Discussion of "Eating disorders and attachment: a contemporary psychodynamic perspective:" does the attachment model of eating disorders indicate the need for psychodynamic treatment? 2014

Heather Thompson-Brenner
Heather Thompson-Brenner, Ph.D., Research Associate Professor, Boston University.

Tasca and Balfour have done admirable work highlighting the importance of attachment security in the psychopathology of eating disorders (EDs), and their contributions are extremely valuable. For their points to be fully appreciated by the research and treatment-research communities, additional data are needed in key areas. Research is needed to help clarify the relative roles and cause-and-effect relationships between attachment insecurity, reflective functioning, and emotion regulation in the development and maintenance of EDs. Tasca and Balfour furthermore call their model "psychodynamic," and call for psychodynamically informed treatment for patients with attachment insecurity. For this call to be heeded, additional research is needed to examine whether the unique elements of psychodynamic psychotherapy have particular benefit for patients with insecure attachment styles. The unique psychodynamic elements considered in this comment include a therapeutic focus on reflective functioning, the patient's developmental history, the "unconscious," and the transference and countertransference. The utility of a non-directive (or patient-directed) therapeutic process is also considered. Investigation of these treatment issues could be extremely useful to practitioners and patients alike.

UI MeSH Term Description Entries
D009769 Object Attachment Emotional attachment to someone or something in the environment. Bonding (Psychology),Bonds, Emotional,Emotional Bonds,Object Relations,Symbiotic Relations (Psychology),Bonding, Psychological,Object Relationship,Psychological Bonding,Attachment, Object,Attachments, Object,Bond, Emotional,Bondings (Psychology),Emotional Bond,Object Attachments,Object Relation,Object Relationships,Relation, Object,Relation, Symbiotic (Psychology),Relations, Object,Relations, Symbiotic (Psychology),Relationship, Object,Relationships, Object,Symbiotic Relation (Psychology)
D011572 Psychoanalysis The separation or resolution of the psyche into its constituent elements. The term has two separate meanings: 1. a procedure devised by Sigmund Freud, for investigating mental processes by means of free association, dream interpretation and interpretation of resistance and transference manifestations; and 2. a theory of psychology developed by Freud from his clinical experience with hysterical patients. (From Campbell, Psychiatric Dictionary, 1996). Psychodynamic Analysis,Analyses, Psychodynamic,Analysis, Psychodynamic,Psychodynamic Analyses
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001068 Feeding and Eating Disorders A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. Appetite Disorders,Eating Disorders,Eating and Feeding Disorders,Feeding Disorders,Appetite Disorder,Disorder, Eating,Disorder, Feeding,Disorders, Eating,Disorders, Feeding,Eating Disorder,Feeding Disorder
D064889 Psychotherapy, Psychodynamic Forms of PSYCHOTHERAPY falling within or deriving from the psychoanalytic tradition, that view individuals as reacting to unconscious forces (e.g., motivation, drive), that focus on processes of change and development, and that place a premium on self understanding and making meaning of what is unconscious. Psychodynamic Psychotherapies,Psychodynamic Psychotherapy,Psychotherapies, Psychodynamic

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