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Chapter 15 - Schema Therapy for Eating Disorders

from Part III - Applications and Adaptations for Mental Health Presentations

Published online by Cambridge University Press:  27 July 2023

Robert N. Brockman
Affiliation:
Australian Catholic University
Susan Simpson
Affiliation:
NHS Forth Valley and University of South Australia
Christopher Hayes
Affiliation:
Schema Therapy Institute Australia
Remco van der Wijngaart
Affiliation:
International Society of Schema Therapy
Matthew Smout
Affiliation:
University of South Australia
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Summary

This chapter illustrates the complex functions that eating disorder behaviour can take, including self-punishment, emotional avoidance, empowerment, mastery, self-regulation, and appeasement of others. The schema therapy approach encourages disaggregating these functions, personifying them, understanding them, and directing dialogues between them. A case study illustrates the way in which the schema mode model can be applied to work with eating disorder symptoms alongside complex trauma. A sufficient level of medical and nutritional stability (as indicated by blood tests and weight) must be reached in order to provide sufficient safety for therapy to proceed. A key component of schema therapy is to understand the unmet needs and schemas that have led to the development of an eating disorder. In schema therapy, the client gradually learns to reconnect with her/his inner child states and needs through extensive therapeutic work – which includes imagery rescripting, chairwork mode dialogues, and somatic, cognitive, and behavioural techniques. Coping modes are not just bypassed, but through imagery and chairwork are actively acknowledged and integrated to form a Healthy Adult ‘team’ that works to prioritise the inner child modes and ultimately meet the client’s nutritional, physiological, and emotional needs.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2023

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References

References

Simpson, S, Smith, E. Schema therapy for eating disorders: Theory and practice for individual and group settings. Routledge; 2019.CrossRefGoogle Scholar

Further Reading

Edwards, D. An interpretative phenomenological analysis of schema modes in a single case of anorexia nervosa: Part 1. Background, method, and child and parent Modes. Indo-Pacific Journal of Phenomenology. 2017;17(1):113.Google Scholar
Edwards, DJ. An interpretative phenomenological analysis of schema modes in a single case of anorexia nervosa: Part 2. Coping modes, healthy adult mode, superordinate themes, and implications for research and practice. Indo-Pacific Journal of Phenomenology. 2017;17(1):112.Google Scholar
McIntosh, VV, Jordan, J, Carter, JD, et al. Psychotherapy for transdiagnostic binge eating: A randomized controlled trial of cognitive-behavioural therapy, appetite-focused cognitive-behavioural therapy, and schema therapy. Psychiatry Research. 2016;240:412–20.CrossRefGoogle ScholarPubMed
Pugh, M. A narrative review of schemas and schema therapy outcomes in the eating disorders. Clinical Psychology Review. 2015; 39:3041.CrossRefGoogle ScholarPubMed
Simpson, S. Schema therapy for eating disorders: A case study illustration of the mode approach. In van Vreekswijk, M, Broersen, J, Nadort, M, eds. The Wiley-Blackwell handbook of schema therapy. Wiley-Blackwell 2012, pp. 4371.Google Scholar
Simpson, SG, Morrow, E, Reid, C. Group schema therapy for eating disorders: a pilot study. Frontiers in Psychology. 2010;1:182.Google Scholar
Simpson, SG, Slowey, L. Video therapy for atypical eating disorder and obesity: A case study. Clinical Practice and Epidemiology in Mental Health. 2011;7:3843.CrossRefGoogle ScholarPubMed
Waller, G, Kennerley, H, Ohanian, V. Schema-focused cognitive-behavioural therapy for eating disorders. In Rodin, J, du Toit, PL, Stein, DJ, Young, JE, eds. Cognitive schemas and core beliefs in psychological problems: A scientist-practitioner guide. American Psychological Association; 2007.Google Scholar

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