The Archetypes of Eating Disorders
I run a supervision group for clinicians working in the field of eating disorders with my good friend and colleague Laura Cipullo, who is a nutritionist. We created the group to be across disciplines, so it includes therapists, nutritionists, psychiatrists, and primary care physicians.
Each week, someone presents a case oriented from their area of expertise, and they can hear the perspectives of the case across disciplines. Professionally, it is one of the most rewarding things I have ever done.
I love teaching newer clinicians about areas of eating disorders that you can’t learn from a book and can only be learned by years of doing this work.
Learning from newer voices and different perspectives gives this work and career a new life. If you are in this group, I am so grateful for your vision, compassion, and commitment.
This past week I brought up the concept of Archetypes in eating disorders. What I mean by Archetype is the idea that there are different “types” of eating disorders that have consistent themes. I don’t mean different diagnoses, I mean how eating disorders look in the individuals they inhabit.
In many ways learning the Archetypes is like learning the language of the ED, becoming fluent so you don’t feel overwhelmed or confused by the power an ED wields.
One of our group members presented a patient that I categorized as the archetype of the “professional patient.” The professional patient is someone who has been in treatment for years and years. They know the ins and outs of various levels of care and can pretty much write their own treatment plans.
As a result, they become defined by their illness- fearful of giving it up because they question who they are without it.
There are seven or eight of these common archetypes. These personality types are manifestations of the way the eating disorder has convinced the sufferer that they require the ED to be successful.
To summarize a few:
Professional patient- without me you have no purpose.
Academic achiever- without me you would fail in school and in life.
Exceptionalist- without me you are basic and ordinary
Intellectualizer- without me you will have to feel your feelings and not just think your way out of them.
Eating Disorders (hijackers) find the Achilles heel of their hostages and exploit it. ED’s convince these patients that without them their lives would fall apart.
This frame is not a way to be reductive, if anything it is a way to demonstrate how consistent human beings are across the continuum.
The Archetypes tell us that we all worry about being successful, worthy, and desperately need love and attention. Our deepest fears are always connected to how we want to be seen in the world and the relationships we crave.
ED’s have found a way to tap into our biggest fears and needs and pretend to be a solution. A way to fix what we need, without having to express the need itself.
The work with ED’s and with ourselves is to identify our Archetypes. How do we feel successful, seen and loved?
Once we determine our archetype, go underneath it to discover the need that fuels it. Once we identify the very need that is primary for us, we can begin to articulate them.
There is very little in this world quite as healing as identifying our deepest need, saying it out loud, and having it be received and cared for.
Try it on. What is your Archetype? What is your deepest need or fear?
My Archetype is The Good Soldier. What is yours?
Write whatever comes to you below. ⬇️
