» Life Topics » Weight Management
Reconnecting with Your True Self: The No-Resistance Method of Treating Eating Disorders
By: By Meghan Vivo
Eating disorder sufferers are one of the most challenging populations to treat. For one, eating disorders have the highest mortality rate of any mental illness, as well as one of the highest rates of relapse. In addition, eating disorder sufferers are generally highly intelligent and fastidious, with a strong tendency to resist treatment.
“Eating disorders are so consuming that victims do everything they can to avoid treatment,” says Barbara Cole, MFT, Psy.D., clinical director at The Victorian of Newport Beach, a world-renowned facility for the treatment of women with eating disorders and co-occurring substance abuse issues in southern California. “A single patient can tie up every doctor, therapist, and staff member in a pretzel knot, hoping that by turning staff on each other they will no longer focus on the disorder, and the person can avoid getting help.”
Despite the challenges, eating disorder sufferers are also one of the most inspiring populations to treat, says Dr. Cole. “These are high-functioning, charming, intelligent, wonderful women whose best traits have been covered up by their disorder,” she says. “It is my job to bring back their true self and systematically diminish the voice of the eating disorder.”
After her first interaction over lunch with a group of women with eating disorders, Dr. Cole was determined to help those suffering from these life-threatening conditions. “When you work with clients to improve social interactions or overcome other mental health issues, the results are hard to quantify,” she says. “But the results are tangible with eating disorder sufferers – if I’m doing well, they’re living; if I’m not doing well, they’re dying. It can happen that quickly.”
Why Resistance Fails
The challenge of treating a condition as complex as an eating disorder is compounded by the fact that there is little consensus among mental health professionals as to the most effective treatment method.
Dr. Cole’s “no-resistance method” of treating eating disorders is a blend of five other theoretical constructs that have been proven to work with eating disorders. A practitioner in the fields of eating disorders and chemical dependency for many years and an author of numerous texts on the subject, Dr. Cole founded her treatment method on the principle that effective treatment goes with the client’s resistance, not against.
“I believe resistance is there for a reason – we are not trying to squash or punish it,” states Dr. Cole. “In fact, we welcome resistance and use it as a tool to determine the issues the eating disorder sufferer needs to address.”
People with eating disorders are often resistant to the logic and common sense thinking of family, friends, and treatment professionals. Their resistance may assume the form of illogical arguments, the false appearance of cooperation, or many others, but is always designed to justify the continuing existence of their disorder.
“Eating disorder sufferers try to push away the support they’re being offered in order to confirm their belief that they’re not worth helping,” explains Dr. Cole. “They often try to aggravate their loved ones until they give up on offering help, and their treatment team until they get kicked out of a program.”
The no-resistance method asks the victim’s treatment team to respond to these forms of resistance with non-confrontational, nurturing, and gentle support that is centered on strong therapeutic relationships. “The treatment team must do the opposite of what is expected – that is, work as a team to stay patient and united in continuing to offer endless nurturing and support,” says Dr. Cole.
The alternative approach, resisting against the eating disorder with discipline and rigidity, engages the victim in a futile confrontation. “If you get into a battle of the wills with someone with an eating disorder, you’re going to lose every time,” Dr. Cole advises. “They have all of the power – all they have to do is restrict a calorie or purge in order to win. No matter how smart, educated, and determined you are, their eating disorder will outsmart you.”
Fighting Fire with Fire
Rather than approaching treatment from an angle that makes sense to family, friends, or the treatment provider, Dr. Cole believes the treatment team must individually and collectively speak the language of the eating disorder.
“It’s hard for people with eating disorders to talk about a silent disease in their heads,” she says. “At The Victorian, we give them a language to explain what is happening to them, and teach the same language to the victim’s loved ones so that they can understand and support the process of recovery.”
By meeting the eating disorder sufferer where she currently is mentally and emotionally, it is possible to make treatment directly relevant to her and get her invested in her own healing process. Early on, Dr. Cole finds out what led the client to seek treatment and starts from that point, so that treatment specifically and immediately addresses the issues relevant in the victim’s life.
“The no-resistance method goes against the ‘I’m the doctor, you’re the patient’ philosophy or the related ‘I’m the parent, you are my child’ approach,” notes Dr. Cole. “We’re doing something the client has never experienced before. In the no-resistance method, the client comes up with the solution and the drive to heal herself. That way, the motivation and ability to heal lasts even when formal treatment ends.”
The malnourishment that often accompanies eating disorders causes concrete or “black or white” thinking, which attracts eating disorder sufferers to facts and figures like weight, clothing size, fat grams, and calories. One technique used by Dr. Cole and the staff at The Victorian is to “fight fire with fire” by asking the client to assess her disorder in equally concrete terms. The staff asks each woman to assign a percentage for how much of her mind represents her “true self” and how much has been taken over by her eating disorder so she can evaluate how well she is doing.
“The goal is to get them one percent closer to their true self each day,” says Dr. Cole. “In this way, we become the allies of the true self and the enemy of the eating disordered mind.”
The Path to Recovery
Eating disorders are life or death conditions, but the good news is that at The Victorian, most women do recover. The Victorian is not a punitive program – the patient and empathetic staff of eating disorder specialists works to show each client that she is valued, supported, and worthwhile, and to help the women learn to live with integrity and accountability.
“I am constantly amazed by how good these women are at healing, despite being up against one of the deadliest diseases,” says Dr. Cole. “The power to heal lies in the woman herself – she walks in our front door with it, and she leaves with it. We’re simply here to nurture her true self and support the healing process.”
The women receiving treatment at The Victorian spend time with Dr. Cole each week reading her book The Eating Disorder Solution and learning about the program’s treatment philosophy. The ladies learn to prepare their own food with the support and supervision of staff, and follow a meal plan they create in concert with a nutritionist. After primary treatment ends, clients are encouraged to participate in The Victorian’s extended care program, which allows them to remain in treatment while working, going to school, and accepting more responsibility for taking care of themselves.
“The right treatment can fill the hole in the eating disorder sufferer’s soul and return her to health,” says Dr. Cole. “Many of our former clients stay in touch through our alumni community, some graduate with advanced degrees in psychology and other fields, and some come back to help other women suffering from these disorders. They have fabulous careers and lives, and are now living in accordance with who they really are.”
Link: Find a Therapist
Take a test:
See also:
|
 |
 |
|
