In reality a person may occupy different positions on the eating disorders spectrum at different times in their life, and there may be many individual variations on the general theme.
The origin of the eating disorder can generally be traced back to problems in early attachment during the first few months of life. Subsequent relationship pressures, particularly in early adolescence, can lead to a sense that their true nature is unacceptable and unlovable, and that this needs to be replaced with a manufactured personality which fits with the expectations of others.
My approach is to explore how the eating disorder is expressed in the therapeutic relationship, and what is involved in allowing the authentic personality, which has been suppressed, hated, and somatised, to be expressed. Dreams, painting, and symbolic expression can be a valuable tool in facilitating the natural healing capacity of the psyche in this regard.