Beginning to overcome eating issues

Since so many felllow practitioners ask for my advice, I thought it migh be interesting - and, ideally, helpful - to share some of the ways I work with people who have eating and body issues. 

I've been working with a client recently, suffering with long term anorexia, who has 'overcome it' in that she does eat enough to maintain her weight, but she recognises, despite going through CBT, that her thinking around food is still not 'normal' and that her anxiety also spills into other areas - hypochondria for one.  My strategy is to get her to do the opposite of what she has done to date.  In other words, forget about the food.  We have agreed, since she is safely maintaining weight and has the 'all clear' from her GP and the eating disorder team, our task is to get her to focus her mind on other aspects of life. 

This is the way I work with any eating or body related issue - and some clients are surprised and think it won't be possible at first (but soon discover it is not only possible but liberating).  I rationalise that it is not normal to think about food all the time, that food is and should be a side issue - enjoyable,  ideally, but NOT the main event in life.  In my view, repeated discussion of what  is being eaten/ how/when/what feelings occur before/during/after,  only serves to (pardon the pun) feed the problem (whateve the eating issue is - and it could as easily be binge-eating) by encouraging a continued focus on the very thing which preoccoupies a huge amount of 'headspace'. 

Our job - as client and therapist -  is to expand the opportunity to a)think about, b) talk about, c)do things unrelated to food, which are enjoyable in some way.  In short, to encourage positive thinking - but providing tools and strategies to make that a more common feature of daily life.  The purpose is to encourage a trickle of positive feeling and, encourage it, in time, to develop - call it ripple effect, butterfly effect or just momentum.  The more we can expand this good feeling, the more we are shifting focus towards what works and away from what doesn't work; and the surprising changes begin to happen in relation to eating and body awareness.

And, as evidence of this, the lady in question made a major breakthrough just last week - after three sessions of focussing attention on other aspects of life plus her personal efforts to continue that work away from the consulting room, she described how she had decided to stand naked in front of a full length mirror (the first time in a long time) and had been HAPPY with what she saw.