The Kildare Street Clinic Approach to Treatment
Recovering from an eating disorder is a process that can take time, therefore it is important to be patient with yourself. Part of the process of recovery is identifying both the negatives and positives of having an eating disorder and what important function your eating disorder is serving for you. As a result this can lead you to feel very ambivalent about your recovery i.e. you want to stop but at the same time don't want to, which can affect your motivation to change. This is a normal part of the recovery process.
Eating Disorders can develop from low self esteem and other underlying issues that can lead you to develop a negative body image and to evaluate yourself worth by your weight/shape. This can lead to controlling your weight through dieting, and other eating disorder behaviours such as obsessive exercising, vomiting, laxative use etc.
The initial goal of treatment is to normalize your eating patterns and develop coping strategies to control the bingeing/compensatory behaviours. As soon as your eating habits are normalized the next stage is to work on both your negative self image and weight related self evaluation while establishing what function your eating disorder serves for you e.g. escapism, stress release, avoidance of painful emotions. The last stage of recovery is to build your self esteem and to deal with any underlying issues that may have played a role in the development of your eating disorder. As you can see this is quite an undertaking, yet it highlights the seriousness of this condition. It is important to remember that small achievable goals can lead to major life changes.
Cognitive behavioural therapy is the most extensively used treatment for eating disorders. Research has shown that this approach does increase normal eating while reducing binge eating and compensatory behaviours. There is also evidence that suggests that beliefs/attitudes about weight and shape can be modified. Cognitive behaviour therapy (CBT) is based on the idea that behaviour, thoughts and feelings are learned, and can therefore be unlearned, or modified. Emotional disturbance is caused by distorted or irrational thinking patterns and that you can change how you feel by changing how you think.
Cognitive behaviour therapy (CBT) is a time-limited psychological therapy approach developed originally in the United States by Aaron Beck for the treatment of depression. Beck believed that the negative thinking characteristic of depressed people was not just a symptom but a diagnostic feature of the disorder, which had to be treated directly. This negative thinking might be triggered by life events such as the loss of a loved one, but arose from the activation of dysfunctional assumptions which were developed in childhood - for example, 'In order to be loved, I have to be perfect.'
The term 'dysfunctional assumption' is sometimes used interchangeably with the term 'schema', to describe the way in which a person organises his or her experience and perception of the world and which dictates the way he or she deals with new experiences. Dysfunctional assumptions are not necessarily the sole cause of a problem, but it is when events occur that drive us, because of our beliefs, to behave in dysfunctional ways that they become a problem.
The therapist helps the client to formulate problems in cognitive terms, and is constantly inviting feedback from the client to ensure that he/she feels understood and can learn to contribute jointly with the therapist to the treatment.
It is very much a problem-solving approach. Goals are set in behavioural terms and potential solutions are tested out in practice: clients are encouraged to explore options for change and evaluate outcomes by comparing progress with previous experience and hence are encouraged to take an objective, scientific, view of their problems. In this way, clients are taught, in theory, to become their own therapists and are thus prepared to deal with relapse and problems if and when they arise in the future.
Cognitive therapy also has a strong educational element. The basis of therapy is to teach clients about the cognitive conceptualisation of their disorder and about the nature of their disorder in general, so that they have the tools to protect themselves from more serious problems and are motivated to aim for change. In the case of anorexia, this means, in addition, teaching about the physical consequences of the disorder and of abnormal eating behaviours and of any attempt to make changes. It also means teaching the principles of normal eating behaviour and nutrition.
The use of a cognitive therapy approach makes it feasible to directly explore and question common assumptions about the importance of weight and shape. Having aired these assumptions, clients can decide whether they wish to continue to espouse them, modify them, or replace them with alternative ones.
At a deeper level too, the approach makes it feasible to address more personal issues regarding self-worth. So, while the therapy takes on board the task of tackling individual assumptions about the importance of weight and shape, it also challenges underlying core beliefs about the personal identity of sufferers.
Cognitive behaviour therapy, because of its collaborative stance, also lends itself well to the treatment of people at different stages of readiness to change. There is continuous checking back with the client about understanding, about acceptance of the rationale for therapy, about readiness to try out suggested homework tasks, and even about the agenda set for the session. When motivation is itself a problem, this becomes the focus of therapy. Clients might be asked to weigh up advantages and disadvantages of particular courses of action in an attempt to uncover attitudes underlying an unwillingness to change. This process can itself help to tip the balance towards motivation for change.
The cost of this session is E90.
The ongoing cost of treatment is E80 per hourly session.
