new insights into the prevention and treatment of bulimia nervosa

Application of Psychodrama and Object
Relations Psychotherapy – An Integrated
Approach to the Treatment of Bulimia Nervosa
Based on Selected Elements of the Theory and
the Author’s Own Experience
Bernadetta Izydorczyk
Department of Clinical and Forensic Psychology, University of Silesia in Katowice,
Poland
1. Introduction
Bulimia nervosa is an eating disorder characterized by self-destructive behaviours which
gradually affect the sufferer’s mental well-being and lead to body emaciation. The results of
the scientific research conducted in the past few decades point to a multitude of
determinants of this disorder, including biological, familial, socio-cultural and individual
factors [Mikołajczyk, Samochowiec, Kent,Waller, Dagnan, Hartt, Wonderlich , Rorty, Yager,
Rossotto, Lacey, Evans].
Chronic stress and traumatic events which the person experiences in his or her life (e.g. acts
of violence or sexual abuse) are considered to be significant triggering factors for bulimia
nervosa [Mikołajczyk, Samochowiec, Kent, Waller, Dagnan, Hartt, Wonderlich, Rorty,
Yager, Rossotto]. Traumatic experiences which bulimia sufferers are exposed to, and their
emotional deficits affect the recovery process. In the therapeutic process, the patient needs
to develop a cognitive and emotional insight into psychological mechanisms underlying the
disorder which he or she suffers from, and to undergo a corrective emotional experience in
the contact with the other person. This points to the significance of an “encounter with the
other person and establishing a positive emotional bond (the therapeutic alliance) with this
person”. Thus, psychodrama is the therapeutic method which allows to intensify reactive
actions and facilitates positive changes in the emotional structure of the patient’s
personality, and proves to be an effective technique of reducing bulimic symptoms.
Eating disorders belong to the category of psychopathology which is characterized by various
levels of personality dysfunctions which range from neurotic disorders to psychosis. The
choice of diagnostic and therapeutic interventions applied in the process of treatment should
then be determined by the kind of a personality disorder identified in the given individual.
Developing insight into psychological mechanisms underlying eating disorders, as well as
establishing a therapeutic bond, constitute a crucial element of therapeutic interactions which
can be supported by such methods as psychodrama and object relations technique.
Integrating psychodrama, which allows to gain insight into psychological mechanisms
underlying bulimia nervosa, with the approach that focuses on corrective interactions in
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