Turning points in therapy with Bulimia Nervosa clients: a qualitative analysis of the therapist's perceptions

by Nadia Mysliwiec

Institution: AUT University
Year: 0
Keywords: Bulimia Nervosa; Turning points; Mindfulness; Eating disorders; Qualitative
Record ID: 1300879
Full text PDF: http://hdl.handle.net/10292/8533


This research explored therapeutic turning points as experienced by therapists working with clients diagnosed with Bulimia Nervosa. A growing body of research reveals that turning points make important contributions to change, transformation and recovery during therapy (King et al. 2003). This research aims to develop a deeper understanding of how turning points and mindfulness-based techniques effect the treatment of this complex eating disorder. While there is existing research on the turning points that occur during therapy with eating disorder clients there is a paucity of research on the turning points that occur specifically with clients diagnosed with Bulimia Nervosa. Studies have documented various changes in clients during and after treatment for bulimia, however, most of this research stems from quantitative data and little from the actual experiences of clients and their therapists. Therefore, this study conducted in-depth interviews with five experienced psychologists and psychotherapists working in this field. Using Braun and Clarke’s (2006) six-step guide to thematic analysis, five major themes emerged from the therapists’ discourses. Firstly, therapists believed that it was essential for their clients to build social relationships with others, and that one of the first turning points was the initial trust and collaboration between client and therapist. Secondly, therapists said that an important turning point in therapy was when clients felt that they wanted to change. This need was often driven by a client’s shame and guilt related to their bulimia and the detrimental consequences of their illness. Thirdly, it was crucial for clients to experience a feeling of success. An initial turning point, as experienced by the therapists, was when a client could resist the urge to binge and purge. This allowed the client to feel empowered and hopeful, in turn increasing their motivation and allowing space for the clients to realise that their lives could be different. Fourthly, therapists strongly believed that “negative” turning points were just as useful as positive ones. Lastly, therapists supported the use of mindfulness and acknowledged the positive influence it had on turning points. A key turning point was when clients could let go of their rigid thinking and be with their emotions. This often lead to “ah-ha” moments, ultimately facilitating the realisation that bulimia is a choice they could have control over. This study has added to the growing field examining the turning points that occur in therapy with clients diagnosed with Bulimia Nervosa and has yielded much needed information for practice and future research.