“It Takes a Village”: Concurrent Eating Disorder Treatment and the Multiperson Field

ABSTRACT

Patients with eating disorders often rely on dissociation, cordoning off parts of the self that come to reside in disconnected mind and body states. In this paper, I explore the use of the multidisciplinary treatment team as a vehicle for accessing, engaging and linking the patient’s dissociated self-states as they emerge within different therapeutic dyads. While it is common for therapists who work with eating disorders to collaborate with other clinicians, the team has not typically been viewed as playing a role in the psychoanalytic process. Through a detailed case illustration, I demonstrate some of the ways that the treatment team can help to provide multiple perspectives on the same patient, generating a rich multiperson field that enhances and augments the psychoanalytic work. I also discuss challenges that can arise in concurrent therapy situations.

This article is referred to by:

Linking Self-States in Eating Disordered Patients: Multiplicity in Multidisciplinary Teams

Alexithymia, Meaning-Making, and Management: Response to Novack

Notes

¹ While direction and limit-setting are necessary aspects of the management part of eating disorder work, this also became an important part of our transference-countertransference dynamic.

² Howell (2005) wrote that a trauma/dissociation model can help us understand psychotic-like symptoms such as unusual perceptions, flashbacks, and visual and auditory hallucinations as dissociative phenomena that are not indicative of schizophrenia or other psychotic disorders.

³ This also occurs between couples and individual therapists (Maltas, 1998), and in split treatments (Busch & Sandberg, 2007; Glick & Roose, 2006; Gould & Busch, 1998; Pilowsky & Bellinson, 1996).

Additional information

Notes on contributors

Danielle Novack

Danielle Novack, Ph.D., is a candidate at the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis. She is a Clinical Associate Supervisor for doctoral students at the New School for Social Research and is in private practice in Manhattan.