Book Review: Treating the Eating Disorder Self

Treating the Eating Disorder Self, by Mary Anne Cohen, NASW Press, ISBN 9780871015501, 2020, 236 pages, paperback $32.99, ePub $28.00.

    It may appear incongruous to describe a book so thorough, useful, and full of client stories as charming, but that descriptor is the one that kept coming back to me.

    This book’s charm lies in the author’s ability to help us understand the dynamics of eating disorders and in her ability to, at the same time, give us a peek inside the lives, hopes, dreams, and horrors of the lives of her patients.

    It’s also an exceedingly thorough volume, providing not only therapeutic techniques, but also much needed information regarding the multi-cultural aspects of eating disorders, a perspective on gender and sexual identity, and an examination of social media and the place it sometimes holds in this “skinny or die” culture. The detailed attention to so many elements of life makes this such a richly rewarding read.

    The section on assessment, presented with specific steps to take, from (1) Your Present Situation to (9) Special Treatment Issues is worth the price of the book. The steps the author outlines in this section are clear, concise, and presented with many client examples. Taken together, they provide the therapist with a roadmap to successful work with the eating disordered client.

    There is also charm in the author’s (successful) attempts at humor. In one instance, she describes a patient with an overwhelming attraction to shoes, describes the link to eating disorders as she sees it and opines that while the patient may not have found a soul mate, she appears to have found sole mates. There are many such examples of the use of humor, and the author suggests that playful humor can bring client and therapist together in a unique way, especially if the therapist is also willing to be the butt of the joke.

    The author is not a fan of telehealth for the treatment of eating disorders and says that online sessions should not be considered best practice. She makes a thorough and well thought out argument. My concern is for the many who may seek out therapy for an eating disorder only to find the help sought is too far away or only available at limited times. I worry that the message then might be, “Your needs are not my concern,” or “You’re too much trouble.” Because this author has done such an outstanding job of helping us to realize that this may be the message most consistently delivered to the eating disordered self, perhaps we could look to ways to improve the delivery of distance therapy for eating disorders, rather than discounting it out of hand.  

Reviewed by Nancy Keeton, PhD, LCSW, Clinical Diplomate, Professor of Social Work, Brescia University, Owensboro, Kentucky.