Psychotherapy

Background

Mandy Florence (082 461 8470)

MA Clin Psych (Wits)

Mandy Florence, a clinical psychologist who has worked in the Tara Eating Disorders and Adolescent Unit and for the Crescent Clinic Eating Disorders Unit as well as in private practice. She has 6 years of clinical experience with individuals, families and groups in the field of eating disorders.

Dean Kilian (011 442 6863)

Dean Kilian (011 442-6863)
M.Ed. (RAU) M.A. (Speech Pathology) (Witwatersrand) M.A.(Psych) (RAU) D. Litt et Phil (Psych) (UJ)

Dean Kilian is a clinical psychologist in private practice. He has 4 years of clinical experience with individuals and their families in the area of eating disorders. He sees individuals with eating disorders and also offers
family therapy and support for partners of people who have eating disorders.

How therapy works

Psychotherapy with eating disordered patients involves providing education, insight, and a corrective emotional experience, allowing the patient to rectify faulty thought patterns, fill in developmental deficits and internalise missing psychological functions. In individual psychotherapy it is the relationship between the patient and the therapist, rather than any specific technique that is most healing. The therapist lends his/her ego and self organisation, capacity to anticipate, to delay gratification, to use sound judgment, to relate to another, to regulate tension and moods, and to integrate, feelings thoughts and behaviour. Once patients have internalised these abilities, they no longer need to use self destructive measures (e.g. eating disorder behaviours) to meet needs or provide important psychological functions.

Themes in therapy

The following are some examples of topics dealt with in individual therapy sessions:

Poor self esteem/diminished self worth

On the surface, many patients present a self to others that looks very together and self confident but in therapy admit that there is an emptiness in them and that they feel insignificant and unworthy.

Feelings of emptiness/need for distraction

Therapy can help patients learn how to address and deal with original problems that cause feelings of depression and emptiness. Sometimes, however, patient need to learn cognitive ways of changing their behaviour, such as challenging "black and while" thinking.

Desire for attention and to be special or unique

Giving up the eating disorder can make the patient feel anxious that they have nothing to take its place or that their need for love, attention and understanding will no longer be acknowledged. Therapy helps the patient to learn to express their needs more openly and to find other ways to feel special.

Need for power and control

Eating disorders can become ways to express and assert power and control over others when the patient struggles to assert herself and her wishes in balanced ways. This can happen as a result of a deep feeling of inadequacy and helplessness in the patient's life.