Essstörung

In this article we provide a detailed outline of a method to evaluate and treat patients with severe behavioural disorders such as eating disorders and addictions. After reviewing 3 major categories of clients with these disorders, we outline a treatment approach based on Davanloo's ISTDP for patients with fragile character structure. This new metapsychology elucidated through extensive case-based research can help the therapist explain and handle the common problems observed when these clients give up various behavioural mechanisms. If the upsurge in emotions is not understood and handled, adverse effects and high rates of drop out can ensue: on the other hand using the ISTDP framework, these events can be turned into therapeutic events accelerating growth and healing processes. A detailed approach to capacity building in patients with fragile character structure is provided as these cases are very common and challenging to treat. This review is particularly applicable to those working in day programs and hospital based programs for behaviour disordered clients.