I'm having an interesting conversation with a clinician.
I told her that I think of active restriction/bingeing/purging as I would shooting heroin: therapy is inappropriate while high. She found that a provocative idea.
I said I wished therapists would refuse to engage in ongoing therapy with a patient who is actively 'using,' and she felt that was wrong: that very useful therapy can go on without weight restoration.
This is probably a matter of emphasis between us. She's a therapist whose tools are rapport and building insight in patients.
I'm a parent. I saw first-hand that our daughter displayed lots of insight even when entirely unable to sustain herself nutritionally. Insight didn't help her. And I saw how full nutrition alone brought her reasoning to a place where her insights were in line with her actions - and to a place she engaged quite successfully in therapy.
I'm curious: parents, do you find it provocative to suggest that therapy in the absence of nutritional rehabilitation is like doing therapy while high?
What role did insight have in your loved one's recovery?