The role of emotional abuse in the eating disorders: implications for treatment

This paper addresses the clinical links between emotional abuse and the eating disorders. It is argued that the core feature of a range of abusive experiences is emotional invalidation. Emotional abuse is associated with problems in the development of emotional skills, manifesting as alexithymia, poor distress tolerance, and emotional inhibition. Cognitive-behavioral approaches are outlined for work with eating-disordered patients with a history of emotional abuse. As well as addressing the central concerns about eating, weight, and shape (using existing evidence-based methods), the focus of treatment is on addressing the conditional assumptions about the acceptability of emotions and the core beliefs that underpin the emotional difficulties.