Facilitating the Shift from Disorganized
Attachment to Secure Attachment, Utilizing
the Therapeutic Relationship as a Base with
Eating Disordered Clients
MEDA Conference, April 2009
Mark Schwartz, Sc.D.
Castlewood Treatment Center for Eating Disorders
800 Holland Road
636‐386‐6611
www.castlewoodtc.com
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Eating Disorder Patients’ Experience of
Recovery
• Realistic appraisal of medical dangers
•
Improvement in care of self (e.g. eating habits, use of
leisure time)
• New ways to self‐soothe, self‐regulate
• Ability to access social support from family, friends, and
fellow patients
• Enhanced problem solving skills
•
Improved capacity to invest in and work on interpersonal
relationships
• Gradual relinquishment of ED identity and eating disorder
thoughts (e.g. “this food will make me fat,” “I’ll feel better
after I eat this package of cookies, etc.)
Eating Disorder Patients’ Experience of
Recovery, cont.
• Ability to take responsibility for self and eschew victim
mentality
• Establishment of a sense of “true self,” “real me,” or
“knowing who I am.”
• Capacity to formulate goals, tolerate setbacks, yet
maintain positive motivation to get better.
• Reclamation of sense of one’s personal power.
• Decreased emphasis on perfectionism.
• Firmer interpersonal boundaries; enhanced capacitates
to set appropriate boundaries.
• Cultivation of sense of purpose, meaning of life.
How is Recovery Measured?
Recovery is not just the absence of symptoms…it is the presence of a full
life as evidenced by the ability to be human. A truly recovered life will
reflect spontaneity, freedom, the ability to breathe, to have wants, needs
and desires, knowing that the quest for perfection is an unattainable
illusion. Having the ability to embrace the feminine, having close intimate
relationships, and it is being aware of the tears in your eyes (whether out
of intense or subtle sadness – or out of the joy – or from a flicker of utter
gratefulness) and then to allow your tears to flow freely. It is a life in
which decis