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 many years of clinical experience with individuals, families and groups in the field of eating disorders as well as in more general clinical practice.

Dr. Dean Kilian (011 442 6863)

B.A.(Witwatersrand), HonsB.A.(Applied Linguistics)(with distinction)(UNISA), M.Ed. (Educational Linguistics)(with distinction)(RAU), B.A. (Hons)(Applied Psychology)(with distinction), B.A.(Sp. & H. Th.), M.A.(Speech Pathology)(with distinction)(Witwatersrand), M.A. (Psychology)(with distinction) (RAU), D. Litt. et Phil. (Psychology)(UJ)

Dean is a clinical psychologist in private practice. He has many years of experience in working with eating disorders and addictions. He also completed his doctorate on intervention with eating disorders and addiction through art therapy. His experience in this field has been in working with clients who find themselves living with eating disorders and/or addiction, as well as working with their partners and families. He sees adolescents and adults. In addition to individual therapy, he occasionally offers group therapies and workshops.

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.