EMS, Nordbø RHS, Skårderud F, Geller J, Holte A (2012) Preferred therapist characteristics in treatment of anorexia nervosa: the patient’s perspective. Int J Eat Disord 45:932–941

    Article  Google Scholar 

  • Higbed L, Fox JR (2010) Illness perceptions in anorexia nervosa: a qualitative investigation. Br J Clin Psychol 49(Pt 3):307–325. https://doi.org/10.1348/014466509x454598

    Article  PubMed  Google Scholar 

  • Kazdin AE (2004) Psychotherapy for children and adolescents. In: Lambert M (ed) Bergin and Garfieds’s handbook of psychotherapy and behavior change. Wiley, New York, pp 543–589

    Google Scholar 

  • Luyten P, Vliegen N, Blatt SJ (2008) Equifinality, multifinality, and the rediscovery of the importance of early experiences: pathways from early adversity to psychiatric and (functional) somatic disorders. Psychoanal Study Child 63:27–60

    Article  Google Scholar 

  • Merleau-Ponty M (1962) The phenomenology of perception. Routledge and Kegan Paul, London

    Google Scholar 

  • Nordbø RH, Espeset EM, Gulliksen KS, Skårderud F, Holte A (2006) The meaning of self-starvation: qualitative study of patients’ perception of anorexia nervosa. Int J Eat Disord 39(7):556–564. https://doi.org/10.1002/eat.20276

    Article  PubMed  Google Scholar 

  • Ogden T (1995) Analysing forms of aliveness and deadness of the transference-countertransference. Int J Psychoanal 76:695–709

    PubMed  Google Scholar 

  • Palazzoli MS (1971) Anorexia nervosa. In: Ariete S (ed) The world biennial of psychiatry and psychotherapy, vol 1. Basic Books, New York, pp 197–218

    Google Scholar 

  • Palazzoli MS (1974) Self starvation. Chaucer, London

    Google Scholar 

  • Robinson PH, Kukucska R, Guidetti G, Leavey G (2015) Severe and enduring anorexia nervosa (SEED-AN): a qualitative study of patients with 20+ years of anorexia nervosa. Eur Eat Disord Rev 23(4):318–326. https://doi.org/10.1002/erv.2367

    Article  Google Scholar 

  • Robinson P, Hellier J, Barrett B, Barzdaitiene D, Bateman A, Bogaardt A, Clare A, Somers N, O’Callaghan A, Goldsmith K, Kern N, Schmidt U, Morando S, Ouellet-Courtois C, Roberts A, Skårderud F, Fonagy P (2016) The NOURISHED randomised controlled trial comparing mentalization based treatment for eating disorder (MBT-ED) with specialist supportive clinical management (SSCM-ED) for patients with eating disorders and symptoms of borderline personality disorder (BPD). BMC Trials 17:549. https://doi.org/10.1186/s13063-016-1606-8

    Article  Google Scholar 

  • Sifneos P, Apfel-Savitz R, Frankel FH (1977) The phenomenon of alexithymia. Psychother Psychosom 28:193–198

    Article  Google Scholar 

  • Skårderud F (2007) Shame and pride in anorexia nervosa: a qualitative descriptive study. Eur Eat Disord Rev 15(2):81–97. https://doi.org/10.1002/erv.774

    Article  PubMed  Google Scholar 

  • Skårderud F, Fonagy P (2012) Eating disorders. In: Bateman A, Fonagy P (eds) Handbook of mentalizing in mental health practice. American Psychiatric Publishing Inc, Arlington, VA, pp 347–384

    Google Scholar 

  • Strober M (2004) Managing the chronic, treatment-resistant patient with anorexia nervosa. Int J Eat Disord 36:245–255

    Article  Google Scholar 

  • Taylor GJ, Bagby RM, Parker JDA (1997) Disorders of affect regulation. Alexithymia in medical and psychiatric illness. Cambridge University Press, Cambridge

    Book  Google Scholar 

  • Vandereycken W, Devidt K (2010) Why do patients drop out of therapy? Eat Disord Rev 21(2):140–147

    Article  Google Scholar 

  • Winnicot DW (1971) Playing and reality. Tavistock, London

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Robinson, P., Skårderud, F., Sommerfeldt, B. (2019). Specific Challenges Working with Eating Disorders. In: Hunger. Springer, Cham. https://doi.org/10.1007/978-3-319-95121-8_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-95121-8_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-95119-5

  • Online ISBN: 978-3-319-95121-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics