Ambivalence

Treatment of eating disorders is characterized by ambivalence towards treatment and a lack of motivation to change. The anorexia nervosa patient perceives success and acknowledges the disorder and is even proud of her efforts to be thin. The need to lose weight is used to serve the self-image that is based on appearance and weight loss. The main source of gratification is weight loss, and everything is dwarfed by the satisfaction and pleasure of losing weight.

Opposing forces operate in an eating disorder. The desire to lose weight is so strong and becomes an uncontrollable urge, resulting in a cycle that makes it difficult to cooperate in treatment.

An anorexic patient only comes to treatment when she starts feeling exhausted or when the environment pressures her to get treatment. Sometimes a referral to treatment is only made after physical intervention or physical failure (for example, fainting or stopping menstruation).

Even the bulimic patients who come to treatment come from distress and frustration, resulting from the inability to lose weight and control eating out of disappointment, and wish to be successful anorexics.

Due to ambivalence to treatment, many patients drop out at different stages of treatment or are afraid to even start treatment when they realize that the goal is to generate change.

Irresponsiveness to treatment is common when physical recovery, weight and eating stabilization, and a menstrual cycle begin — signs that indicate that it is time to return to reality and integrate into society, which provoke anxiety and invite regression and recurrence to old habits. At this stage, a rehabilitation center can reduce anxiety from a place that eases the sharp transition to a normal and healthy life.

Within the protests, despite their ambivalence, they need to feel understood and cared for, so a neutral environment, such as a rehabilitation center that is cut off from an atmosphere of anger and stress, is effective for these patients and helps reduce oppositions.

Supportive Environment

An eating disorder does not usually arouse empathy. Many patients describe difficulties with their family and environment because of an eating disorder. The purpose of the rehabilitation center is to reduce friction with the family and caregivers, recognizing that she won’t be able to do it while on the battlefield of her immediate vicinity. The environment trying to comprehend the reason for the problem’s preservation is confronted with enormous challenges by girls with eating disorders. Common, non-offensive statements such as: “Just eat”; “Why don’t you taste the food I made especially for you”; “How long does it take you to finish a meal”, are perceived as profoundly offensive.

Emotional Regulation

Not eating is a tool used to regulate different feelings; the girl knows only one thing – the food (or lack thereof) calms this emotional mess. The patient does not think that powerful emotions can be felt without negating them. The very idea of having hard feelings is frightening. Weight gain anxiety is controlled by distorted eating habits such as cutting food into small pieces, absorbing it in napkins, or chewing several times. This provides relaxation and anxiety relief.