Treating Eating Disorders at Midlife and Beyond: Help, Hope, and Relational-Cultural Theory
Just published at the Wellesley Centers For Women, Stone Center, Wellesley, MA.
Treating Eating Disorders At Midlife and Beyond: Help, Hope, and Relational-Cultural Theory
Authors: Karen L. Samuels, Ph.D. & Margo D. Maine, Ph.D, FAED, CEDS
Although research is scarce, increasing numbers of midlife and older women are seeking eating disorders treatment, despite prevailing beliefs that these conditions only affect the young. Body satisfaction used to increase with age, but today 65 percent of midlife women express significant weight preoccupation and distress over their shape, appearance, and diet, threatening the health, wellbeing, and status of women across the globe. Many adult women hide their disorder effectively; others may have years of semi-recovery or subclinical symptoms, with the multiple stressors and transitions of midlife triggering relapse. Ashamed, embarrassed, and ambivalent about seeking help, midlife women face more obstacles to treatment due to other responsibilities and commitments. Motivation for recovery is also more complex, as midlife women bring increased knowledge from life experiences and long to release themselves from their eating disorder identity. This paper explores the Relational-Cultural Theory of growth fostering relationships and mutuality as keys to recovery for adult women. RCT understands eating disorders as strategies of disconnection resulting in chronic isolation from meaningful engagement with themselves, their bodies’ needs, and their relationships. Many adults come into therapy acknowledging their eating disorder no longer works for them, but doubt they can recover after decades of suffering or poor response to other treatments. RCT examines the meaning and function of the eating disorder through the lens of these adult relationships, distinct from the objectification of the medical model. The concept of fluid expertise (Jordan, 2010) values that both client and clinician bring wisdom and knowledge to build upon mutual understanding of these disorders and create new pathways towards recovery.