Who is this program for?

Day treatment is an intensive approach for the people who struggle with a Severe and Enduring Eating Disorder (SEED), for whom regular outpatient treatment is not sufficient to make the changes they need towards recovery.

What is SEED?

An Eating Disorder is consider Severe when it affects several domains of a person’s life and the symptoms require complex interventions to approach both the person’s physical as well as psychological health. It is consider Enduring when the person has lived with the disorder beyond usual recovery time (>3 years) and the disorder has become part of their sense of self and identity.

• Physical: You have lost contact with your body and you live in a constant state of disembodiment (disrupted connection from your body, physical discomfort and impaired ability to identify your body’s internal cues). As a result of the disorder your physical health is seriously weakened but at the same time you tend to deny its seriousness.
• Psychological: you tend to fall into obsessive/rigid thinking loops, and your mood is often unstable. You struggle with low self-esteem and a prolonged state of depression and anxiety. You often fall in loops of shame and guilt due to the recurrent ED symptoms, however without it you wouldn’t know who you are as it has become part of your identity.
• Social: Eating disorders thrive in isolation, it is most probable that you lack intimate relationships that you trust, feel part of and safe in. ED symptoms can often prevent you from attending social events and as a result you might lose relationships easily.
• Occupational: Body and food preoccupation can consume so much of your mental space that you might notice you are left with little energy to focus on work or your life goals.

Those who live with severe and enduring eating disorders are locked in a prison within their own minds and trapped in vicious cycles that severely limit their quality of life and further perpetuate the disorder.

Vicious cycles:

• ED as identity: rigid ED convictions and beliefs that become the center of the Self, and provides the person with a sense of identity and internal coherence.
• Relational: Severe interpersonal difficulties that often lead to isolation.
• Thinking style: Inflexible thinking and excessive detailed focus.
• Emotional regulation: Difficulty identifying, expressing and regulating one’s own emotions, in the absence of other strategies the person uses the body and food to self-sooth. Shame and fear tend to overwhelm the person’s psyche and keep them trap in repetitive patters.
• Disembodiment: Disrupted body connection and discomfort within one’s own body is often a result of traumatic life experiences. The body is lived as an object, and recurrent self-neglect and self harm is what the person gets used to.

Eating disorders vary from person to person and the underlying reasons behind the disorder are very unique to each one’s history and life experiences. There is no one single cause for the disorder, research shows that eating disorders are born out of a combination of: socio-cultural, environmental, psychological, physiological and genetic factors.

It is important to remember that the behaviors although harmful, at its core are attempted solutions to underlying problems of self regulation. In the absence of other strategies the disorder develops as an attempt for the sufferer to cope with painful feelings, self-regulate due to social stressors or drown away traumatic experiences that live in the body’s memory.

A person with SEED struggle to get out from their disorder not because they’re “crazy” or “bad”, but because the disorder serves a purpose. That is what keeps them going back to it, even as the costs pile up.

Ambivalence refers to the experience of simultaneously wanting two conflicting things that are pulling in opposite directions.

Given that Eating disorders make sense and serve a powerful purpose for the person’s sense of self and self-regulation, the idea of implementing changes towards recovery often come with a lot of ambivalence. In other words, you might experience something like “I want to change AND I want things to stay the same”!

With this in mind, our approach at Day Treatment is not meant to force or coerce any kind of change that does not feel attainable to you. Instead, our aim is to create the space with the necessary conditions, within in which you can experiment through lived experience how your life can be different when you are part of a community and your Eating Disorder does not have to be at the center of who you are anymore.