A psychodynamically informed, integrated psychotherapy for anorexia nervosa.

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.