The Symbolic Separation of ED and Self in Narrative Therapy

The Symbolic Separation of ED and Self in Narrative Therapy

by Melissa O’Neill, LCSW, Director of Clinical Operations at Timberline Knolls 

An eating disorder is an all-consuming disease. It seeks to destroy a woman or girl’s body through the abuse of food. But equally important, yet unseen, is the disorder’s desire to consume her soul.
Over months or years, the individual abdicates more and more of herself to the illness. Eventually, she is completely defined by the disorder to the degree that she and the disease are one.
An important goal in therapy is to redefine the relationship, to separate the individual from the disorder and reestablish her power and control over her life.

Narrative therapy aims to externalize the eating disorder first by reassigning the disorder to an inanimate object, such as a hardcover book or even a coat rack. The person is then encouraged to confront the object (and disorder) directly—tell it how it has damaged her life, compromised her health, and hurt her relationships with family and friends. By labeling the disorder as a relentless, mean bully, she can ultimately challenge its right to be a part of her life.

This symbolic separation and straightforward confrontation is not just emotionally beneficial, it has profound cognitive value. In certain ways, the human brain is similar to a computer. If a specific keystroke creates a new document, it will always do so… until the computer is reprogrammed.

The brain also works in a default system. The distorted thoughts of a person with an eating disorder will continue to reinforce themselves as they repeatedly travel along the same neuro pathways. Yet neuroplasticity research has revealed that the brain is also highly flexible and resilient. It delights in establishing new pathways and discarding the old when they go unused. When a person intentionally creates new thoughts, the brain embraces these new connections. Repeating the mantra, “I am strong, I do not want you in my life anymore,” creates a new default. Commensurately, the previous default, “I love you, I cannot do anything without you in my life,” slowly fades away.

Establishing new thoughts in the form of neuro pathways, strengthening them through practice, repetition and active engagement leads to change. It is this tangible transformation that often proves the bedrock for true, sustainable recovery.



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