Steiger H, Israël M
Eating Disorders Unit, Douglas Hospital, Verdun (Quebec), Canada.
J Clin Psychol. 1999 Jun;55(6):741-53. doi: 10.1002/(sici)1097-4679(199906)55:6<741::aid-jclp7>3.0.co;2-0.
Anorexia nervosa is a multiply determined syndrome, thought to require integrated, multimodal treatment. In this article, we discuss the place of psychodynamically inspired psychotherapy techniques in the treatment of Anorexia Nervosa, and attempt to provide a practical heuristic for the application of such techniques with anorexic clients. Our recommendations for therapy emphasize confrontation of interpersonal patterns arising within the therapeutic dyad and linkage of these patterns to parallel adaptations that structure the client's generalized patterns of coping and eating symptoms. Case vignettes, drawn from different clinical contexts, are used to illustrate dynamic themes that frequently emerge in psychotherapeutic work with anorexic clients, and techniques that use interactions that occur in the therapeutic relationship to (i) expose implicit metaphors between interpersonal adaptations and eating symptoms, and (ii) balance against the intensity of anorexic preoccupations.
神经性厌食症是一种由多种因素导致的综合征，被认为需要综合的多模式治疗。在本文中，我们讨论了受心理动力学启发的心理治疗技术在神经性厌食症治疗中的地位，并试图为在厌食症患者中应用此类技术提供一种实用的启发式方法。我们的治疗建议强调应对治疗二元组中出现的人际模式，并将这些模式与构成患者普遍应对模式和饮食症状的平行适应联系起来。从不同临床背景中选取的病例 vignettes 用于说明在与厌食症患者进行心理治疗工作中经常出现的动态主题，以及利用治疗关系中发生的互动的技术，以（i）揭示人际适应与饮食症状之间的隐含隐喻，以及（ii）平衡厌食症先入之见的强度。
