Types of group therapy for eating disorders treatment: psychodynamic group therapy

TYPES OF GROUP THERAPY FOR EATING DISORDERS TREATMENT: PSYCHODYNAMIC GROUP THERAPY

Asked to imagine group therapy, most people probably picture the "Bob Newhart" variety, in which a handful of colorful characters sit in a room and interact with each other. That's called interpersonal group therapy, and is one valid method. But group therapy comes in many forms, and groups operate in different ways. Some, for example, don't focus on eating behavior at all; others focus on eating exclusively.
Psychodynamic therapy helps the patient gain insight into her situation and works to bring about changes in her personality. This type of group offers patients the chance to express themselves and interact with others in a safe, supportive environment. Therapists in eating disorder groups often take a more active role than they do in other types of group therapy.
One goal of treatment is usually to help the patient identify and trust her feelings. Another goal is to improve her close relationships with other people. Conversation often focuses on family issues, such as problems with parents or siblings, responsibilities at home, and so on. Other common themes include:
• The sense of ineffectiveness
• Low self-esteem
• Anxiety
• Misperception of feelings
• Mistrust of others and of oneself
• Disturbances in body image
• Avoiding maturity
• Behavior that reinforces symptoms of the illness
Dr. Irving Yalom, a psychiatrist at Stanford University and a noted group-therapy expert, has shown that group therapy works partly because the issues that concern patients aren't just talked about as abstract theories, as may happen in individual therapy. Instead the issues are experienced firsthand, in the "here and now" of the therapeutic process itself.
Let me give an example. A seventeen-year-old anorexic named Terri had trouble keeping friends because, as a certified perfectionist, she couldn't tolerate the slightest personal shortcoming. She was always correcting other people's grammar or brushing lint off their clothes. Once, in a group session, she told a patient named Gail, "You can't say 'irregardless.' There's no such word."
"What's it to you?" Gail fired back. "Why does it bother you if I make a mistake?" Picking up on this exchange, we were then able to examine Terri's perfectionist attitude and how it affected her relationships-not in the outside world, but in that very room at that very moment.
One drawback to the psychodynamic method is that discussions may not give enough focus to symptomatic behavior. Poor eating habits that contribute to the illness may go unaddressed.

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